Deviated Nasal Septum

Background 

Septum is the thin wall between the nostrils made of cartilage and bone. When this cartilage and bone is off centre or crooked it is referred to as deviated nasal septum. A deviated septum may be present at birth, or may be caused during the growth of foetus or due to some injury to nose or face. 

Symptoms of Deviated Septum

A deviated septum might not cause any problem in some people however some people might experience following symptoms

  • Recurrent Sinus infections
  • Nosebleeds
  • Nasal congestion, usually one side.
  • Difficulty breathing through the nose
  • Sleep problems such as loud snoring or sleep apnea
  • Headache
  • Mouth breathing during sleep in adults
  • Frequent crusting or dry nose
  • Facial pain
  • Tendency to sleep on one side, often the side opposite to the blocked nasal. 

Causes of Deviated Septum

There are two main causes for not having a perfectly straight septum.

  • A person is born with a deviated septum or it can bend due to normal growth during childhood. 
  • Another cause is due to injury or trauma. 
  • It can also be developed in utero, when the foetus is in womb as well as during delivery of the baby. 
  • Injury related deviations may have dislocated or fractured portions of cartilage.

Diagnosis of Deviated Septum

The doctor will do the diagnosis mainly through physical examination.

Usually a bright light or an instrument is required to analyse the condition and if the deviated septum is found to be deep then it may be further evaluated using telescope or endoscope.

A Contrast enhanced computerised tomography (CT scan) might also be done to view the extent but this is very rare. 

Treatment of Deviated Septum

If the symptoms of deviated septum are not that severe then no particular treatment is needed. For mild cases, medical treatment is usually sufficient.

Symptoms such as stuffy nose may be alleviated with medications like decongestants or nasal sprays. In many cases medications are tried before surgery.

If the symptoms get severe such that they affect the regular lifestyle like sleep and breathing problem then surgery is being done. This surgery is namely Septoplasty, Sub mucous resection of the septum or Septal Reconstruction. 

Septoplasty is typically not performed on young children as the facial growth and development is still occurring. As the surgery is performed through nostrils there is no bruising or outward sign of surgery. 

The surgery usually requires one to two hours depending upon the type of deformity. It is done under general anaesthesia. Surgery may be combined with rhinoplasty that changes the outwards shape of the nose, in such a case swelling and bruising may occur. 

It may also be combined with sinus surgery.  

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