Deviated Septum

What divides the two nostrils of the nose is a cartilage known as the septum. When the condition known as deviated septum is in place, it means that the septum is off center enough to appear visibly crooked and/or make breathing difficult. Air conditions in New York City irritate a deviated septum even further. Conditions can arise causing snoring, sleep apnea or even sinus infections. A deviated nasal septum may be from birth, from normal aging, or as a result of trauma. Diagnosis of a deviated nasal septum is based on a complete history and examination of the nose.

nasal septum side view

Side View of Nasal Septum

A significant amount of people experience some type of imbalance in breathing passage size. One nostril is commonly larger than the other, and causes no troubles at all. Some estimates suggest that 80% of the U.S. population have some sort of misalignment. Only those which cause breathing issues will require treatment. Treatment should be sought after if breathing becomes hindered, especially in major cities like New York because higher levels of irritants could injure you further.

What are enlarged turbinates?

Turbinates are the large mucosal covered bony structures on either side of the nasal septum inside the nose. Enlarged turbinates, or turbinate hypertrophy, are caused by turbinate irritation or allergies and may grow to fill an area left by a deviated nasal septum. The swelling may be treated by nasal sprays or oral medication. Allergy testing may be needed to determine the triggers that contribute to the nasal congestion, so they can be avoided or treated.

deviated septum surgery catscan

Nasal Obstruction Catscan

Causes of a Deviated Septum

A deviated septum can be caused by compression of the nasal area during childbirth. It also has a significant appearance as a normal family trait or with genetic conditions such as Ehler-Danlos syndrome, Homocystinuria and Marfan syndrome. However, most often it is caused by a blunt impact injury to the nose area of the face.

Symptoms of a Deviated Septum

Symptoms of a deviated septum almost always include nasal congestion. This nasal congestion is typically chronic and manifests itself more on one side than the other. Another symptom is difficulty breathing. Frequent unexplained nosebleeds, facial pain in the area of the nose, headaches and postnasal drip are other common symptoms.

Another condition, brought on by a deviated septum, is loud breathing and snoring during sleep. When left untreated, this can lead to Sleep Apnea.

Sleep apnea is a very serious condition which results in the patient ceasing to breath while sleeping. The type of sleep apnea caused by this is known as obstructive (OSA), but no matter the type, the patient is rarely aware that he has the condition, even after waking. The condition will exist for years, even decades without diagnosis. Sleep apnea caused by a deviated septum may result in daytime sleepiness, fatigue and mild depression.

what is sinus surgery side by side

Deviated Septum After Surgery

Deviated Septum Surgery

To straighten the nasal septum, a corrective surgical procedure called a Septoplasty is performed. Septoplasty may be indicated when medication and other treatments have failed. The purpose of the procedure is to allow easier breathing, decrease snoring, or improve sinus function. Dr. Bennett works through the nostrils to straighten the twisted cartilage and bone. The surgery is normally setup as an outpatient procedure. Most of these surgeries are less than sixty minutes in length and general anesthesia is usually required. You generally go home about an hour after surgery. Dr. Bennett rarely finds it necessary to pack the nose.

If there are cosmetic deformities of the nose, the surgery may be combined with rhinoplasty — a procedure then called a septorhinoplasty.

The deviated portion of the septum is removed leaving a straighter and better functioning nasal cavity. If a full septorhinoplasty is conducted, a week or two of swelling and bruising afterward is normal. If just the septoplasty was performed there will be little or no swelling on the outside of the nose.

Turbinate surgery, or turbinoplasty, may be necessary when medication and allergy avoidance do not improve breathing. The turbinate size is reduced by repositioning the enlarged bone laterally and shrinking the mucosa. Breathing is usually better than before surgery at 1 week and can improve over the next year or more. Turbinoplasty and septoplasty can be combined with sinus surgery as well as with rhinoplasty (nasal reshaping surgery).

Some very rare conditions include:

  1. Nasal septum perforation.
  2. Septal haematoma and septal abscess.
  3. Adhesions and synachiae.
  4. Saddle nose.
  5. Dropped nasal tip.

References

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