Has your nose gotten up your nose?

Your nose is the first part of your respiratory system and its problems can greatly affect your breathing. The nasal septum is one of the most vulnerable parts of your body to deformity problems. Statistics show that more than 80% of the population have some misalignment or deformity of their nasal septum, mostly undetected during the years. Therefore, there is a fair chance that you have the same physical disorder. Now take a look at your nasal cavity in the mirror and check where both cavities are symmetrical. If they do not seem the same, do not worry. In fact, there is no need to any medical intervention if you do not have difficulty with your “deviated nasal septum” or as it is sometimes called “nasal septum deviation.” However, it is not always like this and in some cases, there may be some breathing difficulties and other problems that are related to your septum although you may not be aware of them. Therefore, you need to visit an ENT specialist to diagnose your problematic problematic deviated septum.

Anatomy

Your nasal cavity is divided into two cavities with separate nostrils by the bone and cartilage in the middle called nasal septum. This septum determines the form of your nose and is covered with mucous membrane. The bone consists of the maxillary bones, the vomer, and the ethmoid bone. In every one in five, the septum is in the center of the nasal cavity, but in the rest, the cartilage deviates from the center to the left or right resulting in near or completely blockage of one of the nasal passages.

Causes

It is thought that deviated nasal septum may have genetic reasons. Some of the septal deformities are related to genetic connective tissue disorders such as Homocystinuria and Ehlers-Danlos syndrome. Traumas and injuries such as a blow to the nose can also cause septum deviation. Impacts during childbirth, when the nose of the child is compressed, is another reason for this deformity. Aging may affect the nasal septum.

Signs and symptoms

Mild cases of a deviated nasal septum are mostly symptom-free. In these cases, you may have symptoms only when you also have a cold or other upper respiratory tract infection. In more serious cases, there may be symptoms including:

• Blockage of one or both nostrils
• Sinus infections: The obstruction predictions drain from sinuses leading to the fluid accumulation in the sinuses and the following infections.
• Nasal congestion
• Snoring: Your uvula and soft palate collapse and vibrate noisily.
• Mouth breathing: Due to the relative obstruction of the nose
• Cessation of breathing during sleep
• Repetitious sneezing
• Headaches
• Sleeping on a particular side
• Pain in the face
Postnasal drip
• Losing the sense of smell
• Bloody noses

Differential diagnosis

There can be other reasons for the nasal airway construction that should be considered. Reactive edema from the infected areas, allergies, mucosal hypertrophy, and other anatomic abnormalities can contribute to a blocked nose. An ENT specialist can determine the exact cause of your problem.

Treatment

In most of the mild cases, the treatment is limited to indications such as saline nasal rinses, antihistamines, nasal sprays, and decongestants. Obviously, these medications have no effect on the underlining condition. Nasal strips are another way of relieving the symptoms at nights. The surgical procedure utilized to correct the condition is called “septoplasty.” In this surgery, the cartilage is realigned. There may also be a need for some bone alterations. The surgery should be performed following complete growth of the nose, after age 15. There is also a more modern non-surgical procedure called “balloon septoplasty”, which is addressed for milder cases of septum deviation.

What is septoplasty?

Septoplasty is the short time (less than an hour) surgery of choice for a deviated septum which is on an outpatient basis. The procedure does not aim at esthetics and leaves no facial scar. Septoplasty can be induced under general anesthesia or local anesthesia. First, the surgeon peels the mucous membrane off your nasal septum. In the next stage, deleted portions of the septum (and sometimes bone) are removed or they may be reshaped and relocated to the new position. Surgeons utilize internal splints or the Kotler Nasal Airway procedure instead of packing the nose. You can leave the hospital, a few hours after the surgery. The recovery period lasts from a few days to a month. The bones never grow. In more complicated cases or where esthetic considerations are at stake, rhinoplasty is also performed. This procedure is called septorhinoplasty. In some cases of sinusitis, septoplasty and sinus surgery can both be performed simultaneously.

Complications of septoplasty

There may be only a mild swelling or bruising after the operation. In cases of septorhinoplasty, there will be some degree of swelling and bruising for about two weeks. Bleeding, infection, loss of the sense of smell are other possible complications. The reappearance of the symptoms after the surgery may be related to mucosal metaplasia of the nose, and not the deviation. The other rare complications include nasal septum perforation, septal hematoma, saddle nose, septal abscess, adhesions between the septum and lateral nasal wall, and dropped nasal tip.

Outcome

If you still have symptoms of a deviated septum continuous conventional medical treatments, you need to consider septoplasty to correct your problem. During this surgery, your deformed nasal septum is straightened and repositioned in the center. Typically, the symptoms will completely resolve. However, any related nasal or sinus conditions affecting your nose can not be treated with just septoplasty and need further medical care.