Role of the sphenoidal process of the septal cartilage in the development of septal deviation

Objective. The sphenoidal process of the septal cartilage (SP) is a small strip of cartilage between the perpendicular plate of ethmoid bone and vomer. The present study was performed to evaluate the clinical significance of the SP in the development of nasal septal deviation. Study Design. Prospective, controlled. Setting. Academic rhinologic practice. Subjects and Methods. The authors examined 136 patients with nasal septal deviation. The length of SP was measured during septal surgery, and values were compared with the deviation angle. The distance between the anterior nasal spine (ANS) and the breakpoint of the suture line between the septal cartilage and the perpendicular plate of the ethmoid bone (ANS-PPE) and that from the ANS to the point where the choana meets the sphenoid sinus (ANS-CS) were determined and compared according to the age. Results. The mean length of SP in patients with a deviated nasal septum was 25.90 ± 7.82 mm and decreased with age. The average deviation angles at the level of the ostiomeatal unit and nasal valve area were 8.28° ± 3.50°and 10.37° ± 4.38°, respectively. These angles increased with the length of SP (P < .01). The mean length of ANS-PPE showed a significant negative correlation with age. The mean length of ANS-CS had no correlation with age. Conclusion. SP was longer with increasing deviation angle in patients with nasal septal deviation. A long SP, a remnant cartilaginous tail of the nasal septum resulting from delayed ossification of the nasal septum, contributes to the exacerbation of septal deviation.