OtoRhinoLaryngology Portal

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Deviation of Nasal Septum

This figure shows a deviated nasal septum towards left

and compensatory right inferior turbinate hypertrophy.

                Right nasal cavity.                                     Left nasal cavity.

          Star- maxillary crest area.                  Convexity of septum towards left.

Hypertrophied inferior turbinate (IT) with C-shaped convexity of septal deviation to the left.  [V - vestibule, S - nasal septum, (+) - middle turbinate]

S-shaped deviated nasal septum made obvious after decongestion spray (dashed line).  S - nasal septum, IT - inferior turbinate (right). 

Deviated Nasal Septum with Caudal End Dislocation


Severe deviated nasal septum with dislocated caudal end (+) causing persistent nasal obstruction and mouth breathing.




  Endoscopic view of right nasal introitus.




Endoscopic view of left nasal introitus. 

Deviated Nasal Septum: The Nasal Valve & Cottle's Manoueuvre

These figures show a significant nasal septum deviation with co-existing allergy rhinitis. The convex surface to the right had caused narrowing at nasal valve area and on the opposite site there was compensatory inferior turbinate hypertrophy. Patient should be advised to performed Cottle's manoeuvre prior to topical corticosteroid spray actuation. This manouevre involves pulling the skin of the cheek in an upward and outward direction. By doing so, the nasal valve becomes wider, thus optimal delivery of the nasal spray mist to the inferior turbinate 

can be achieved (right side in this case).

[V- vestibule, S- septum, IT- inferior turbinate,

yellow dots- mucocutaneus junction]

Septal Spur

Spur is a sharp projection involving either the cartilaginous or bony septum of the nose.  It can occur in isolation or combined with deviated nasal septum.  Most the patient has no significant symptom and the finding is usually incidental.  Epistaxis, nasal blockage, or facial pain can occur in those who are symptomatic.

     Another example of septal spur (SS).        An obvious spur pricking left inferior

              [IT - inferior turbinate].                      turbinate (circle).  [S - nasal septum

                                                                                  IT - inferior turbinate]

Septal spur in contact with right middle turbinate.  This phenomena was implicated in Sluder's neuralgia (other causes of facial pain been ruled out).


Watch video of septal spur @ YouTube

Nasal Septum Granuloma

MT - middle turbinate, S - nasal septum, ss - septal spur, arrow - granuloma