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Predicting factors of recurrent deviated nasal septum after primary septoplasty in Jeddah, Saudi Arabia



Deviated nasal septum is a common cause of symptoms for nasal obstruction. Patients with nasal septum deviation who undergo septoplasty have improvements in their disease-specific quality of life for nasal obstruction.


The aim of this study was to identify the contributing factors of recurrent nasal septum deviation following primary septoplasty.

Materials and methods

This retrospective cross-sectional study reviewed the records of all patients who underwent primary septoplasty between 2017 and 2018; then presented to Otolaryngology-Head and Neck Surgery Outpatient Clinic, King Abdulaziz University Hospital with recurrent deviated nasal septum.


In the current study, 362 patients were included. Most patients were Saudis (73.2%); and had neither comorbidities (73.5%) nor chronic diseases (92%). At the time of primary septoplasty, most patients were aged from 18 to 59 years (78.2%). Most patients had left septal deviation; underwent closed approach; and did not suffer postoperative complications (94.5%). The most common types of deviated nasal septum at the time of primary septoplasty were types 3 (38.1%) and 2 (31.5%), while type 2 was the most common at second septoplasty. The time between first septoplasty and recurrence of deviated nasal septum ranged from 1 to 72 months; with a median time of 12 months. The results of multiple linear regression showed that Saudi male patients who had a concomitant nasal surgery had a significantly increased time interval between first septoplasty and recurrence (P<0.05). The presence of either comorbidities or chronic diseases resulted in a decrease of the interval.


In patients who suffered from recurrence after primary septoplasty, types 2 and 3, left deviated nasal septum, and closed approach septoplasty were significantly frequent. Factors that resulted in longer time interval between first septoplasty and recurrence were male gender, Saudi nationality, concomitant nasal surgery, and absence of either comorbidities or chronic diseases.


  1. 1

    Neskey D, Eloy JA, Casiano RR. Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am 2009; 42:193–205.

    Article  Google Scholar 

  2. 2

    Hsia JC, Camacho M, Capasso R. Snoring exclusively during nasal breathing: a newly described respiratory pattern during sleep. Sleep Breath 2014; 18:159–164.

    Article  Google Scholar 

  3. 3

    Serifoglu I, Oz İİ, Damar M, Buyukuysal MC, Tosun A, Tokgöz Ö. Relationship between the degree and direction of nasal septum deviation and nasal bone morphology. Head Face Med 2017; 13:3–11.

    Article  Google Scholar 

  4. 4

    Nilsen AH, Helvik AS, Thorstensen WM, Bugten V. A comparison of symptoms and quality of life before and after nasal septoplasty and radiofrequency therapy of the inferior turbinate. BMC Ear Nose Throat Disord 2018; 18:2–13.

    Article  Google Scholar 

  5. 5

    Teixeira J, Certal V, Chang ET, Camacho M. Nasal septal deviations: a systematic review of classification systems. Plast Surg Int 2016; 2016:1–8.

    Article  Google Scholar 

  6. 6

    O’Reilly BJ, Simpson DC, Dharmeratnam R. Recurrent epistaxis and nasal septal deviation in young adults. Clin Otolaryngol Allied Sci 1996; 21: 12–14.

    Article  Google Scholar 

  7. 7

    Hytönen ML, Lilja M, Mäkitie AA, Sintonen H, Roine RP. Does septoplasty enhance the quality of life in patients? Eur Arch Otorhinolaryngol 2012; 269:2497–2503.

    Article  Google Scholar 

  8. 8

    Berkiten G, Kumral TL, Saltürk Z, Atar Y, Yildirim G, Uyar Y, et al. Effect of deviated nasal septum type on nasal mucociliary clearance, olfactory function, quality of life, and efficiency of nasal surgery. J Craniofac Surg 2016; 27:1151–1155.

    Article  Google Scholar 

  9. 9

    Wang J, Dou X, Liu D, Song P, Qian X, Wang S, Gao X. Assessment of the effect of deviated nasal septum on the structure of nasal cavity. Eur Arch Otorhinolaryngol 2016; 273:1477–1480.

    Article  Google Scholar 

  10. 10

    Rao JJ, Kumar EV, Babu KR, Chowdary VS, Singh J, Rangamani SV. Classification of nasal septal deviations – relation to sinonasal pathology. Indian J Otolaryngol Head Neck Surg 2005; 57:199–201.

    PubMed  PubMed Central  Google Scholar 

  11. 11

    Mladina R. The role of maxillar morphology in the development of pathological septal deformities. Rhinology 1987; 25:199–205.

    CAS  PubMed  Google Scholar 

  12. 12

    Guyuron B, Uzzo CD, Scull H. A practical classification of septonasal deviation and an effective guide to septal surgery. Plast Reconstr Surg 1999; 104:2202–2209.

    CAS  Article  Google Scholar 

  13. 13

    Siegel NS, Gliklich RE, Taghizadeh F, Chang Y. Outcomes of septoplasty. Otolaryngol Head Neck Surg 2000; 122:228–232.

    CAS  Article  Google Scholar 

  14. 14

    Hsiao YC, Chang CS, Chuang SS, Kolios G, Abdelrahman M. Forty-five degree cutting septoplasty. Plast Surg (Oakv) 2016; 24:199–203.

    Article  Google Scholar 

  15. 15

    Becker SS, Dobratz EJ, Stowell N, Barker D, Park SS. Revision septoplasty: review of sources of persistent nasal obstruction. Am J Rhinol 2008; 22:440–444.

    Article  Google Scholar 

  16. 16

    Gillman GS, Egloff AM, Rivera-Serrano CM. Revision septoplasty: a prospective disease-specific outcome study. Laryngoscope 2014; 124:1290–1295.

    Article  Google Scholar 

  17. 17

    Badia L, Lund VJ, Wei W, Ho WK. Ethnic variation in sinonasal anatomy on CT-scanning. Rhinology 2005; 43:210–214.

    PubMed  Google Scholar 

  18. 18

    Min YG, Jung HW, Kim CS. Prevalence study of nasal septal deformities in Korea: results of a nation-wide survey. Rhinology 1995; 33:61–65.

    CAS  PubMed  Google Scholar 

  19. 19

    Daghistani KJ. Nasal septal deviation in Saudi patients: a hospital based study. J KAU Med Sci 2002; 10:39–46.

    Google Scholar 

  20. 20

    Jessen M, Ivarsson A, Malm L. Nasal airway resistance and symptoms after functional septoplasty: comparison of findings at 9 months and 9 years. Clin Otolaryngol Allied Sci 1989; 14: 231–234.

    CAS  Article  Google Scholar 

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Correspondence to Abdullah A. Alamri DMD.

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Alamri, A.A., Alsulami, A.A., Almahyawi, R.A. et al. Predicting factors of recurrent deviated nasal septum after primary septoplasty in Jeddah, Saudi Arabia. Egypt J Otolaryngol 34, 266–271 (2018).

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  • nasal obstruction
  • nasal septum
  • recurrence
  • Saudi Arabia
  • septoplasty