A comparative study of effect of deviated nasal septum on nasal mucociliary clearance and to comprehend the effect of septal and turbinate surgeries on restoring the mucociliary clearance


  • Smitha B. C. Chandra Department of ENT, SIMS&RH, Tumkur, Karnataka, India
  • Kiran Bylappa Department of ENT, SIMS&RH, Tumkur, Karnataka, India




Deviated nasal septum, Inferior turbinate hypertrophy, Nasal mucociliary clearance time, Septoplasty, Partial inferior turbinectomy


Background: One of the important functions of nose is mucociliary transport by its epithelium. Any structural abnormalities of nose like deviated nasal septum, turbinate hypertrophy and polyps can easily damage the mucociliary clearance. This can lead to increased inflammation leading to osteomeatal complex obstruction and sinusitis. The purpose of the study is to determine the nasal mucociliary clearance time (NMC) in patients with deviated nasal septum. And to compare the changes in nasal mucociliary clearance time before and after septoplasty and septoplasty with turbinectomy.

Methods: Nasal mucociliary clearance time was measured preoperatively in patients with deviated nasal septum on concave and convex side. Post operatively it was again recorded after septoplasty in group A and septoplasty with turbinectomy in group B. These values were compared with the control group C.  

Results: Postoperatively group A patients NMC time was 11.11±2.76 on convex side, 14.01±2.39 on concave side. In group B patients NMC time was 11.18±1.91 on convex side and 12.62±1.42 on concave side.

Conclusions: Nasal septal deviation and hypertrophied inferior turbinates can cause considerable impairment of nasal mucociliary clearance. Septoplasty combined with partial inferior turbinectomy of compensatory hypertrophied inferior turbinate on concave side preserves the normal NMC mechanism on both the sides of nasal cavity than just septoplasty.

Author Biography

Smitha B. C. Chandra, Department of ENT, SIMS&RH, Tumkur, Karnataka, India




Simmen D, Scherrer JL, Moe K, Heinz B. A dynamic and direct visualization model for the study of nasal airflow. Arch Otolaryngol Head Neck Surg. 1999;125:1015–21.

Toremalm NG. Aerodynamics and mucociliary function of upper airways. Eur J Respir Dis Suppl. 1985;139:54–56.

Drake-Lee A. Physiology of the nose and paranasal sinuses. In: Micheal Gleeson (eds). Scott- Brown Otorhinolaryngology, Head and Neck Surgery. Edition 7th. Vol 2, Hodder Arnold: 2008: 1355-1371.

Widdicombe J, Wells UK. Airway secretions. In: Proctor D, Andersen I (eds). The nose: upper airway physiology and the atmospheric environment. Amsterdam: Elsevier; 1982: 215-244.

Pandya VK, Tiwari RS. Nasal mucociliary clearance in health and disease. Indian J Otolaryngol Head Neck Surg. 2006;58(4):332-4.

Surinder MB, Sunder S, Ajit S. Mucociliary clearance in chronic sinusitis. Indian J Otolaryngol Head Neck Surg. 1998;50(1):15-9.

Passali D, Ferri R, Becchini G, Passali GC, Bellussi L. Alterations of nasal mucociliary transport in patients with hypertrophy of inferior turbinates, deviations of nasal septum and chronic sinusitis. Eur Arch Otorhinolaryngol. 1999;256(7):335-7.

Vamanshankar H, Kumar S, Pretham AP, Feshan M. Mucociliary function: its variation with disease. Clin Rhinol An Int J. 2016;9(2):68-73.

Piatti G, Scotti A, Ambrosetti U. Nasal ciliary beat after insertion of septo-valvular splints. Otolaryngol Head Neck Surg. 2004;130:558–62.

Cole P, Chaban R, Naito K, Oprysk D. The obstructive nasal septum: effect of simulated deviations on nasal airflow resistance. Arch Otolaryngol Head Neck Surg.1988;114:410-2.

Ishikawa Y, Kawano M, Honjo I, Amitani R The cause of nasal sinusitis in patients with cleft palate. Arch Otolaryngol Head Neck Surg.1989;115:442-6.

Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ. CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg. 1991;104:480-3.

Jang YC, Myong NH, Park KH, Koo TW, Kim HG. Mucociliary transport and histologic characteristics of the mucosa of deviated nasal septum. Arch Otolaryngol Head Neck Surg. 2002;128:421-4.

Polat C, Dostbil Z. Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy before and after surgery in patients with deviated nasal septum. Eur Arch Otorhinolaryngol. 2010;267:529–35.

Sakallıoglu O, Duzer S, Kapusuz Z, Soylu E. The Evaluation of Nasal Mucociliary Activity After Septoplasty and External Septorhinoplasty. Indian J Otolaryngol Head Neck Surg. 2013;65(Suppl 2):360–5.

Abdel-Naby Awad OG, Abd El-Karim ARA, Hamad MS. Role of surgical septal correction in subjective improvement of chronic rhinosinusitis. Egypt J Otolaryngol. 2014;30:196-200.

Rosner B. Fundamentals of Biostatistics, 5th Edition, Duxbury; 2000: 80-240.

Suresh KP, Chandrasekhar S. Sample Size estimation and Power analysis for Clinical research studies. J Human Reprod Sci. 2012;5(1):7-13.

Naxakis S, Athanasopoulus I, Vlasstos IM, Giannakenas C, Vassilakos P, Goumas P. evaluation of nasal mucociliary clearance after medical or surgical treatment of chronic rhinosinusitis. Eur Arch Otorhinolaryngol 2009;266(9):1423-6.

Di Gueda D, Galli J, Calcagni ML, Corina L, Paludetti G, Ottoviani F, et al. Rhinoscintigraphy: a simple radioisotope technique to study the mucociliary system. Clin Nucl Med. 2000;2:127.

Polat C, Dostbil Z. Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy before and after surgery in patients with deviated nasal septum. Eur Arch Otorhinolaryngol 2010;267:529–35.

Ulusoy B, Arbag H, Sari O, Yöndemli F. Evaluation of the effects of nasal septal deviation and its surgery on nasal mucociliary clearance both nasal cavity. Am J Rhinol. 2007;21:180–3.

Jang YJ, Myong NH, Park KH, Koo TW, Kim HG. Mucociliary Transport and Histologic Characteristics of the Mucosa of Deviated Nasal Septum. Arch Otolaryngol Head Neck Surg. 2002;128(4):421-4.

Ohashi Y, Nakai Y, Ikeoka H, Furuya H. Regeneration of nasal mucosa following mechanical injury. Acta Otolaryngol Suppl. 1991;486:193–201.

Yigit O, Akgul G, Alkan S, Uslu B, Dadas B. Changes occurring in the nasal mucociliary transport in patients with one-sided septum deviation. Rhinology. 2005;43:257–60.

Aroor R, Zainab SA, Somayaji KSG. Do nasal surgeries affect mucociliary clearance? Indian Journal of Otolaryngology And Head and Neck Surgery. 2017;69(1):24-8.

Sapci T, Sahin B, Karavus A, Akbulut UG. Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope. 2003;113:514–9.






Original Research Articles