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Plastic Surgery International
Volume 2016 (2016), Article ID 7089123, 8 pages
Review Article

Nasal Septal Deviations: A Systematic Review of Classification Systems

1Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
2Department of Otorhinolaryngology/Sleep Medicine Centre, Hospital CUF, 4100-180 Porto, Portugal
3Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, 4200-450 Porto, Portugal
4Tripler Army Medical Center, Department of Surgery, Division of Otolaryngology, Tripler AMC, Honolulu, HI, USA
5Tripler Army Medical Center, Division of Otolaryngology, Sleep Surgery and Sleep Medicine, 1 Jarrett White Road, Tripler AMC, HI 96859, USA

Received 31 July 2015; Accepted 16 December 2015

Academic Editor: Selahattin Özmen

Copyright © 2016 Jeffrey Teixeira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To systematically review the international literature for internal nasal septal deviation classification systems and summarize them for clinical and research purposes. Data Sources. Four databases (including PubMed/MEDLINE) were systematically searched through December 16, 2015. Methods. Systematic review, adhering to PRISMA. Results. After removal of duplicates, this study screened 952 articles for relevance. A final comprehensive review of 50 articles identified that 15 of these articles met the eligibility criteria. The classification systems defined in these articles included C-shaped, S-shaped, reverse C-shaped, and reverse S-shaped descriptions of the septal deviation in both the cephalocaudal and anteroposterior dimensions. Additional studies reported use of computed tomography and categorized deviation based on predefined locations. Three studies graded the severity of septal deviations based on the amount of deflection. The systems defined in the literature also included an evaluation of nasal septal spurs and perforations. Conclusion. This systematic review ascertained that the majority of the currently published classification systems for internal nasal septal deviations can be summarized by C-shaped or reverse C-shaped, as well as S-shaped or reverse S-shaped deviations in the anteroposterior and cephalocaudal dimensions. For imaging studies, predefined points have been defined along the septum. Common terminology can facilitate future research.