The nasal septum is a structure that separates to two part the nasal cavity from the middle and it is cartilage at the front part and bone at the back part. When the septum is not located in the middle, unequal gaps occur in the nostrils, which sometimes causes nasal blockage. Many people have mild septal deviation that do not cause any complaints. In case of more serious deviation, obstruction develops due to disruption of air flow on the curved (deviated) side. We can see these curvatures unilaterally or in both nasal cavities.
What are the causes of septal deviation in the nose?
Septal deviation may be congenital or may occur due to the trauma occurring during the passage of the baby through the birth canal at birth and the traumas to the nose during childhood. In addition, although there are no problems in childhood, we can see different nose shapes that become genetically in adulthood.
What type of complaints does the patient have in the presence of septal deviation?
Complaints may also vary depending on the condition of the deviation. In the presence of mild bone curvature, the patient does not have a problem at normal, while nasal obstruction becomes evident when there are upper respiratory tract infections such as flu. In more serious septal deviation, obstructive problems affecting unilateral or both nostrils occur in the nose. If there is a concha hypertrophy along with septal deviation, the patient feel the problem more. The patient with a blocked nose breathes through the mouth and the development of lower and upper respiratory tract infections becomes easier because the nose’s functions such as heating, humidification and filtering are impaired. Dry mouth, bad breath (halitosis), dental and gum problems, frequent sore throat and pharyngitis, deterioration in voice quality and nasal speech sound are observed. In addition, patients with nasal obstruction may develop problems such as snoring, impaired sleep quality, waking up tired from sleep, headache, daytime sleepiness, decreased work performance, weakness in smell and becoming more prone to heart and vascular diseases in case of prolonged obstruction. Moreover, septal deviation also increases the development of nasal discharge and sinusitis infection, pressure problems in the middle ear, other middle ear diseases (such as fluid accumulation in the middle ear and middle ear infection), and sleep apnea problems. In fact, considering all these probable problems, the conclusion is as follows: Nasal congestion is an important health problem that negatively affects the quality of life of the person.
How is septal deviation diagnosed?
With an endoscopic examination of the nose, the disease is easily diagnosed and, if any, nasal concha growth can also be seen. However, the evaluation of the nose should be done not only as an internal examination of the nose, but with all internal and external bone, cartilage and soft tissue structures that contribute to the formation of the nose. Possible external problems that contribute to obstruction and cosmetic problems should be identified.
In addition, if there are also some paranasal sinus problems like sinusitis along with the nose problems, sinus tomography contributes to diagnosis.
How is septal deviation treated?
The only treatment option for nasal septal deviation is surgery. However, the important thing here; “Should every septal deviation in the nose be treated surgically?” is the answer to the question. There is no need for any surgical treatment in light bone curvatures (deviations) that do not cause problems for the patient, and such bone curvatures already exist in a significant part of the population. If the septal deviation constitutes the problems we mentioned in the above complaints section, then it should be treated surgically.
Septal deviation surgery is called “Septoplasty” and can be performed under local or general anesthesia. However, general anesthesia is preferred more in terms of both patient comfort and the comfort of the doctor performing the surgery. The surgery time can vary between 30-60 minutes depending on the severity of the deviation. Bone and cartilage structures that are curved are corrected or removed according to the situation with an incision made through the nasal septum. After the operation, according to the physician’s approach, tampons of different properties are placed in the nose. In general, silicone tampons with canal are used to breathe air, and these tampons are kept in the nose about 1-7 days, depending on the condition of the procedure performed and the physician’s preference. After removing the tampons, the nostrills should be washed with hypertonic saline solutions for at least 1-2 months against swelling, crusting and dryness that may occur in the first periods and moistened with moisturizers (especially if it is done along with nasal concha surgery). There is no scar tissue on the skin since no external incision is made during this surgery, and there is no bruising or swelling around the eyes seen in aesthetic nose surgeries.
Is it always possible to solve nasal curvature problems with “septoplasty” alone?
As mentioned in the diagnosis section, bone, cartilage and soft tissue structures that make up the structure of the nose should be considered as a whole and the inside and outside of the nose should be evaluated together while evaluating the nasal obstruction. Some bone curvature problems may also be associated with the outer bone and cartilage structures that form the roof of the nose, and in this case it may not be possible to solve inside deviation by the “septoplasty” operation alone. Therefore, if the problem concerns both the external and internal structures of the nose together, the patients should be given detailed information about the subject and after patient’s consent, an aesthetic nasal surgery (such as rhinoplasty) should be done along with septoplasty.
