Nasal septum spike

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Deviation of the nasal septum. When is surgery indicated?

The nasal cavity is divided into two halves by a septum and usually they are not equal to each other. This is due to the fact that the right and left halves of the human body are not identical to each other, but such asymmetry is normal and does not interfere with breathing at all.

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A completely different situation arises after injuries to the nose, which can lead not only to deformation of the external nose, but also to curvature of the nasal septum. Sometimes a deviated septum is present in patients who deny any history of trauma. Since the nasal septum is very rarely deviated in newborns, it is believed that its deviation develops during the formation of the facial skeleton. However, this situation also does not always require surgical treatment, and the need for surgery arises when there is a significant curvature that impairs nasal breathing or contributes to the narrowing of the middle nasal passage - the territory of the outlet openings (or more correctly, anastomoses) of the paranasal sinuses.

How can a doctor determine if nasal breathing is impaired? Well, first of all, the patient himself says that one or both halves of his nose “can’t breathe”; often this situation is accompanied by the so-called dependence on nasal drops or medicinal rhinitis, when the patient is forced to daily, and sometimes several times per day, resort to the help of decongestants (naphazoline, xylometazoline, oxymetazoline, tramazoline - on the basis of which all decongestants available in pharmacies in the form of drops and sprays are created). His arguments that he uses different drops/sprays are untenable. since all of the listed chemical compounds are addictive when used regularly for more than 7 days.

The variations in the curvature of the nasal septum are numerous - it can be deviated in one direction or another along its entire length, or have an S-shape, can be curved only in the cartilaginous part, or involve the bone part as well.

The most unpleasant moment in this case is the possibility of contact with the opposite side - the nasal turbinates. In case of contact with the middle nasal concha, the so-called spine or ridge of the septum, conditions arise for the development of sinusitis (sinusitis, frontal sinusitis, ethmoiditis). Often both the middle and inferior turbinates are “in contact” with the nasal septum.

Symptoms of a deviated nasal septum include unilateral difficulty breathing, persistent runny nose, impaired sense of smell, and sometimes nasal sound. If this situation is accompanied by a complication in the form of chronic rhinitis (medicinal, vasomotor), the complaints will be dominated by alternating congestion of the halves of the nose, especially in the lying position.

The diagnosis is made by anterior and posterior rhinoscopy, which is performed by any otolaryngologist. Posterior rhinoscopy is traditionally performed using a nasopharyngeal speculum, through which it is extremely difficult to see anything and is associated with discomfort for patients. Such an inconvenient technique has been replaced by excellent modern visualization methods - endoscopes. But, unfortunately, such equipment is not available everywhere. In our center, already at an outpatient appointment, you can perform a full endoscopic examination of the nasal cavity, the area of ​​the middle nasal passage, nasopharynx, ear and larynx. It also helps to monitor postoperative healing in our patients, thanks to which we can successfully carry out the rehabilitation period, significantly reducing its time.

The operation by which a deviated nasal septum is corrected is called septoplasty.

Despite the fact that the development and beginning of practical use of combined general anesthesia (anesthesia), which is suitable for operations on the ENT organs, dates back to the middle of the last century, for a long time they were performed under local anesthesia. This was mainly due to the inadequate state of the anesthesiology service compared to the existing needs.

Currently, the standard for classical ENT operations, excluding surgical procedures that are small in scope and duration, is anesthesia.

SHOULD YOU BE AFRAID OF NARCOSIS?

It is impossible to answer this question unequivocally, since providing a patient with anesthesia is an art that depends on the qualifications of the anesthesiologist, the quality of the drugs used, the condition of the body and many other factors.

The surgical technique may vary depending on the clinical situation. Classically, septoplasty is performed as follows: after an incision in the mucous membrane and perichondrium, the mucous membrane is peeled off along with the perichondrium over the entire surface of the cartilaginous section of the septum with the transition. On the opposite side, detachment is carried out after dissection of the quadrangular cartilage through a previously made incision of the mucous membrane and perichondrium. Curved sections of cartilage or bone are removed, straightened and necessarily reimplanted, mainly this applies to the cartilaginous part, since it is this that provides the supporting function of the nose. The previously separated sheets of mucous membrane together with the perichondrium are pressed against the reimplanted cartilage, sutures are applied and tampons are installed.

The second option for performing septoplasty is detachment of the mucosa with the perichondrium and then the periosteum, only on one side. In this case, the second side remains intact, and they try to eliminate all distortions using notches. Pronounced ridges and spines are removed, flattened using special instruments and reimplanted.

There is a third option for septoplasty - ENDOSCOPIC SEPTOPLASTY. This operation is now very popular all over the world. It requires expensive endoscopic equipment and specialized surgeon skills in performing endoscopic operations. Technically, this operation turns out to be less invasive: under endoscopic control, local incisions are made only in places of curvatures, followed by their removal/flattening/reimplantation/suturing. The advantages of this approach include a shorter recovery period and less blood loss, however, with significant curvature (for example, in combat sports athletes), endoscopic septoplasty may have limited options.

But it is worth reassuring patients that, regardless of the tactics, this operation does not take a long time, it is not characterized by fatal complications associated with the actions of the surgeon, since the intervention area, unlike surgery on the paranasal sinuses, is relatively far from critical structures - the brain, the organ of vision and large arteries . In each case, the surgeon’s tactics are determined on the basis of a preliminary consultation, examination of the nasal cavity using an endoscope, and analysis of the patient’s computed tomogram.

A number of authors identify the so-called critical places of the nasal septum (figure). Surgical tactics, however, vary depending on the location of the defect.

If there is a curvature in them, tactics In addition to the above, in our center we carry out so-called scientific monitoring of all patients for whom we perform surgical treatment. We are interested in each case, we evaluate the degree of satisfaction with treatment and analyze the contribution of all components to this indicator.

When dealing with nasal breathing disorders, we are helped by advanced research methods such as acoustic rhinometry and anterior active rhinomanometry. Both methods are available in a few clinical centers in Russia, since the objectification of the results of intranasal interventions is currently in its infancy.

An important component of the success of surgical treatment is the equipment and instruments used during the operation. In this regard, it should be emphasized that we did not doubt for a minute the need to equip our center with the most advanced equipment and instruments, despite the sometimes tenfold increase in the cost of each instrument.

The duration of nasal tamponade after septoplasty varies depending on the clinical situation, but as a rule, it is 1 day. We use modern materials as tampons, for example Merocel, which are the most gentle option in relation to the mucous membrane and the patient’s subjective sensations (feeling of pressure, distension), and are also characterized by excellent hemostatic potential. However, in some cases, for example, with simultaneous rhinoplasty (changing the shape of the nose), traditional gauze swabs soaked in antibacterial ointment are used. The tampon is inserted into the nasal cavity in layers, helping to maintain the achieved shape and is often left for 2 days.

After a successful operation, breathing is restored almost immediately. With concomitant surgery on the nasal turbinates - and this happens in 80% of cases, postoperative swelling may continue for several days, but with proper care of the nasal cavity, these periods are also reduced. There are no visible changes on the face after septoplasty (bruises, incisions, stitches). Everything is “hidden” in the nasal cavity and, theoretically, a person can return to full-time work immediately after discharge from the hospital (in normal cases this happens within 2-3 days), however, such tactics are not recommended and the rehabilitation period at home should not be less than 7 days. In the future, it is advisable to limit heavy work or sports for a month. This patient management system adopted in our center helps to preserve the results of surgery to correct a deviated nasal septum forever!

IF YOU HAVE ANY QUESTIONS, PLEASE COME TO A CONSULTATION OR ASK IT BY PHONE. WE ARE ALWAYS GLAD TO COMMUNICATE!

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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.

Source: http://sovets.net/12639-iskrivlenie-nosovoj-peregorodki.html

Deviated nasal septum

Resident of the microdistricts "Savelovsky", "Begovoy", "Airport", "Khoroshevsky"

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Balashova Yulia Vyacheslavovna

Varnel Olga Leonidovna

Doctor of the highest category

Egorova Margarita Yurievna

Kapustina Anna Alexandrovna

Pyshny Dmitry Vladimirovich

Otorhinolaryngologist of the highest qualification category

Candidate of Medical Sciences

Ramazanova Gunay Alniyaz-kyzy

The nose is a very necessary organ that performs several important tasks. Our nose warms and humidifies the inhaled air, traps dust particles brought with the air, and neutralizes bacteria entering from outside. In addition, thanks to the olfactory region of the nose, we perceive and differentiate different odors.

Nasal septum

The nasal septum performs an important function in our nose, ensuring an even distribution of air flow between the right and left lobes of the nose. With the help of the nasal septum, the harmonious fulfillment of the following conditions is achieved: warming, cleansing, moisturizing. When the nasal septum is deviated, these functions are disrupted.

A deviated nasal septum is one of the most common diseases of the nasal cavity.

According to statistics, a deviated nasal septum is quite rare in young children; most often, almost half of all adults suffer from this disease, and in men, a deviated nasal septum is much more common than in women.

The baby's nasal septum is smooth and straight. Almost all of it consists of cartilaginous tissue, in which there are islands of ossification. Over time, the nasal septum turns into a bone one, and the bones grow together. As a person grows and certain processes in the body are disrupted, the nasal septum begins to bend.

Causes of a deviated nasal septum

  • uneven growth of the skull bones, which leads to the fact that the dimensions of the nasal cavity also change, the nasal septum becomes crowded in the nasal cavity, and it has to bend;
  • traumatic causes (most often they are typical for boys and men): as a result of a strong blow, the nasal bones are displaced, the nasal septum is deformed and the bones do not heal properly, which leads to a curvature of the nasal septum;
  • the presence of polyps and tumors of the nasal mucosa, which leads to breathing problems in one of the nostrils, and then to a curvature of the nasal septum;
  • hypertrophy (uneven development of one of the nasal conchas), putting pressure on the nasal septum.

Deviation of the nasal septum. Symptoms.

A deviated nasal septum can “give itself away” with the following symptoms:

  • asymmetrical shape of the nose (especially noticeable when the nasal septum is deviated as a result of injury);
  • constant chronic runny nose (impaired nasal breathing, mucous discharge from the nose);
  • reflex headaches that arise as a result of constant touching of the nasal mucosa by the deviated nasal septum;
  • loud snoring at night;
  • nosebleeds that appear due to thinning of the mucous membrane in the direction of the curvature of the nasal septum;
  • decreased performance, increased fatigue of the body due to reduced oxygen supply to the blood;
  • discomfort during nasal breathing;
  • frequent acute respiratory infections with coughing, sneezing, runny nose, fever;
  • sore throat, sore throat, cough;
  • hearing loss as a result of inflammation in the ear;
  • decreased olfactory abilities;
  • absent-mindedness, memory impairment.

Types of deviated nasal septum

The vast majority of adults have slight deviations of the nasal septum. But they do not interfere with proper air circulation through the nostrils and proper breathing.

The following types of deviated nasal septum are known:

  • deviated nasal septum;
  • crest;
  • thorn;
  • a combination of various types of curvature.

Most often, people have a deviated nasal septum in the front part. Deformations of the posterior part of the nasal septum are less common.

Configuration of the nasal septum and turbinates with a deviated septum: a - slight curvature of the nasal septum; b — S-shaped curvature of the nasal septum; c — curvature of the nasal septum at an angle.

Diagnostics of the nasal septum

To find out whether you need surgery on the nasal septum, you need to undergo a comprehensive diagnosis. Diagnosis includes an external examination by an ENT doctor, rhinoscopy, and the use of additional laboratory tests and tests.

An external examination by an otorhinolaryngologist allows you to determine the type of nose. In addition, the doctor evaluates nasal breathing. By bringing the cotton wool separately to each nostril, the vibration of the villi is examined during inhalation and exhalation.

An assessment of a person's sense of smell is also carried out for each nostril separately. The patient must identify the smell on the cotton wool with his eyes closed. If there is a curvature of the nasal septum, then the sense of smell is usually reduced.

Thanks to rhinoscopy, examination of the nasal cavity is achieved using special instruments. In his examination, the doctor may use anterior and posterior rhinoscopy.

Anterior rhinoscopy is used to better examine the nasal cavity and the formations there. It is performed using a nasal dilator and a special probe. Using anterior rhinoscopy, you can see nasal polyps, hematomas, abscesses and tumors in the nasal cavity.

Posterior rhinoscopy is an examination of the nasopharynx and nasal cavity from the mouth. This is done using a spatula and a special mirror.

Why do you need surgery on the nasal septum?

Indications for surgery to correct the nasal septum may be as follows:

  • external cosmetic defect;
  • difficulty breathing through the nose;
  • chronic rhinitis;
  • inflammation of the middle ear (otitis media), resulting from a deviated nasal septum;
  • constant headaches;
  • sinusitis, ethmoiditis, which appeared due to a deviated nasal septum.

Treatment of deviated nasal septum

Is surgery necessary for a deviated nasal septum? If you are very concerned about its consequences, then it is better to decide on this operation.

In our clinic, low-traumatic correction of the nasal septum is possible using various modern techniques.

Surgical treatment, for example, laser surgery for a deviated nasal septum, is carried out to normalize nasal breathing and restore the anatomy of the nasal cavity. Our clinic performs septoplasty surgery, which involves partial removal of the deformed cartilage and, if necessary, the bony part of the septum. Correction of the nasal septum through surgery allows for alignment and thinning of the curved cartilage, i.e. modification. The modified cartilage becomes flexible and pliable, allowing the surgeon to put it back in place and straighten the nasal septum.

For local curvatures of the nasal septum (spike, ridge, tubercle), minimally invasive endoscopic septoplasty is possible. Laser surgery to straighten the nasal septum is also considered one of the gentlest techniques.

In cases where a patient with a deviated septum complains of external deformation of the nose, rhinoplasty may be performed.

Our clinic employs highly qualified otolaryngologists and plastic surgeons with extensive experience in the field of aesthetic medicine. Trust your health to professionals, and soon you will forget about all the consequences of a deviated nasal septum! As a result of a successful operation, the halves of the nasal cavity become symmetrical and nasal breathing becomes free.

The price for surgery for a deviated nasal septum is here.

If you have any questions, call us at:

Contact center operators will provide you with the necessary information on all your questions.

You can also use the forms below to ask our specialist a question, make an appointment at the clinic, or request a call back. Ask a question or indicate a problem with which you would like to contact us, and we will contact you as soon as possible to clarify the information.

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Nose comb surgery

A bone ridge is a pathological neoplasm, the symptoms of which depend on the degree of deformation of the nasal septum. In most cases, this pathology requires removal through surgery. Before choosing the type of operation to remove it, a set of diagnostic measures should be carried out.

What is the bony ridge of the nasal septum?

A ridged nasal septum is a type of deformity in which the crooked cartilage of the nasal septum protrudes to the side. The location of the ridge is the bony part of the nasal membrane.

This is what a nose ridge looks like

The ridge of the nasal septum can have different lengths and directions. In particular cases, this deformation reaches the mucous membrane of the opposite side of the nasal cavity and leads to its compression, with the subsequent development of undesirable symptoms.

The ridge may consist only of bone tissue and be covered by a continuation of the mucous membrane of the nasal cavity or have an additional cartilaginous component.

This deformation not only affects the basic functions of the nose, but also leads to the formation of a visible cosmetic defect. But if the ridge is not large, then patients may not know about its presence and live a full life.

In most cases, bone deformity in the form of a crest of the nasal septum is formed as a result of trauma, a history of invasive interventions in the patient, or pathology of embryogenesis.

Nose ridge symptoms

The severity of clinical changes depends on the degree of deformation of the nasal septum as a result of the formation of a bone ridge. In some cases, these changes are characterized by an asymptomatic course. But deformation changes tend to grow, which aggravates clinical symptoms.

There are the following types of complications due to the presence of a crest of the nasal septum:

  • Difficulty in nasal breathing. This symptom develops as a result of the presence of a mechanical obstruction in the path of air flow.
  • Decreased smell function. Anosmia or hyposmia develops only if there are deformities in the upper parts of the nasal membrane.
  • Periodic development of nosebleeds. The reason for the development of bleeding is the application of great efforts to cleanse the nasal passages, as well as the intense proliferation of blood vessels in the pathological area.
  • Disturbance in sleep and wakefulness.
  • Foreign body sensation. Often patients mistake the deformity for a foreign body and try to get rid of it, which in turn provokes the development of bleeding.
  • Development of chronic diseases of the ENT organs (chronic rhinitis, sinusitis, tonsillitis and even otitis media).
  • Symptoms of increasing brain hypoxia (decreased memory function, swelling under the eyes, absent-mindedness). The brain is the most sensitive organ to hypoxia. Insufficient oxygen supply leads to the development of a clinical picture of brain hypoxia.
  • Change in voice (closed humming).
  • Periodic headaches and dizziness.
  • Drainage of mucus down the back of the throat. The development of this symptom leads to a number of undesirable consequences, the most important of which is the development of chronic pharyngitis and constant discomfort in the throat.
  • Feeling of fullness in the ears. This symptom develops as a result of changes in pressure in the auditory tube. In rare cases, patients note a decrease in cases, which is transient in nature.
  • The appearance of snoring during sleep.
  • Increased tendency to develop respiratory diseases.

Nasal septum ridge photo:

Nasal septum ridge treatment

Treatment of the bony crest of the nasal septum is carried out if patients have complaints associated with deformation changes in the nose, as well as with a complicated history of ENT organs.

How to treat a ridge in the nose? The only effective method of eliminating symptoms caused by the presence of a bone ridge in the nose is surgical treatment (an operation to restore the structure of the septum).

The operation must be performed under general anesthesia, since the nasal cavity is well innervated and any invasive interventions are accompanied by pain.

Nose comb surgery

Different types of surgery to restore the structure of the nasal septum will help not only restore lost nasal functions, but will lead to an improvement in the cosmetic picture.

There are the following types of operations to restore the structure of the nasal membrane due to the formation of a bone ridge:

Septoplasty before and after surgery

Septoplasty is a surgical method

straightening the nasal septum. This type of surgery will help eliminate the symptoms caused by its deformation. The operation to remove the bone ridge lasts from 45 minutes to 1.5 hours. This difference in operation time is due to the individual characteristics of the bone crest structure.

Indications for surgery to remove the bone crest:

  • Development of chronic inflammatory processes in the upper respiratory tract.
  • Difficulty in the process of drainage of the paranasal sinuses.
  • Symptoms of cerebral hypoxia.
  • The appearance of night apnea.

Operation technique:

  1. Conducting anesthesia.
  2. The position during the operation is lying down.
  3. Surgical exposure of the lower parts of the nasal septum.
  4. Resection of the most prominent defects.
  5. The key point of the operation is to preserve the supporting function of the nasal septum. It is very important to prevent excessive thinning of the nasal septum at any part of the septum.
  6. Carrying out nasal tamponade. Tamponade will help fix the septum in the correct position and prevent the development of hematomas and synechiae.

Rhinoseptoplasty is a complex operation to eliminate bone crest deformities and restore the shape of the nose.

Indications for rhinoseptoplasty:

  • Congenital deformation of the nasal membrane.

Rhinoseptoplasty before and after surgery

Functional rhinoseptoplasty is indicated primarily for patients with impaired breathing and smell function.

Reconstructive rhinoseptoplasty is indicated for patients with combined significant impairment of the external structure of the olfactory organ.

Characteristics of the operation - rhinoseptoplasty:

  • The average duration of surgery is from 30 to 90 minutes.
  • Full restoration of respiratory and aesthetic function occurs 2 weeks after the operation.
  • Surgical intervention can be performed under general or local anesthesia, in case of minor deformation changes.
  • If a pronounced cosmetic defect is observed, then surgical intervention is performed using an open approach. If the cosmetic function is not severely impaired, then it is possible to perform surgery using a closed method.
  • In severe cases, surgical intervention is resorted to using endoscopic techniques.

Features of the postoperative period:

  • The duration of the patient's stay in the hospital after rhinoseptoplasty is three days, unless postoperative complications are observed.
  • In the first three days of the postoperative period, severe nasal congestion persists, caused by functional swelling of the nasal mucosa.
  • During the first 2-3 days after surgery, minor bleeding from the nasal cavity may be observed.
  • The function of smell is fully restored only a month after surgery.
  • The aesthetic appearance is restored after 2 weeks with closed access and 4-6 weeks with open access surgery.

On the second day after surgery, the tampons should be removed from the nose. If nosebleeds persist for a week, systemic blood pressure should be monitored.

Recommendations for patients after septoplasty or rhinoseptoplasty:

  • During the first 3 days after surgical procedures, it is contraindicated to consume hot food or drinks.
  • Promptly change nasal tampons after bleeding through them.
  • Avoid prolonged stay in a room with high air temperature.
  • Do wet cleaning in the house 2 times a day.
  • Ventilate the room in a timely manner.
  • Avoid contact with infectious patients.
  • 2 months after surgery, undergo a preventive examination by an otolaryngologist.

Add an article to social networks:

She contacted a plastic surgeon with complaints of a crooked nose and difficulty breathing through the nose. The surgeon referred me to an ENT specialist, who diagnosed “Bone ridge of the nasal septum.” After the operation, it was possible not only to eliminate the cosmetic defect, but also to restore nasal breathing

During the examination, the ENT diagnosed me with a bony ridge of the nasal septum. I had surgery to remove it. Three days later, all symptoms associated with the deformation disappeared.

I developed a bone ridge after being hit on the nose. Eliminated after the swelling disappeared through surgery.

Since early adolescence, I have been suffering from difficulty breathing and headaches, only one side of my poor nose was always breathing, and the other was blocked, so they took turns, of course, no amount of rinsing and blowing my nose helped. I am now 21 years old, today I had surgery to remove a thorn. I’m lying in the ward, blood is leaking from the part of my nose where the operation was performed. The feeling before the operation, when you are taken to the surgical room, and there the surgeon and nurses are working over you, are simply wonderful. I have never received so much human attention in my life. The operation itself was similar to breaking the nose from the inside; a dull pain was felt, which was quite tolerable. It seemed to me that the operation lasted 5-10 minutes, but then I was told that 45 had passed. I was slowly recovering from the anesthesia, and my nose began to howl. But they told me that if everything goes well, they will discharge me tomorrow. Don’t worry about your noses, good people, don’t procrastinate, and enjoy breathing with both halves! Your brain and lungs will make you feel good :)

What is the cost of the operation? How much did everything cost you?

Please tell me where the surgery was performed and what the cost was?

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Source: http://nos-zdorov.com/operacii/septoplastika/udalenie-grebnya-nosovoj-peregorodki

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. 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/