Association of Nasal Septum Area and Deviation with Anteroposterior Maxillary Position and Facial Skeletal Asymmetries

During growth of the craniofacial structure, the nasal septum is posited to exert a downward and forward effect on the midface. This phenomena is well documented in vitro and on animals but is still uncertain in humans. This study examined the nasal septum association with craniofacial structures using cone-beam computed tomography (CBCT) of human subjects. First, cartilaginous nasal septum area was tested for association with anteroposterior position of the maxilla. The area of the cartilaginous nasal septum was calculated using the CBCT scan and a lateral cephalometric radiograph was created from the CBCT to evaluate the anteroposterior position of the maxilla. Second, nasal septum deviation was tested for association with frontal skeletal asymmetry. The absolute septal deviation (ASD) was calculated in the frontal plane where most deviated and a frontal cephalometric radiograph was created from the CBCT to evaluate for skeletal asymmetry. Nasal septum area and anteroposterior position of the maxilla were not associated (bivariate regression analysis, p>0.05). Nasal septum area was significantly associated (p<0.05) with lower gonial angle, total anterior face height, upper face height, lower face height. Subsequently, a model was created to assess nasal septum area with cranial base measurements association on the maxillary, mandibular, and maxillo-mandibular measurements (multivariate stepwise regression). This showed a significant association (p<0.05) in females for SNA (R²=23.80%), total maxillary length (R²=60.80%), and Wits (R²=14.20%). In males, the model association was significant with total maxillary length (R²=35.20%), SNB (R²=31.40%), and ANB (R²=40.00%). ASD and skeletal asymmetries were split into right and left deviations and tested for association with right and left measurements, respectively. Right side ASDs had statistically significant (p<0.05) correlations with right facial width, right mandibular width, and right occlusal plane. No measurements were significantly associated with left side ASDs and left side measurements. Though we were unable to test the causal relationship of the nasal septum with facial growth, our results suggest that the nasal septal cartilage may exert a downward force and has minimal forward influence on the midface in humans. It also suggests that a deviated nasal septum may influence the asymmetry of the facial skeleton.

Name thesis:degree_name

M.S. (Master of Science)

Level thesis:degree_level

Masters

Discipline thesis:degree_discipline

Oral and Craniofacial Sciences (UMKC)

Grantor dc:publisher

University of Missouri -- Kansas City

Year dc:date.issued

2018

Author dc:creator

• Kaiser, Kevin

Advisor dc:contributor.advisor

• Venugopalan, Shankar Rengasamy

Language dc:language.iso

en_US

Handle dc:identifier.uri

https://hdl.handle.net/10355/70645

OAI identifier oai:identifier

oai:mospace.umsystem.edu:10355/70645