Deviated septum in the nose

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Deviated nasal septum: causes, consequences, surgery

A deviated nasal septum is a common pathology. Varying degrees of deviation of the septum from the median position can lead to various complications.

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Operations to correct a crooked nasal septum make up a significant part of surgical interventions in ENT hospitals and really help get rid of many problems.

Nasal septum

The nasal septum is a plate made of cartilage and bone that divides the nose into two halves. In the anterior part, the septum is represented by a quadrangular cartilage, and in the rear by a vomer and a perpendicular plate of the ethmoid bone. The nasal septum is inserted into a frame of the frontal bones above, the hard palate below, and the sphenoid and ethmoid bones behind.

Actually, this multicomponent structure is most often the prerequisite for its curvature, since there is uneven growth of the various parts of the septum and the bones that form the “frame” into which the septum is inserted.

The nasal septum is needed to distribute air flow evenly. Dividing the air flow into two parts is necessary for its fastest warming, humidification and cleansing.

Causes of a deviated nasal septum

A deviated nasal septum is present to a greater or lesser extent in 90% of people. However, mostly it goes unnoticed and does not cause any inconvenience.

Reasons for the formation of deviated nasal septum:

  • Physiological reasons. The uneven growth of the brain and facial parts of the skull, as well as different parts of the septum, leads to the fact that the septum bends in one direction or another, some parts of it thicken, and bone growths appear - spines and ridges. Such defects form most intensively in adolescence (12-16 years), but congenital deformities that arise in the prenatal period also occur.
  • Injuries. This is the most common cause of septal deformation. Most often these are nasal fractures. For obvious reasons, they are more common in adolescents and men (fights, sports injuries). But sometimes even a minor injury to the nose without a fracture, received in childhood and passing almost unnoticed, can subsequently cause a significant curvature of the septum. The reason is the displacement of the growth zones, which are located at the border of the cartilage and bones of the septum. In children, septal displacement can occur during childbirth, especially with facial presentation.
  • Compensatory reasons. It happens that the septum shifts under the influence of some factor that puts pressure on it. This could be an overgrown nasal concha, a polyp, or a tumor.

Curvature forms

Deformations of the nasal septum are divided into several types:

  • A shift to one side or the other from the median position. The arching of the nasal plate can be S-shaped or C-shaped, in different planes.
  • Spines are pointed projections of the bony part of the septum.
  • Ridges are elongated bone growths.
  • A combination of two or three types of deformities. This type is the most common.

Also, curvatures can be one- or two-sided.

How does a deviated nasal septum affect our body?

When the nasal septum is displaced, the lumen of the nasal passage decreases, and air passes through the narrowed nasal passage with difficulty. In addition, the resulting pathological air turbulence dries out the mucous membrane, the ciliated epithelium loses its cilia, thereby losing its protective function. The secretion of mucus and the cleansing of the mucous membrane from microbes are impaired. Chronic rhinitis occurs.

Our nose also communicates with other organs. In each nasal passage, the natural anastomoses of the four paranasal sinuses, the auditory tube (communication with the tympanic cavity of the middle ear), and the lacrimal canal open. It happens that the nasal septum is curved in such a way that it blocks these natural openings. The outflow of contents is hampered, cleansing and aeration (air exchange) of the paranasal sinuses and middle ear cavity are disrupted. Diseases such as sinusitis (sinusitis, frontal sinusitis, sphenoiditis, ethmoiditis), acute and chronic otitis, dacryocystitis (inflammation of the lacrimal sac) occur.

Chronic sinusitis is a common consequence of a deviated nasal septum.

A long-term deviated septum can lead to compensatory thickening (hypertrophy) of one or more turbinates on the side opposite the deviation. This leads to worsening problems with nasal breathing not on one side, but on both sides.

The nasal septum may be so deviated that it touches the side of the nose, causing irritation to the sensory branches of the trigeminal nerve. This causes constant headaches, reflex spasm of the respiratory tract, coughing, and frequent sneezing.

The narrowing of the nasal passages leads to less air entering the respiratory tract, resulting in oxygen starvation of the tissues of the entire body. Signs corresponding to this are chronic fatigue, headache, shortness of breath, poor sleep. In children, this can lead to delays in physical and mental development.

Due to impaired breathing through the nose, a person is forced to breathe mainly through the mouth. This leads to dryness of the oral mucosa, the development of chronic pharyngitis, and bad breath. Air that does not enter the respiratory tract through the nose is not cleaned and warmed properly, and this can cause inflammatory diseases not only of the upper but also of the lower respiratory tract (bronchitis, pneumonia).

Symptoms of a deviated nasal septum

At first glance, man is a symmetrical creature. However, ideal symmetry does not exist in living organisms; too many factors influence their development. Same with the nasal septum. 90% of people have a deformity of the nasal plate to one degree or another.

But most do not even suspect that they have such a pathology. Basically, people with a crooked nasal septum either do not have any complaints, or do not in any way relate their complaints to this defect.

The severity of symptoms is not directly dependent on the degree of curvature. It happens that a person with a severe curvature does not feel any discomfort at all. Conversely, even a slight deviation of the septum can cause complications.

There are no specific (pathognomonic) symptoms characteristic only of a deviated nasal septum.

But we can identify a number of symptoms with which patients most often go to the doctor; upon examination, they are diagnosed with a deviated nasal septum, and after correcting this defect, these complaints disappear.

  1. Nasal congestion. This is perhaps the most common complaint of patients with a deviated nasal septum. A person cannot breathe normally through his nose for a long time; he continually drips vasoconstrictor drops into his nose, which only aggravates the situation due to the development of vasomotor rhinitis.
  2. Frequent acute sinusitis or the presence of a chronic inflammatory process in one or more sinuses.
  3. Acute or chronic otitis media.
  4. Dacryocystitis. Violation of the outflow of tear fluid through the nose leads to disruption of the natural cleansing of the eye and inflammation of the lacrimal sac.
  5. Snore.
  6. Impaired sense of smell. In the area of ​​the upper nasal passage there is the olfactory zone. If the curvature is localized in the upper part of the septum, the patient may not feel odors.
  7. Frequent headaches.
  8. Nosebleeds.
  9. Hearing loss.

Pain in the nasal septum is not typical for uncomplicated curvature, unless it is a recent injury. So, if the nasal septum hurts, you need to look for other causes - sinusitis, boil, neuralgia of the nasociliary nerve.

It is always quite difficult, even for a doctor, to associate these symptoms with a deviated nasal septum, especially in patients with concomitant pathology (chronic vasomotor rhinitis, allergic rhinitis), hypertrophy of the nasal turbinates. Surgery to correct a deviated nasal septum is usually offered after unsuccessful conservative treatment for these diseases.

Treatment of deviated nasal septum

A crooked nasal septum is an anatomical defect and can only be corrected surgically. Surgical treatment of curvature is indicated only if there are complaints. If there is a curvature without any clinical symptoms, surgery is usually not indicated.

Surgery to correct the nasal septum is suggested in cases where this defect is combined with long-term nasal breathing disorders, frequent sinusitis, and otitis media.

Surgery to straighten the nasal septum is called septoplasty. There are two types of septoplasty:

  • Conventional standard septoplasty (or submucosal resection, the oldest method of surgical intervention on the septum). In the nasal cavity, the mucous membrane is cut in an arcuate manner, a section of quadrangular cartilage is isolated and cut off, then the curved bony part of the septum is removed (a hammer and a chisel are used for this). The mucosal flaps along with the perichondrium and periosteum are brought closer to each other and fixed with tampons in the middle position.
  • Gentle endoscopic septoplasty is a more modern method, performed using endoscopic equipment. During this operation, under the visual control of an endoscope, a thorough inspection of the nasal cavity is carried out and only those areas that narrow the nasal passage are removed with special gentle micro-instruments.

There are various modifications of both operations. For example, the resected cartilage can be straightened in a special way and placed in its place between the layers of perichondrium. After healing, such a modulated septum occupies a normal physiological position.

Often, simultaneously with septoplasty, other surgical manipulations in the nasal cavity are performed: conchotomy - trimming a thickened nasal concha, removal of polyps, vasotomy - resection of the choroid for chronic vasomotor rhinitis.

The operation to straighten the nasal septum is performed in a hospital. Before the operation, it is necessary to undergo an examination. General blood tests, urine tests, biochemical blood tests, ECG, fluorography are prescribed, the state of the coagulation system is determined, and you need to be examined by a therapist.

There are contraindications to such an operation: acute infectious diseases, severe chronic diseases, bleeding disorders, old age, mental illness.

It is not recommended to correct the nasal septum in children under 18 years of age, however, if a child has severe difficulty in nasal breathing, this operation can be performed at an earlier age, from 5-6 years.

For women, septoplasty is recommended to be performed 2 weeks after menstruation.

An operation to straighten the nasal septum can be performed free of charge under the compulsory medical insurance policy. The cost of septoplasty in paid clinics ranges from 20 to 100 thousand rubles. The price depends on the volume of the operation, the qualifications of the surgeon, the category of the clinic, the type of anesthesia, and the length of hospital stay after the operation.

After surgery, tampons are inserted into the nose to keep the septum in the correct position. Tampons are removed after 1-2 days. The patient is discharged on days 5-6, but complete recovery usually occurs after 2 weeks. All this time, observation by an ENT doctor, daily treatment of the nasal cavity with antiseptics, and rinsing with sterile cleansing solutions are necessary. After 2 weeks, complete healing and restoration of nasal breathing occurs.

Complications of septoplasty

As with any other operation, complications may occur after septoplasty:

  1. Bleeding. Minor bleeding is acceptable, but within 1-2 days after the operation there is a discharge of ichor - a mucous discharge with blood.
  2. Septal hematoma is an accumulation of blood between layers of tissue.
  3. Perforation of the nasal septum. A fairly rare but unpleasant complication. Occurs when tissues are cut through. As a rule, it heals poorly. Requires further surgery to restore the nasal septum.
  4. Saddle-shaped retraction of the nasal bridge.
  5. Suppuration.

Other treatments for deviated septum

Recently, laser straightening of the nasal septum has been increasingly advertised. The advertising is really tempting: the operation is almost painless, bloodless, performed on an outpatient basis, lasts 15 minutes, recovery period is 1-2 days.

Removal of curvature with a laser is carried out by heating the curved part of the cartilage and giving it the desired shape. The cost of laser septum straightening ranges from 20 to 50 thousand rubles.

However, despite all the advantages over conventional surgery, the widespread use of laser correction of the nasal septum is limited. The fact is that the laser can only deform the cartilaginous part of the septum, which is very rare. The most common type of curvature is a combination of deformation of both the bone and cartilaginous parts.

Is it necessary to straighten a deviated nasal septum?

Many patients cannot decide for a long time to undergo surgery to remove a deviated septum. Many people get used to a constantly stuffy nose, chronic sinusitis and other consequences of a crooked nose. Yes, indeed, the pathology is not fatal, you can live like this. And any operation is a risk.

But there is also such a thing as quality of life. According to reviews from patients who underwent septal alignment, only after the operation did they understand that this quality may vary. When you breathe like a normal person, you begin to smell all the smells, constant headaches and depression go away, life begins to play with new colors.

A few words about prevention

The only method available to anyone to prevent a deviated septum is timely consultation with a doctor in case of any injury to the nose. This is necessary to exclude or confirm a septal fracture (it is advisable to do a CT scan for this) and, if the septum is broken, to reposition the broken bones in a timely manner.

Source: http://uhonos.ru/nos/bolezni-nosa/iskrivlenie-peregorodki/

What is dangerous about a deviated nasal septum, causes, treatment and rehabilitation, possible complications

A person who wages an endless struggle with rhinitis, suffers from colds or flu several times a year, suffers from insomnia and loss of smell, may not realize that the problem is not only in the immune system and nervous system. A deviated nasal septum is a diagnosis that is rarely made, but is present in the majority, although predominantly severe forms require urgent correction: thorn, ridge. Is treatment possible without surgery and why is this problem dangerous?

What is a deviated nasal septum?

A central, flat, thin plate that divides the air flow into equal parts, due to which it is processed and delivered harmoniously - this is the nasal septum, consisting of cartilage and bone tissue. If the air begins to flow unevenly, the doctor may say that there is a displacement of the nasal septum (its cartilaginous sections), or its deformation in the form of a spike or ridge in the bone area. Curvature occurs in 95% of people, but with varying degrees of severity, so you may not know about it until the end of your life.

Symptoms

A deviated nasal septum can make itself felt both externally and through internal changes in the body. If there is deformation of the cartilaginous tissues close to the front, or at the top of the bridge of the nose (bone section), it will be visible due to the loss of symmetry of the nose. Internal curvature is mainly expressed in:

  • frequent nosebleeds caused by thinning of the mucous membranes in the narrowed nostril;
  • difficulties with nasal breathing (feeling that air is not coming in at all);
  • headaches;
  • snoring if a person sleeps on his back;
  • frequent overwork (due to hypoxia due to difficulty in nasal breathing);
  • decreased immunity, which entails acute respiratory infections, influenza, and other difficult to tolerate diseases;
  • chronic diseases of the ENT organs (mostly doctors focus on the appearance of chronic rhinitis in patients with a deviated septum).

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Why is a deviated nasal septum dangerous?

If timely and complete air purification does not occur, a sufficient amount of oxygen does not enter the blood and brain, immunity and brain activity gradually decrease, and blood vessels suffer. Subsequently, a deviated septum leads to inflammation of the mucous membrane and chronic hypoxia, which can cause constant headaches and can cause male impotence.

Symptoms of the disease gradually develop into chronic disorders, and the result is:

  • nasal polyps;
  • problems with olfactory function;
  • chronic sinusitis;
  • hearing impairment;
  • the occurrence of allergic rhinitis.

Types of curvatures

There are 2 classifications of deformation of the nasal septum - according to the prerequisites for its appearance and according to the type that the plate takes. Curvatures of the front opener are predominantly observed, and even if there is a defect in the rear, its edge remains smooth. The classification of deviated septum most commonly used by doctors is as follows:

  • A spine is the appearance of a process from bone tissue; it can be one-sided or two-sided. Depending on the length and direction, it can provoke irritation of the mucous membrane of the opposite wall and injure it.
  • The ridge is a local thickening of the nasal septum at the point of bending, associated with its deformation, which can also injure the lining of the nasal cavity by protruding into it.
  • The classic curvature of the nasal plate is a C-shaped deformity, in which a slight deflection appears mainly in the central part. Such minor curvatures are very common, but a person is not always aware of their existence, since they may not manifest themselves in any way.
  • Combination of all 3 types –
  • The most difficult type of curvature, since it is not only responsible for breathing difficulties, but often its complete absence (if the deformation is bilateral, there is a displacement of the anterior and middle sections).

Causes of a deviated nasal septum

Doctors divide the entire list of prerequisites for deformation of the nasal septum into 3 categories:

  • Traumatic. Caused by blows to the facial area of ​​the skull, this cause is predominantly found in males. Even with minor injuries, a bent nose is not excluded if the fusion of bones and cartilage tissue has not occurred correctly.
  • Compensatory. They are a consequence of pathologies of the nasal cavities, including polyps, tumors and even persistent rhinitis, due to which a person, unnoticed by himself, due to congestion in one of the nasal passages, learns to breathe only freely and thereby provokes a curvature of the septum. Separately, there is compensatory hypertrophy, in which one of the nasal conchas, due to its increased size, puts pressure on the septum and can displace it. In compensatory curvatures, cause and effect often change: even a doctor cannot always say what occurred first - deformation of the plate or breathing problems due to an increase in bone formations that divide the nasal cavity into zones.
  • Physiological. Associated with congenital structural features of the skull - mainly uneven development of its bones. In rare cases, such a physiological curvature of the septum is observed, such as the development of a rudiment behind the olfactory zone, pressing on the nasal dividing plate. This deviation is rare.

The child has

The nasal septum in children under 10 years of age is predominantly a cartilaginous plate: more flexible than bone, and more vulnerable. Doctors mention cartilage fractures in children more often than in adults, and this often becomes the cause of septal deformation. If you do not pay attention to the disruption of proper breathing after an injury in time, the plate will ossify over time (as the child gets older), and the curvature will no longer be corrected as easily as in childhood.

However, there are several more prerequisites for this problem in children:

  • birth injuries;
  • uneven growth of the skull bones (minor curvatures, corrected independently);
  • inflammation of cartilage tissue.

Diagnostics

An attempt to confirm or refute the diagnosis of a deviated septum begins with an examination of the patient by an otolaryngologist, who first evaluates the appearance of the facial part of the nose. If there are serious deformations of the nasal septum, they will be visible already at this stage. Afterwards, the breathing of each nostril is checked separately, the results are correlated: if there is no curvature of the nasal septum, the force of inhalation and exhalation is the same for the left and right sides. The last thing to do is test your sense of smell.

If suspicions that the nasal septum is deviated grow stronger, the doctor may prescribe:

  • Rhinoscopy - involves examining the nasal cavity (left and right) using a special instrument that widens the nostrils. Next, a thin probe is inserted into the lumen to palpate the mucous membrane and evaluate neoplasms (if any): these are polyps, tumors, and ulcers. Additionally, hypertrophy of the posterior ends of the turbinates can be detected when examining the curvature through the oral cavity.
  • Endoscopy is a more informative examination that should be performed with local anesthesia of the nasal mucosa. Her condition is assessed through a probe with a “video camera”. Thanks to the endoscopic method, the lower shell, where mucus accumulates, is clearly visible.
  • X-ray of the skull is necessary to determine whether there are formations in the paranasal sinuses, to confirm or refute the presence of traumatic deformation, congenital bone anomalies of the skull, which could provoke a curvature.
  • Computed tomography - helps to examine in detail the back of the nasal cavity, determine the presence or absence of spines and ridges on the septum.

Treatment

A crooked nasal septum is an anatomical problem, so it is impossible to straighten the plate with medication. If, as a result of its deformations, breathing and hearing disturbances are noted, a disorder of smell develops, the middle concha is additionally enlarged, or hypertrophy of the lower one is observed, we will definitely talk about surgical interventions, mainly traditional ones - septoplasty or endoscopic surgery. In rare cases, a deviated septum can be corrected with a laser.

Treatment without surgery

Conservative therapy can be aimed at eliminating chronic inflammation, polyps, adenoids (a consequence of a deviated septum), helping to alleviate the condition of allergic diseases, restoring breathing and strengthening the immune system. However, correcting a crooked septum is impossible, so doctors question the effectiveness of such treatment. Mostly experts can advise:

  • removal of adenoids, polyps;
  • osteopathy (manual therapy);
  • a long course of drugs to eliminate swelling.

Operation

The doctor may recommend surgical correction of the curvature in case of serious deviations in the development of the cranial bones, which provoke a large number of complications: among them, concha hypertrophy, persistent sinusitis, and the inability to breathe through a narrowed nostril. Surgery is performed only on persons over 16 years of age (exceptions are possible). Resection of the nasal concha can be performed with an endoscope, which is less painful. In case of severe injuries, rhinoplasty is performed simultaneously with classical surgery.

Laser chondroseptoplasty

Classic septoplasty is performed only in cases of severe forms of curvature, and for minor deformities the doctor may suggest laser treatment. This method is used only if it is necessary to straighten the cartilage tissue - the laser will not perform resection of spines and correct the bending of bone tissue, nor will it help with traumatic curvature. According to reviews, the procedure is painless, but it is not recommended for children and elderly people.

Rehabilitation after surgery

If it was necessary to perform surgical correction of a curved nasal plate, after it tampons are inserted into the patient’s nostrils, and silicone retainers must be installed. The next day they are removed, if there is no heavy bleeding, the patient returns home, but he may remain in the hospital for 4 days. However, completely normal breathing is restored only 3 weeks after straightening the septum. During rehabilitation you need:

  • during the first week, have your nasal passages cleaned daily by an ENT doctor to remove crusts and prevent the appearance of pathogenic microorganisms;
  • do breathing exercises that will prevent adhesions from forming;
  • use wound healing agents for external use (they must be prescribed by a doctor).

Possible complications after surgery

According to doctors, doing septoplasty is relatively safe (even from an aesthetic point of view - photos of people who have undergone it prove that there are no scars): blood loss is minimal, and trauma is also minimal. However, any operation is accompanied by risk, so after septoplasty you may:

  • ulcers and hematomas form;
  • prolonged nosebleeds appear during the rehabilitation period;
  • fusion of cavities and narrowing of the lower passage are observed;
  • develop purulent sinusitis, perichondritis.

Treatment at home

If the nasal septum is not so curved that the doctor insists on surgery (resection of the ridges, removal of spines, correction of the consequences of the fracture is not required), but causes problems, you can independently do procedures to make breathing easier and expel mucus, but this will only relieve symptoms. Home therapy may include:

  • Corticosteroids.
  • Silver preparations.
  • Antiseptics.
  • Compositions for rinsing the nasal passages (combat a common symptom of a crooked septum - rhinitis).

Prevention

You can protect yourself from deformation of the central nasal plate only if it is initially smooth or the curvature is slight. For this it is recommended:

  • avoid activities that are accompanied by fractures of the skull bones (traumatic sports, etc.);
  • do not allow ENT diseases to develop into polyps and adenoids;
  • strengthen the immune system.

Video

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

Deviated nasal septum - treatment

The nasal septum is an anatomical formation, which is a plate that divides the nasal cavity into two halves. Its anterior part is formed by cartilage tissue, and the posterior part by thin bone. A deviated nasal septum is a fairly common disease that occurs at any age and is characterized by a whole range of symptoms.

Depending on the cause of the deviated nasal septum, there are several types of this disease:

  1. Physiological curvature is most often diagnosed in adolescence. The deformity develops as a result of a discrepancy between the growth rates of the cartilaginous and bone parts of the nasal septum.
  2. With prolonged pressure on the cartilaginous part of the septum from foreign bodies and polyps in the nasal cavity, a compensatory curvature of the septum develops.
  3. Deformation of the nasal septum as a result of trauma occurs 3 times more often in men than in women, since males are much more likely to be injured.

Symptoms of a deviated nasal septum

The severity of the symptoms of the disease depends on how severely the septum is deviated. A slight deviated septum that causes no symptoms occurs in many people. In such cases, treatment is usually not required.

The following symptoms are characteristic of this disease:

  1. Difficulty in nasal breathing, up to its complete absence. With a unilateral curvature, airflow disturbance will be observed on one side of the nose. It should be noted that in many patients with severe deformation of the nasal septum, this symptom may be completely absent.
  2. Due to impaired nasal breathing, snoring occurs during sleep.
  3. Dryness in the nasal cavity.
  4. Frequent inflammatory diseases of the paranasal sinuses are sinusitis (sinusitis, ethmoiditis, frontal sinusitis), resulting from a violation of the outflow of secretions from the sinuses through the nasal passages. The accumulation of secretions in the cavity of the paranasal sinuses creates favorable conditions for the development of infection.
  5. In some patients, when the disease persists for a long time, polyps form in the nasal cavity, which make breathing even more difficult.
  6. Changes in the shape of the nose, which most often occurs due to injuries to the nose.

Treatment of deviated nasal septum

This disease is characterized by changes in the osteochondral structures, so elimination of the curvature of the nasal septum is performed surgically. Conservative therapy aimed at alleviating the symptoms of the disease is usually ineffective.

Surgery

An endoscopic operation during which a defect in the nasal septum is corrected is called “septoplasty”. The surgical approach is performed through the nasal cavity; no incisions are made on the face. The duration of the surgical operation, performed under general or local anesthesia, usually does not exceed one hour. At the end of the operation, gauze swabs and special silicone retainers are installed in the nasal cavity, which are removed one day after surgery. Therefore, the patient usually does not need to stay in the hospital for more than a day. 5–7 days after septoplasty, the patient’s nasal breathing is completely restored, and all other signs of the disease disappear.

If a deformity of the nasal septum is detected in childhood, septoplasty is performed after the child reaches the age of 14 years. The exception is when the child has severe symptoms of the disease or often has infectious sinusitis. In such a situation, the operation can be performed under general anesthesia for children over 6 years of age. Surgical treatment of the disease in early childhood should be performed only after a thorough examination of the patient, as a result of which it will be proven that the cause of the symptoms is precisely the curvature of the nasal septum.

Laser treatment

This is a fairly new method of treating deformities of the nasal septum, which has a number of limitations, but is nevertheless successfully used in otorhinolaryngology. This treatment method is based on the effect of a laser beam. Certain areas of the cartilaginous part of the nasal septum are heated to the required temperature and fixed in the correct position using tampons for a day. The duration of the manipulation, performed under local anesthesia, does not exceed 15 minutes. Treatment can be carried out on an outpatient basis and causes virtually no discomfort to the patient. Treatment of deformities of the nasal septum with a laser is possible only in cases where only its cartilaginous part is curved and the cartilage has not been broken.

Many patients diagnosed with this disease refuse treatment because they believe that the symptoms of the disease do not significantly impair their quality of life. Before refusing treatment or deciding whether it is necessary, you should understand the dangers of a deviated nasal septum, since the consequences of the disease can be very diverse. It has been scientifically proven that as a result of impaired nasal breathing, the brain does not receive 10–15% of oxygen, which affects the ability to work in adults and the mental development of children. In addition, changes are observed in the hematopoietic, cardiovascular and reproductive systems of the body. Due to disorders in the immune system, patients are less able to tolerate exposure to adverse environmental factors, especially hypothermia, which significantly increases the risk of infectious diseases of the respiratory system.

A specialist talks about the dangers of a deviated nasal septum:

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Commentary “Deviated nasal septum - treatment”

Azamat

Hello. I operated on my nose 2 times, (curvature) there was no effect. How much does the operation cost for CIS citizens? Thank you.

Source: http://otolaryngologist.ru/8

Consequences of a crooked nasal septum and methods of treating pathology

Sometimes a person feels severe discomfort, thinking that he has some kind of viral disease, accompanied by a runny nose and breathing problems. However, the real cause may be a deviated nasal septum.

What is the nasal septum

Nasal septum: structure and functions

This element belongs to the osteochondral tissue of the facial part of the skull and is located in a vertical position in the nasal opening, dividing it into two halves. It is almost never strictly vertical and even - for various reasons it can deviate from its natural position, have slopes, curvatures, growths and other types of deformations.

Nasal cartilage is essentially an extension of the bony structure of the septum. The size and shape of the nose, as well as the attractiveness of facial features, largely depend on the structure of this part of the skull. Violation of the vertical structure can cause not only a cosmetic defect.

Pathologies of the nasal septum can lead to numerous diseases, some of which can be quite painful and unpleasant.

If there is a crooked nasal septum, the health consequences may be completely invisible or manifest themselves in clearly identifiable signs.

Causes and types of curvature

Congenital and acquired causes of deviated nasal septum

A deviated nasal septum can be congenital or acquired.

There are several main reasons for this defect:

  • Curvature that occurs during the period of active tissue growth. Since this part of the nose is made up of bone and cartilage, in some cases dissimilar tissues can grow at different rates. As a result, deformation or change in the shape of the septum occurs, and the formation of internal defects.
  • Since the bridge is very thin, fragile and pliable, various neoplasms in the nose, for example, polyps or foreign bodies in the cavity, can cause it to deviate from the vertical and become crooked.
  • Deformation can also occur as a result of the development of a strong inflammatory process that affects this part of the bone, or accompany some diseases associated with the destruction of bone tissue of the facial part of the skull (syphilis in the last stage, leprosy, and so on).
  • Trauma is one of the most common causes of curvature. It can be caused by an accident or a bad fall, but most often it happens when a blow to the face causes injury or a broken nose. Men suffer from nasal injuries more often than women; athletes receive blows to the face with a crooked nose more often than people who do not engage in sports, tourism, or simply do not lead an active lifestyle.

It is not always possible to determine the curvature of the nasal septum by external signs, since what we see is a cartilaginous structure, and the septum itself is located deep in the nose. Therefore, a crooked nose does not always mean the presence of septal defects, and the curvature may well accompany a perfectly straight nose.

Symptoms

Symptoms of a deviated nasal septum

It should be noted right away that in most people this part of the skull is curved to one degree or another. It is very rarely completely smooth, but small defects do not manifest themselves as pathological phenomena. For its curvature to become noticeable, it must be quite intense.

A crooked nasal septum, the consequences of which may not appear immediately, may have “blurred” manifestations, or demonstrate obvious health problems.

The main symptoms of the pathology:

  • Most often, there is a violation of breathing through the nose, and it can be bilateral or unilateral. The violation can be complete or partial, it depends on how severely the nasal passage is blocked. In most cases, this occurs after an injury when a piece of bone becomes dislodged or breaks off, completely or partially blocking breathing.
  • Due to the deformation of the septum, noisy breathing and snoring occur during sleep. At the same time, both men and women, even children, can snore.
  • A person suffering from curvature may have a chronic runny nose or its complicated forms - inflammation of the maxillary and frontal sinuses. This is due to the fact that the curvature of the nose does not allow the contents of the sinuses, especially purulent ones, to freely separate and come out. As a result, stagnation occurs, secondary infection occurs and serious chronic diseases develop.
  • The hearing organs can also be affected - due to chronic infection, inflammation of the middle ear occurs. If the infection “settles” close to the septum, this can cause even greater deformation.
  • Many patients note increased dryness of the mucous membranes, which is accompanied by irritation and frequent sneezing.
  • If the septum is curved for a long time, polyps may form on it due to injury to the mucous membrane. They can be single or multiple. Their presence and size significantly complicate the course of the disease.

Curvature of the nose, noticeable to the naked eye. All of these symptoms may not necessarily be diagnosed all together. The most common reasons for visiting a doctor are frequent runny noses and breathing problems, especially under exertion.

Diagnosis of the disease

The patient's history can help identify a violation of the shape of the nasal septum. After carefully listening to the complaints, an experienced doctor can draw a conclusion about the possible presence of a disease and send the patient for further examination. If the patient's record contains data on injuries, accidents or fractures, bruises of the face and nose, the examination must be continued.

The next step should be a visual inspection. Sometimes this is enough to identify the problem, since some external defects of the nose clearly indicate the presence of a deformed septum.

If the defects are obvious and require surgical intervention, photographic images in different projections must be taken.

Next, the doctor may palpate the nose to identify possible defects in the cartilage and nostrils. Then you can move on to instrumental research. This includes anterior rhinoscopy without the use of a nasal speculum, only with the help of a head reflector. For an experienced doctor, such an examination is usually sufficient, since he can immediately assess the degree of curvature of various elements of the nose structure.

To examine the deep parts of the nose using anterior rhinoscopy, the mucous membranes are treated with an anesthetic to eliminate pain during the examination. In cases where it is not possible to understand the problem with the help of conventional examinations or in the presence of injuries to the facial bones, an X-ray of the skull and a tomogram are prescribed. They help to see all the violations as a whole.

Consequences of a crooked nose

The influence of a crooked nasal septum on human life

Once a crooked nasal septum is diagnosed, the consequences can vary. If there are no significant health problems, no special treatment will be required, but if the deformation is visually noticeable, or there are chronic ailments that cause great inconvenience, treatment is simply necessary.

The consequences of a deviated nasal septum may not immediately affect your health. For example, at rest a person does not feel that the nose is “working” incorrectly, but under load the body begins to suffer from a lack of oxygen. This may include shortness of breath, heavy breathing, cramps, headache, dizziness, and even loss of consciousness.

A person with such a problem experiences difficulties in playing sports, dancing and other intense activities; he cannot run fast, it is difficult for him to read aloud for a long time, sing and even talk.

Prolonged lack of air can negatively affect the condition of the cardiovascular system and even the lungs.

Sometimes the consequences of having a crooked septum in the nose can only appear in old age.

Curvature of the nose is especially dangerous for children:

  • It may not manifest itself in any particular way, but a chronic lack of oxygen has a detrimental effect on brain development, affects the child’s mental abilities and his learning ability.
  • If such a defect is congenital, the child may be permanently delayed in development.
  • In addition to the negative impact on the baby’s mental development, prolonged oxygen deprivation can negatively affect the child’s health. Due to the restriction of air intake, the baby tries to breathe through his mouth, he even develops a characteristic appearance - an “adenoid face”, puffy, pale, with a constantly slightly open mouth and hoarse breathing.
  • If nasal breathing is impaired and air is inhaled through the mouth, bacteria, viruses and fungi easily enter the child’s body. This causes a variety of diseases; such a baby is more susceptible to colds and ARVI, allergies, sinusitis and otitis media.
  • In turn, constant infection in the body “harms” the immune system, causing problems with the cardiovascular system and diseases of internal organs.
  • Such a child is usually lethargic and inactive, since it is difficult for him to run, and this entails muscle weakness and diseases of the musculoskeletal system. And the reason for everything may be a subtle defect in the nasal septum.

Treatment methods

A crooked nasal septum is treated by two main methods - surgical and laser.

Surgical intervention can be:

Surgery is prescribed when the curvature is very significant, is accompanied by other defects and causes serious problems for the patient. Endoscopic correction is performed using a special flexible instrument - an endoscope and is carried out with miniature instruments under the control of a video camera. No external incisions are made - all manipulations are performed through the nasal passages.

After the operation, gauze turundas and special silicone pads are placed in the nose, which are removed one day after the intervention. The patient is discharged the next day. As soon as the swelling of the mucous membranes subsides, and this happens after about a week, nasal breathing is restored and the patient becomes much easier. This type of surgery is called septoplasty.

More information about a crooked nasal septum can be found in the video.

This type of surgery can be performed on children over 14 years of age. For young children, such an operation is performed only in exceptional cases, when possible risks are outweighed by health benefits. This procedure is performed under general anesthesia for children over 6 years of age after a very thorough examination.

Laser surgery on the nose is only possible if we are talking about deformation of the cartilage and the absence of a fracture.

It is performed under local anesthesia and lasts no more than a quarter of an hour. When performing rhinoplasty in cosmetic surgery, nasal septum defects are often corrected at the same time, especially if they are directly related to external manifestations and affect the patient’s appearance.

Complete reconstruction of the nose with restoration of the septum and cartilage is performed under general anesthesia in cases of extensive facial trauma with bone fractures, lacerations and damage to the nose. This is a very complex operation that requires long-term rehabilitation and sometimes repeated surgery.

Complications with a crooked nasal septum

The most dangerous complications are fraught with a deviated nasal septum resulting from injury. A severe blow to the face or a traumatic brain injury that breaks the integrity of the nose usually results in very extensive nosebleeds.

It can be very difficult to stop, especially if the victim's face is very damaged and it is not possible to find the source of the bleeding. In such a situation, before the ambulance arrives, you should try to secure the victim in such a way that blood does not enter the respiratory tract, try to stop the bleeding, if possible, by applying luda in sterile gauze or introducing pieces of a hemostatic sponge into the nostrils.

The main danger of a deviated nasal septum as a result of trauma is that a piece of broken bone can enter the respiratory tract or bloodstream. If the victim is unconscious and no one provides first aid, he may simply choke on his own blood due to a nosebleed.

A frequent complication of a deviated septum is the formation of polyps.

They greatly complicate the patient’s life and make surgical intervention inevitable. During the operation, the patient can simultaneously have the adenoids removed and the nasal septum corrected.

Since the curvature of the nose is accompanied by breathing problems, it can be dangerous for people suffering from respiratory diseases, for example, asthmatics. They already constantly lack air, and the presence of complicating defects significantly aggravates the problem. The same applies to hypotensive patients and heart patients. Lack of air can provoke headaches, irritability, sleep disturbances and lead to fainting, heart attacks, and decreased performance. No matter how insignificant the problem with a deviated nasal septum may seem, it requires careful attention, a thorough examination and timely correct treatment.

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Deviated nasal septum - symptoms, signs, diagnosis, causes. Treatment of curvature: indications, contraindications for surgery

FAQ

The site provides reference information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious doctor.

Anatomy of the nose

  • nostrils - entrance holes through which air enters the nasal cavity;
  • the initial section of the nasal cavity is a space that is divided into right and left halves by the vertical nasal septum;
  • nasal passages - located posterior to the initial part of the nasal cavity, there are lower, middle and upper nasal passages, which are respectively limited by the upper, middle and lower nasal concha;
  • Choanae are two openings through which the nasal cavity communicates with the nasopharynx.

Walls of the nasal cavity:

  • The anterosuperior wall is formed by the bones of the skull (maxillary process, nasal bones) and nasal cartilage.
  • The lower wall - the bottom of the nasal cavity - is formed by the palatine processes of the upper jaws (hard, or bone, palate), as well as the soft palate.
  • The lateral walls of the nasal cavity are formed mainly by the ethmoid bone.
  • The nasal septum, which divides the nasal cavity in half, is formed in the posterior part by the vomer, and in the anterior part by cartilage.

The inside of the nasal cavity is lined with mucous membrane. It is abundantly supplied with blood and secretes a large amount of mucus. In the area of ​​the upper nasal passage in the mucous membrane there are many sensitive nerve receptors - this area is called the olfactory area.

  • The superior nasal passage communicates with the posterior sinuses of the ethmoid bone and the sinus located in the sphenoid bone.
  • The middle nasal passage communicates with the anterior and middle ethmoid sinuses, with the maxillary sinuses (sinuses located in the bodies of the maxillary bones).

The ethmoid bone contains many small cavities - sinuses, which are usually divided into three groups: posterior, middle and anterior.

Functions of the nasal cavity:

  • carrying air into the nasopharynx and larynx;
  • humidification of the air with the secretion of glands located in the mucous membrane;
  • warming the air flow - the venous plexus located under the mucosa is responsible for this function;
  • protection of the respiratory tract from mechanical irritants: hairs and mucus in the nose trap dust particles and bring them out;
  • protection against infection: nasal mucus retains pathogens and removes them from the nasal cavity, has bactericidal properties;
  • The olfactory region of the nasal cavity is responsible for the reception (perception) of odors.

The main function of the nasal septum is the correct distribution of air flows between the right and left halves of the nasal cavity. The significance of this mechanism was established through a series of studies using magnetic resonance imaging and computed tomography.

Causes of a deviated nasal septum

  • Uneven growth of the skull. The human skull consists of the facial and brain sections. The facial skull is formed from the upper and lower jaw, zygomatic, palatine bones, etc. The brain section of the skull is represented by the frontal, temporal, parietal, occipital, ethmoid, and sphenoid bones. If there is uneven growth of the facial and cerebral parts of the skull, then the size of the nasal cavity also changes. It becomes “tight” for the nasal septum. As a result, the latter has to bend.
  • Hypertrophy (excessive development) of one of the nasal conchas. An enlarged concha puts pressure on the nasal septum and causes it to shift.
  • Uneven growth of the skull. The human skull consists of the facial and brain sections. The facial skull is formed from the upper and lower jaw, zygomatic, palatine bones, etc. The brain section of the skull is the frontal, temporal, parietal, occipital, ethmoid, and sphenoid bones. If there is uneven growth of the facial and cerebral parts of the skull, then the size of the nasal cavity also changes. It becomes “tight” for the nasal septum. As a result, the latter has to bend.
  • Polyps and tumors of the nasal mucosa. If they reach a large enough size, they interfere with breathing in one nostril. By deforming, the nasal septum tries to compensate for this condition.
  • Excessive development of the rudiment of Jacobson's organ. This cause of a deviated nasal septum is extremely rare. Jacobson's organ is developed in reptiles, which with its help are able to literally “taste the air.” In humans, there is only a rudiment of it, represented by a cluster of nerve formations behind the olfactory region. If this rudiment is overdeveloped, then it limits the space for the growth of the nasal septum, and curvature occurs.
  • Constant congestion of one half of the nose. The curvature of the nasal septum in this case is an attempt to adapt to breathing through one nostril, to make it more complete.

Disorders that occur when the nasal septum is deviated

Difficulty in nasal breathing

Pathological mechanisms that lead to difficulty in nasal breathing when the nasal septum is deviated:

  • Narrowing of the nasal passage on the side of the convex septum. Reducing the volume of space on one side leads to difficulty in the passage of air flow, up to the complete inability to breathe through one nostril.
  • Disruption of air dynamics inside the nasal cavity. Normally, during inhalation, the air in the nose rises and passes through the middle and partially upper nasal passage. During exhalation, it is directed into the lower nasal passage. When the nasal septum is deviated, disruption of air flow even through one nasal passage leads to difficulty breathing. Despite the fact that the other two nasal passages on the same side may have normal clearance.
  • Narrowing of the nasal passage and difficulty breathing on the side of the concavity of the deformed nasal septum. Often the symptoms here are even more pronounced than on the side of the convexity. As a result of the expansion of the nasal passage, compensatory hypertrophy (growth) of the nasal concha occurs. Over time, they become so large that they begin to make breathing difficult.
  • The reaction of the nerve endings (receptors) of the mucous membrane of the nasal cavity. Normally, the air flow in the nose is uniform. When the nasal septum is deviated, turbulence occurs in it. They irritate sensitive receptors located in the mucous membrane. A reflexive defensive reaction occurs: the vessels of the mucous membrane dilate, swelling occurs, and a large amount of mucus is released.
  • Suction of the wing of the nose to the septum. This is often noted when the septum is deviated in the anterior part. The wing of the nose is constantly tightly adjacent to the septum, as a result, the passage of air is greatly hampered.

Changes in the nasal mucosa

Rhinitis develops - runny nose, constant nasal congestion.

Oxygen starvation of organs and tissues

Mouth breathing

  • Air that is not humidified or warmed enters the lungs: as a result, gas exchange in the alveoli is not as efficient as with nasal breathing. Less oxygen enters the blood.
  • The protective properties of nasal mucus are disabled. The likelihood of developing a respiratory infection increases.
  • Mouth breathing can eventually lead to adenoiditis - inflammation of the pharyngeal tonsil.

Nervous disorders

  • Bronchial asthma is a type of disease, the main cause of which is a neuropsychic imbalance.
  • Spasms of the larynx, manifested in the form of short attacks of suffocation.
  • Headache.
  • Convulsive epileptic seizures.
  • Reflex sneezing and coughing.
  • Dysmenorrhea in women is a violation of the frequency and duration of menstruation.
  • Disorders of the eyes, heart and other organs.

Violations from neighboring organs

  • Disorders of the Eustachian tube and middle ear. The nasal cavity passes into the nasopharynx, on the mucous membrane of which there are pharyngeal openings of the auditory, or Eustachian, tubes on the right and left. The Eustachian tube connects the nasopharynx with the middle ear cavity (tympanic cavity, which contains the auditory bones: incus, stapes, malleus). A chronic inflammatory process as a result of a deviated nasal septum leads to the fact that mucus and infectious agents can enter the auditory tube and the tympanic cavity.
  • Inflammation of the paranasal sinuses - sinusitis. A direct connection has been proven between a deviated nasal septum and the development of inflammatory processes in the paranasal sinuses. Such patients often develop sinusitis (inflammation of the mucous membrane of the maxillary, or maxillary sinus) and frontal sinusitis (inflammation of the frontal sinus).
  • Inflammation of the tear ducts and lacrimal sac. Tears, which are produced by the lacrimal glands, normally flow into the nasal cavity through the nasolacrimal duct. It can serve as a route for spreading infection.

Types of deviated nasal septum:

  • actual curvature of the nasal septum
  • crest
  • thorn
  • a combination of two or three types of curvature

Varieties of the actual curvature of the nasal septum:

  • in a vertical or horizontal plane
  • in the front or back of the nasal septum
  • one-sided and two-sided
  • with the capture of the cartilaginous part of the septum (so-called dislocations of the cartilage occur, when it is torn from the bone), the vertical plate of the ethmoid bone (forms the anterior part of the bony nasal septum) or the vomer (forms the posterior part of the nasal septum)
  • S-shaped, C-shaped, in relation to the bony crest of the upper jaw.

The development of complications with a deviated nasal septum depends on the severity and type of deformation. Almost every adult has a slight curvature, but it does not lead to breathing problems. There are cases where significant deformations do not prevent normal air flow.

Deviations of the nasal septum in the anterior part occur more often. The opener located behind is less often caught. The rear edge of the opener is almost always exactly vertical.

Symptoms of a deviated nasal septum

Complaints that patients with a deviated nasal septum make when visiting a doctor:

  • Difficulty in nasal breathing. The symptom can be of varying degrees: from a slight disturbance to a complete inability to breathe through the nose (in this case, the patient breathes through the mouth). However, the absence of this complaint is not a sign that there is also no deviated nasal septum. If the deformation occurs at a young age, the body can compensate for it over time. The patient has no complaints of difficulty in nasal breathing. If the nasal cavity is large, then no difficulties arise either.
  • Chronic rhinitis - runny nose. Manifests itself in the form of nasal congestion and constant mucous discharge. Sometimes the patient does not see a doctor for a long time, because he believes that he has frequent colds, and the whole point is a decrease in immunity.
  • Allergic reactions. The changes that occur in the nasal cavity as a result of the curvature of the nasal septum are always accompanied over time by a violation of local protective mechanisms and immunity. This manifests itself not only in a decrease in resistance to infections, but also in the appearance of allergic reactions. Allergic rhinitis is a common problem among people with a deviated septum. Chronic rhinitis is a pre-asthma - a condition against which bronchial asthma often develops. The patient complains to the doctor that nasal congestion and discharge occur mainly during contact with some allergen, for example, pollen from certain plants.
  • Headache. A spike, ridge, or deviated nasal septum may come into contact with the lining of the nose and put pressure on it. Constant irritation of nerve receptors leads to the development of reflex headaches.
  • Dry nose, discomfort and unpleasant sensations during nasal breathing. A symptom that develops as a result of prolonged irritation and inflammation in the nasal cavity.
  • Nosebleeds. They are also the result of irritation of the mucous membrane. On the side where there is a bulge on the nasal septum, the mucous membrane is very thin. Even with minor impact it is easily damaged.
  • Snoring at night as a result of impaired nasal breathing.
  • Increased fatigue, decreased performance, decreased resistance to physical activity. These symptoms are associated with impaired nasal breathing and insufficient oxygen supply to the blood from the lungs.
  • Frequent infections that occur with symptoms of acute respiratory infections (runny nose, cough, sneezing), increased body temperature.
  • Symptoms of chronic inflammation of the pharynx and larynx: sore throat, dryness and pain, cough.
  • Symptoms of inflammation in the middle ear: pain, hearing loss.
  • Violation of the shape of the nose. This symptom is characteristic of a deviated nasal septum of traumatic origin.
  • In severe cases, the patient and his relatives note periodic convulsive epileptic seizures, blurred vision, heart pain and increased blood pressure, shortness of breath and other symptoms. They can also be associated with deformations of the nasal septum.
  • Deterioration of memory, thinking, absent-mindedness. Schoolchildren with a deviated nasal septum experience decreased school performance over time.

Diagnosis of a deviated nasal septum

Visual inspection

Assess the appearance of the patient's nose. With a traumatic curvature of the nasal septum, it is changed.

Rhinoscopy

There are anterior and posterior rhinoscopy. An anterior rhinoscopy is most often performed. Rear - according to indications.

The doctor asks the patient to raise his head slightly, lifts the tip of his nose and inserts the instrument into the nostril. Using a button probe (see picture), the otolaryngologist can better examine the nasal cavity and assess the consistency of the formations inside.

Anterior rhinoscopy is performed separately for each nostril.

  • mucosal polyps
  • hematomas - hemorrhages under the mucous membrane, which, reaching large sizes, can impede nasal breathing
  • tumors in the nasal cavity
  • abscess - abscess.

If anterior rhinoscopy is difficult due to severe swelling of the nasal mucosa, the doctor first instills a 0.1% solution of adrenaline into the patient’s nostrils. It constricts the blood vessels and makes the nostrils free for inspection.

Additional instrumental studies for deviated nasal septum

  • assessment of the condition of the paranasal sinuses;
  • identification of anomalies in the bones of the skull;
  • identification of existing deformations after a nasal injury.

    • It is carried out using a rhinoscope - a thin probe, at the end of which there is a miniature video camera. It is inserted into the nostril and moved a little deeper. Most patients tolerate the study well. Local anesthesia of the nasal mucosa is performed using anesthetic sprays.

    Laboratory research methods for deviated nasal septum

    Treatment of deviated nasal septum

    Indications for surgery for deformities of the nasal septum:

    • Difficulty in nasal breathing on one or both sides. Surgical intervention is absolutely indicated provided that the difficulty in breathing is caused precisely by a deformation of the nasal septum.
    • Chronic rhinitis is inflammation of the nasal mucosa.
    • Otitis and eustachitis (inflammation of the middle ear and auditory, or Eustachian, tube), the initial cause of which is a violation of the shape of the nasal septum.
    • Inflammation of the paranasal sinuses (sinusitis): sinusitis, ethmoiditis (inflammation of the cells of the ethmoid bone). Surgery is indicated if these complications are caused by a deviated nasal septum.
    • Frequent, recurring headaches.
    • External cosmetic defects. Sometimes, in rare cases, after fractures, the bridge of the nose is straightened and septoplasty is performed.

    Contraindications to septoplasty for deviated nasal septum:

    • Senile age. With age, breathing problems caused by a deviated nasal septum are partially compensated. Therefore, the symptoms of the disease become less pronounced. In older people, atrophy of the nasal mucosa occurs, so the operation is difficult and the risk of complications is high.
    • Blood clotting disorder. For example, septoplasty is contraindicated in people with hemophilia.
    • Severe diseases of the cardiovascular system.
    • Diabetes.
    • Mental illnesses.
    • Malignant tumors.
    • Severe infections.
    • General serious condition of the patient.
    • Children and people over 48 years of age can undergo surgery, but the indications for it at this age are narrowed.

    Preparation for septoplasty

    Surgery for deviated nasal septum

    • minimal tissue trauma;
    • blood loss during surgery is minimized;
    • the laser has antiseptic properties;
    • rehabilitation measures in the postoperative period are minimized.

    The main disadvantage of the laser is that it is not able to eliminate all deformations of the nasal septum, especially its bony part.

    Postoperative period

    • the formation of large hematomas (hemorrhages) under the mucous membrane;
    • nosebleeds;
    • perforation of the nasal septum - the formation of a hole or defect in it;
    • formation of an abscess under the mucous membrane - an abscess;
    • purulent sinusitis;
    • deformation of the nose - most often the back of the nose becomes retracted as a result of the fact that the surgeon performed a resection of the septum too high.

    Is it possible to treat a deviated nasal septum without surgery?

    Is it possible to prevent deviated nasal septum?

    How does a deviated nasal septum manifest in children? What are the treatments?

    • Injuries during childbirth;
    • A blow to one side of the nose;
    • Discrepancy between the growth rates of the bone and cartilaginous parts of the nose in adolescence.

    Signs of pathology. Externally, changes may not be visible and both sides of the nose appear symmetrical. Upon examination, the doctor discovers that one side of the child’s nose is narrowed, and there is practically no air circulation in it. This is accompanied by swelling of the mucous membrane of the respiratory tract, which gradually loses its protective properties. Due to a decrease in local immunity, the child suffers from prolonged runny nose and otitis media.

    • Breathing problems on the affected side. Parents note that periodically one nostril is completely blocked. In some cases, this causes the baby to sleep on only one side to optimize breathing.
    • Prolonged or chronic runny nose. Frequent sinusitis and sinusitis are associated with increased susceptibility of the mucous membranes to infection. Hypertrophied (overgrown and thickened) mucosa is the basis for the formation of a polyp - a growth that blocks the nasal passage.
    • Frequent nosebleeds. Dryness of the mucous membrane leads to the formation of cracks in it.
    • Otitis. Blockage of the eustachian tube impairs ventilation and cleaning of the tympanic cavity and causes inflammation of the middle ear.
    • Frequent colds and viral infections: ARVI, sore throat, laryngitis. Mouth breathing reduces the protective properties of the pharyngeal mucosa, making it susceptible to viruses and bacteria.
    • Snoring. Parents note noisy breathing during sleep even in healthy children. The narrowed cavity of the nasal concha becomes an obstacle to the passage of air. Its turbulence causes vibrations in the walls of the respiratory tract, which produces a characteristic sound.
    • Enlarged adenoids. Due to frequent infections, the nasopharyngeal tonsil (adenoids) become enlarged, which can cause snoring and coughing.
    • A headache is a sign that the central nervous system is experiencing oxygen deficiency.
    • Impaired sense of smell. It develops gradually and is associated with damage to sensitive receptors on the nasal mucosa.

    Treatment of deviated nasal septum in children. Not all children with a deviated nasal septum need treatment. Correction of the defect is necessary if the child’s breathing is significantly impaired, and there is evidence that the curvature leads to frequent otitis media and sinusitis.

    • Intranasal glucocorticosteroids (Mometasone, Fluticasone, Beclomethasone) eliminate allergic rhinitis and medicinal rhinitis caused by prolonged use of vasoconstrictor drops. Use once a day, preferably in the morning.
    • Cromons. Cromoglin - cromoglycic acid in the form of a spray is used to treat allergic rhinitis 4 times a day.
    • Antibacterial drugs (Isofra, Polydex, Bioparox) - local use of antibiotics stops the growth and reproduction of bacteria on the mucous membrane and in the sinuses.
    • Mucolytic sprays - (Sinuforte, Rinofluimucil) are used to thin mucus and facilitate its removal from the sinuses.
    • Moisturizing sprays - (Salin, Aqua-Maris) moisturize the mucous membrane, cleanse it of microorganisms, and help strengthen local immunity.
    • Vasoconstrictor drops and sprays - (Naphthyzin, Farmazolin, Noxprey). They constrict blood vessels, reducing swelling of the mucous membrane, and restore nasal breathing. Drops reduce swelling of the nasal tissues, increasing the lumen through which air passes.

    Surgical treatment of deviated nasal septum in children. In childhood, they try to avoid surgery, fearing that it may affect the formation of the nose in the future. Doctors recommend postponing surgery until later. The earliest age of patients is 6 years. Surgery is resorted to when it is not possible to restore nasal breathing by other methods.

    What is the cost of surgery for a deviated nasal septum?

    How does it feel after surgery on a deviated nasal septum?

    • Consequences of general anesthesia (anesthesia):
      • dizziness;
      • shiver;
      • nausea;
      • headache;
      • confusion;
      • fainting state;
      • pain in the back and muscles.

      Unpleasant sensations can last from 30 minutes to 2 days. These complications occur quite often in 1 in 10 patients. Their appearance is associated with the effect of anesthesia on the cells of the central nervous system. Deep, slow breathing can reduce their manifestation. The exhalation should be 2 times longer than the inhalation.

    • After premedication and local anesthesia, minor adverse reactions are possible:
      • short-term nausea;
      • vomiting and dizziness;
      • dry mouth;
      • rash on the face and chest.

      To avoid vomiting, avoid eating or drinking anything after surgery. You can drink a sip every 5-10 minutes, then the liquid has time to be absorbed into the blood and does not linger in the stomach.

    • Moderate pain begins to be felt after the effect of the anesthetics wears off, the most pronounced pain is in the nose, where the tissue is damaged. Your head may hurt and your eyes may water. To reduce pain, the doctor may recommend applying cold or taking analgesics: Nurofen, Nise. Unpleasant sensations practically disappear after 3-5 days. Pain when touched can last up to 3 months.
    • A sore throat develops due to dryness of the mucous membrane if the patient breathes through the mouth or through tubes used during anesthesia. Strepsils or Faringosept can alleviate the condition.
    • An elevated temperature of up to 37.5 °C can last 3-5 days. Doctors consider this to be the norm and explain it as the body’s reaction to surgery. Chills and fever above 37.5°C may indicate an additional infection. Tell your doctor immediately.
    • After the operation, special tampons are inserted into the nose. They press the mucous membranes against the cartilage. This is necessary to speed up healing and prevent the development of hematomas. Modern tampons have air vent tubes that allow you to breathe through your nose. If they are clogged with blood clots, the tubes are washed with saline using a syringe without a needle. In ENT departments of hospitals, bandages are traditionally used for nasal packing. They perform the same function as tampons, but do not allow the patient to breathe through the mouth. Bandages are changed once a day - this procedure can be quite unpleasant due to the fact that the bandage dries to the nasal mucosa. Regardless of the tamponing technique, patients experience a feeling of pressure and fullness in the nose.
    • A sling-shaped bandage is applied at the entrance to the nose. Its task is to absorb ichor - a clear liquid that is released from the wound surface. When the bandage gets wet, it is changed to a dry one.
    • Bruises under the eyes are the result of injury and often occur after deep manipulation of the bony part of the nose.
    • Numbness of the nose is the result of damage to small nerve endings.
    • For the first 2-3 days, the outer part of the nose is enlarged due to tissue swelling. But gradually it passes. After 7-10 days, there are no external signs of the operation.
    • Breathing returns to normal after 2-3 weeks, when the mucous membrane is restored. Full recovery may take up to 3 months. During this period, the mucous membrane grows to the cartilage, the ciliated epithelium and chemoreceptors responsible for the sense of smell are restored. During this period, it is not recommended to blow your nose. Wash it with Salin or other saline solutions 3-5 times a day.
    • For a month, you should avoid physical activity, saunas, swimming pools, and solariums. Otherwise, bleeding may occur and hematomas may form under the mucous membrane.

    When to see a doctor:

    • repeated bleeding;
    • severe pain in the nose 5-7 days after surgery;
    • temperature increase ;
    • purulent nasal discharge.

    Inform your doctor about any health problems - this will help you take timely measures and prevent possible complications.

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    Source: http://www.polismed.com/articles-iskrivlenie-nosovojj-peregorodki-simptomy.html