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Deviated Nasal Septum: Symptoms, Causes And Treatment

The septum or the nasal septum is the wall between the right and left sides of your nose. The septum is firm but bendable and is covered by skin surrounded by a rich supply of blood vessels. In other words, the septum is the cartilage that separates the nostrils evenly. It is located at the centre and is in a straight line [1] . However, that is not the case in everyone as various people have an uneven septum. An uneven septum can cause one nostril to be larger than the other.

A deviated nasal septum or nasal septum deviation is termed as being a physical disorder affecting the nose. About 80 per cent of people have a deviated septum but are unaware of it. A normal unevenness does not affect one's health, however, severe unevenness can result in the development of health complications like breathing difficulties or a blocked nostril [2] , [3] .

Some people are born with a deviated septum, while others can develop it in the later years as a result of an injury or trauma [4] . A deviated septum can also be caused by injury to the nose during birth. Severe cases of a deviated septum can result in crusting or bleeding in certain individuals [4] .

Symptoms Of Deviated Nasal Septum

The signs that an individual has a deviated septum are as follows [5] , [6] :

  • Blockage of one or both nostrils
  • Nasal congestion, sometimes on one side
  • Frequent nosebleeds
  • Sinus infections
  • Facial pain
  • Headaches
  • Difficulty breathing, especially through the nose
  • Dryness in one nostril
  • Post-nasal drip
  • Whistling noise while inhaling or exhaling
  • Noisy breathing during sleep in infants and young children
  • In severe cases, sleep apnoea

When To See A Doctor

If you experience the following, go to a doctor immediately [7] .

  • Blocked nostrils that do not respond to basic treatment.
  • Constant sinus infections.
  • Frequent nosebleeds.

Causes Of Deviated Nasal Septum

A deviated septum can be congenital. In most cases, it occurs during foetal development and is apparent at birth [8] .

The other cause is an injury to the nose. One can develop a deviated septum as a result of an injury which results in the dislocation of the septum [9] . Trauma to the nose most commonly occurs during contact sports, automobile accidents, fighting etc.

The condition can get worse with age if left untreated [4] .

Complications Of Deviated Nasal Septum

The physical condition can result in the development of the following complications when left untreated [10] .

  • Disturbed sleep, due to the restricted and uncomfortable breathing through the nose at night.
  • Dry mouth, due to chronic mouth breathing.
  • Nosebleeds.
  • Only being able to sleep on one side.
  • Chronic sinus problem.
  • A feeling of congestion or pressure in your nasal passages.

Diagnosis Of Deviated Nasal Septum

In order to understand the severity of the condition, the doctor will begin by inquiring about the symptoms [11] .

After that, the doctor will examine the insides of your nose using a bright light or a nasal speculum; designed to spread open your nostrils. The doctor may also use a long tube-shaped scope with a bright light at the tip to check farther back in your nose. A decongestant spray will be applied before examining your nasal tissues. In most cases, you will not need any special tests. The doctor will examine your sleep, snoring, sinus problems, and if you have difficulty breathing [12] .

If the condition is causing nosebleeds, repeated sinus infections or other significant problems, the doctor will refer you to an otolaryngologist or a plastic surgeon for treatment [12] .

Treatment For Deviated Nasal Septum

Rather than directly going into the complex treatment methods, the doctor will prescribe medicines and means to manage the symptoms of the condition. This, in turn, can help treat nasal obstruction and drainage as well [13] , [14] .

Your doctor can prescribe you with decongestants, antihistamines and nasal steroid sprays. The decongestants can help reduce nasal tissue swelling and help keep the airways on both sides of your nose open. However, use it in a controlled manner as frequent use can create dependency and worsen the symptoms after you stop using them.

Antihistamines can help prevent allergy symptoms, including obstruction and runny nose. Some antihistamines cause drowsiness and can affect your ability to perform tasks such as driving [15] . Nasal steroid sprays can reduce inflammation in your nasal passage and help with obstruction or drainage. Nasal strips are also used to manage the symptoms [13] .

Surgery

If the symptoms do not improve with medication or other treatment attempts, your doctor may suggest a reconstructive surgery called septoplasty. The surgery is carried out with the intention of correcting your deviated septum [16] .

Before undergoing septoplasty, you will be required to stop taking medications such as aspirin or ibuprofen for two weeks before and after the surgery. You will be instructed to quit smoking as it can hinder with the healing process [16] .

The surgery takes about 90 minutes and is performed under anaesthesia. During the procedure, a surgeon cuts the septum and takes out excess cartilage or bone which is causing the deviation. Once the excess cartilage is removed, your septum and nasal passage will be straightened. Silicone splints may be inserted to support the septum [17] .

Even though it is an extremely safe procedure, some risks may develop after the surgery is done. And the risks pertaining to the surgery are as follows [18] :

  • Changing of nose shape
  • Temporary numbness in upper gums and teeth
  • Excessive bleeding
  • Incomplete correction with persistent nasal symptoms
  • Septal haematoma (mass of blood)
  • Decreased sense of smell
  • Nasal septum perforation
  • Scarring inside the nose and nose bleeding
  • Dropped nasal tip due to resection of the caudal margin

After the surgery is carried out, you will be required to take proper rest and follow the doctor's instructions during your recovery. Following are the steps to be taken into consideration while recovering from the surgery [19] , [20] .

  • Follow the prescribed medications.
  • Avoid bumping your septum.
  • Do not blow your nose.
  • Avoid doing strenuous exercise.
  • Keep your head elevated when sleeping.
  • Wear clothes that fasten in the front instead of pulling over your head.
View Article References
  1. [1] Gray, L. P. (1978). Deviated nasal septum incidence and etiology.Annals of Otology, Rhinology & Laryngology,87(3_suppl2), 3-20.
  2. [2] Heimer, D., Scharf, S. M., Lieberman, A., & Lavie, P. (1983). Sleep apnea syndrome treated by repair of deviated nasal septum.Chest,84(2), 184-185.
  3. [3] Stallman, J. S., Lobo, J. N., & Som, P. M. (2004). The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease.American Journal of Neuroradiology,25(9), 1613-1618.
  4. [4] Berger, G., Hammel, I., Berger, R., Avraham, S., & Ophir, D. (2000). Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum.The laryngoscope,110(12), 2100-2105.
  5. [5] Goldman, I. B. (1956). New technique in surgery of the deviated nasal septum.AMA archives of otolaryngology,64(3), 183-189.
  6. [6] Gray, L. (1965). The Deviated Nasal Septum—1—Ætiology.The Journal of Laryngology & Otology,79(7), 567-575.
  7. [7] van Egmond, M. M. H. T., Rovers, M. M., Tillema, A. H. J., & Heerbeek, N. V. (2018). Septoplasty for nasal obstruction due to a deviated nasal septum in adults: a systematic review.Rhinology,56(3), 195-208.
  8. [8] Rambabu, P., Rao, S. S. P., Prasad, T. L., & Chanakya, K. S. R. (2018). KEYWORDS Deviated Nasal Septum, Conventional Septoplasty, Endoscopic Septoplasty, Complications of Septoplasty.COMPARATIVE STUDY OF COMPLICATIONS IN ENDOSCOPIC SEPTOPLASTY VERSUS CONVENTIONAL SEPTOPLASTY, (97901).
  9. [9] Hb, S., Sanogo, H., Fane, S., Hd, B., & Bouare, M. (2016). Nasal Septoplasty in Mali.Online Journal of Otolaryngology,6(3).
  10. [10] Sharma, S. (2016). Importance of Treating Compensatory Hypertrophy of Inferior Turbinate in Cases of Septal Deviation Causing Nasal Obstruction.J Otolaryngol ENT Res,4(3), 00097.
  11. [11] Aziz, T., Ansari, K., Lagravere, M. O., Major, M. P., & Flores-Mir, C. (2015). Effect of non-surgical maxillary expansion on the nasal septum deviation: a systematic review.Progress in orthodontics,16(1), 15.
  12. [12] Patel, S., Dasgupta, K., Khan, M. I., & Bhagat, T. (2016). Evaluation of Eustachian Tube Function by Tympanometry in Patients of Deviated Nasal Septum and Sinonasal Polyposis.Journal of Rhinolaryngo-Otologies,4(1), 7-10.
  13. [13] Orhan, I., Ormeci, T., Bilal, N., Sagiroglu, S., & Doganer, A. (2019). Morphometric Analysis of Sphenoid Sinus in Patients With Nasal Septum Deviation.The Journal of craniofacial surgery.
  14. [14] Teixeira, J., Certal, V., Chang, E. T., & Camacho, M. (2016). Nasal septal deviations: a systematic review of classification systems.Plastic surgery international,2016.
  15. [15] Berkiten, G., Kumral, T. L., Saltürk, Z., Atar, Y., Yildirim, G., Uyar, Y., ... & Arslanoglu, A. (2016). Effect of deviated nasal septum type on nasal mucociliary clearance, olfactory function, quality of life, and efficiency of nasal surgery.Journal of Craniofacial Surgery,27(5), 1151-1155.
  16. [16] Baser, B., Patel, D. K., & Mishra, A. (2017). The Role of Extracorporeal Septoplasty in Severely Deviated Nasal Septum.Indian Journal of Otolaryngology and Head & Neck Surgery, 1-7.
  17. [17] Hong, Y. K., Jeun, S. S., Park, J. S., Kim, S. W., Cho, J. H., Park, Y. J., ... & Kim, S. W. (2018). Is Septoplasty Necessary When Using the Endoscopic Endonasal Transsphenoidal Approach for a Deviated Nasal Septum?.Journal of Neurological Surgery Part B: Skull Base,79(06), 569-573.
  18. [18] Rambabu, P., Rao, S. S. P., Prasad, T. L., & Chanakya, K. S. R. (2018). KEYWORDS Deviated Nasal Septum, Conventional Septoplasty, Endoscopic Septoplasty, Complications of Septoplasty.COMPARATIVE STUDY OF COMPLICATIONS IN ENDOSCOPIC SEPTOPLASTY VERSUS CONVENTIONAL SEPTOPLASTY, (97901).
  19. [19] Van Egmond, M. M. H. T., Rovers, M. M., Hendriks, C. T. M., & van Heerbeek, N. (2015). Effectiveness of septoplasty versus non-surgical management for nasal obstruction due to a deviated nasal septum in adults: study protocol for a randomized controlled trial.Trials,16(1), 500.
  20. [20] Lupa, M., Antunes, M., Becker, S. S., & Becker, D. G. (2019). Septoplasty. InAtlas of Endoscopic Sinus and Skull Base Surgery(pp. 3-10). Content Repository Only!.

Read more about: nose causes treatment
Story first published: Friday, April 26, 2019, 10:48 [IST]
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