Influence of Deviated Nasal Septum on Nasal Epithelium: An Analysis

Abstract

Nasal obstruction is one of the most common complaint that ENT surgeon faces in his day to day practice. Deviated nasal septum is the most common cause for the nasal obstruction. It causes altered airflow dynamics which leads to various histopathological changes in nasal mucosa.Histopathological changes like lymphocytic infiltration and squamous metaplasia were studied and comparison was done between convex and concave side. A prospective randomized study conducted on 42 patients of deviated nasal septum from January 2015 to December 2015 selected from inpatient department of Otorhinolaryngology, KLES Dr. Prabhakar Kore Hospital and Medical Research Center, Belagavi. This study determined significantly higher rate of squamous metaplasia and lymphocytic infiltration in septal mucosa on concave side when compared with convex side. Furthermore, there was increased lymphocytic infiltration and squamous metaplasia in lateral wall mucosa on concave side as compared to convex side but the difference was not statistically different. Deviated nasal septum predisposes the nasal epithelium to chronic inflammation and squamous metaplasia as a result of altered airflow. Due to changes in pathophysiology the patient is more susceptible to chronic rhinitis/rhinosinusitis.

Keywords: Chronic inflammation; Microscopy; Nasal mucosa; Nasal septum; Squamous metaplasia.

Fig. 1

Microscopic picture of nasal mucosa. Epithelium is partly ulcerated, subepithelial tissue shows few mucosal glands and dense lymphocytic infiltration—Grade 3 (arrow)

Fig. 2

Microscopic picture showing nasal mucosa partly lined by ciliated columnar epithelium (thin arrow) and partly showing squamous metaplasia (thick arrow)

Fig. 3

Microscopic picture of nasal mucosa. Epithelium is ulcerated, subepithelial tissue shows lymphocytic infiltration—Grade 2 with granuloma (arrow) (H&E, ×100)