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Nasal Septal Deviation:
Congenital or Developed Over Time?

The question of whether septal deviation is predominantly congenital or develops later in life has been a topic of discussion in the literature for some time. The findings across various studies provide evidence for both perspectives, suggesting that the etiology of septal deviation may not be straightforward and could involve a combination of factors.

 

Evidence for Congenital Origin

Early Observations Some studies have found evidence of septal deviation in newborns, suggesting a congenital origin. These deviations may arise from intrauterine compression or from the birth process itself, particularly in difficult deliveries or those requiring the use of forceps.

 

Association with Developmental Anomalies Septal deviations have been associated with certain congenital conditions and craniofacial syndromes, further supporting the theory that at least a subset of septal deviations may have a congenital basis.

 

Evidence for Acquired Deviations

 

Trauma A significant body of evidence links trauma, both nasal and non-nasal, to the development of septal deviations. This includes injuries sustained during childhood, sports injuries, and other accidents. Trauma can cause immediate deviation or lead to deviation over time due to scar tissue formation or altered growth patterns.

 

Growth Patterns Some researchers argue that deviations may develop or worsen during growth spurts in adolescence due to asymmetrical growth of facial structures or due to the differential growth rates of the septum and the surrounding skeletal structures.

 

Age-Related Changes Studies, including the one by Reitzen et al., indicate that the severity or occurrence of septal deviations may increase with age. This could be due to cumulative effects of minor traumas, changes in nasal and facial structures with age, or the late manifestation of congenitally weak points in the septal cartilage.

 

Combining Perspectives

Potential for Both Origins The current consensus in the literature leans towards a model where both congenital factors and acquired influences play roles in the development and progression of septal deviations. It's likely that some individuals are born with deviations or predispositions to develop them, while others acquire deviations due to trauma or other factors later in life.

 

Variability and Individual Differences There is considerable individual variability in the occurrence and severity of septal deviations, suggesting that a range of factors—including genetic predispositions, environmental influences, and life experiences—may contribute to the development of septal deviations.

 

In summary, the literature suggests a nuanced view of the etiology of septal deviation, encompassing both congenital origins and factors that contribute to its development or progression later in life. Understanding the complex interplay of these factors is crucial for tailoring treatment approaches to the needs of individual patients.

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