To explore whether nasal septal deviation (NSD) is predominantly congenital or develops later in life, as suggested by Reitzen and Shah, we can refer to several recent studies that offer insights into the origins and implications of NSD.

 

Congenital Aspects and Early Detection:

• Harugop et al. (2012) investigated the prevalence of neonatal NSD and identified it in approximately 20% of all newborns. This prevalence suggests a congenital element to NSD, potentially arising from birth trauma or prenatal development factors .

• A study by Lawlor et al. (2017) on neonatal NSD due to difficult deliveries further supports the notion of congenital NSD. They presented cases where early surgical intervention for NSD in neonates resulted from birth trauma, highlighting the congenital presence and potential for early correction.

 

Development and Progression Over Time:

• The comprehensive review by Alghamdi et al. (2022) summarizes NSD as a condition that can significantly impact nasal airflow and is associated with a variety of clinical presentations. While minor deviations are common and may not cause symptoms, significant deviations can lead to obstructive symptoms, indicating that the degree and clinical impact of NSD can evolve over time.

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• Garcia et al. (2010) utilized computational fluid dynamics to show that the location of septal deviation within the nasal passages significantly affects nasal resistance. This study suggests that deviations, particularly those at the anterior part of the septum, can have a more pronounced impact on nasal airflow, which might not be immediately evident in congenital cases but becomes more significant as the deviation worsens or as other nasal structures develop .

 

Associations with Other Conditions:

• Studies have also examined the relationship between NSD and other conditions, such as the work by Sistani et al. (2019), which explored the associations of NSD with mastoid pneumatization and chronic otitis. They found that moderate and severe NSD significantly affected the volume of mastoid air cells and was associated with chronic otitis, suggesting that NSD's effects might extend beyond nasal obstruction and impact adjacent structures .

 

In summary, the literature indicates that NSD can have both congenital origins and develop or become more pronounced later in life due to various factors, including trauma, growth patterns, and associated conditions. The studies mentioned above, along with the initial findings by Reitzen and Shah, suggest a complex etiology of NSD, involving both inherent anatomical variations present at birth and factors that influence the nasal septum's structure over time. This multifactorial perspective underscores the importance of considering both congenital and acquired elements when diagnosing, evaluating, and treating NSD.