Background  Nasal septum deviation (NSD) is a common disease in otolaryngology, but there are few literatures about nasal comorbidities of patients with NSD. In addition, a lot of studies have explored the possible role of NSD in the occurrence and development of chronic rhinosinusitis (CRS) and fungal rhinosinusitis (FRS), but the results are controversial.

  Objective  To describe the demographic characteristics and nasal comorbidities of patients with NSD, and analyze the possible role of NSD in the occurrence and development of CRS and FRS.

  Methods  Clinical data about patients with NSD admitted to Chinese PLA General Hospital from January 2017 to June 2020 were retrospectively analyzed. The nasal cavity on the side of the deviated was defined as the narrow side nasal cavity, and the opposite side was defined as the wide side. The difference in incidence of CRS, FRS on both sides of the nasal cavity of NSD patients was analyzed.

  Results  Among 548 patients with NSD, 86.9% were male and 13.1% were female, with average age of 36.4 years. Patients in the 14-30 years old group accunted for 40.3% of the whole sample, and the proportion decreased with the increase of age. The deviation of the nasal septum to the left was slightly higher, accunted for 55.8%. The top five complaints of NSD patients included: nasal obstruction (86.9%), snoring (17.2%), head and face pain (11.7%), nasal allergy symptoms (10.2%), and purulent discharge (9.3%). Totally 59.7% of NSD patients had nasal comorbidities. The top five nasal comorbidities in the NSD patients included: cysts of nasal sinus (28.1%), chronic rhinosinusitis (20.3%), allergic rhinitis (13.7%), fungal rinosinusitis (3.3%), and nasal polyps and adenoid hypertrophy (2.2%). The top five nasal comorbidities in the male patients included: cysts of nasal sinus (30.3%), chronic rhinosinusitis (19.1%), allergic rhinitis (13.4%), adenoid hypertrophy (2.5%), fungal rhinosinusitis and nasal polyps (2.3%). The top five nasal comorbidities in the female included: chronic rhinosinusitis (27.8%), allergic rhinitis (15.3%), cysts of nasal sinus (13.9%), fungal rhinosinusitis (9.7%), and nasal sinus benign tumors (5.6%). In 111 patients with NSD and CRS, there was no significant difference in the incidence of CRS on both sides of the nasal cavity (P=0.163). In 18 patients with NSD complicated with FRS, the incidence of FRS in the narrow nasal cavity was significantly higher than that in the wide nasal cavity (P=0.007).

  Conclusion  The majority of NSD patients are male, the deviation of the nasal septum to the left is slightly higher than the deviation to the right, and nasal obstruction is the most common complaint. Nearly 60% of NSD patients have nasal comorbidities. NSD may be a factor correlated with the pathogenesis of CRS and FRS.