Nasal septum deviation is a physical disorder of the nose, involving a displacement of the nasal septum. Some displacement is common, affecting 80% of people, mostly without their knowledge. A deviated septum is an abnormal condition in which the top of the cartilaginous ridge leans to the left or the right, causing obstruction of the affected nasal passage.
It is common for nasal septa to depart from the exact centerline; the septum is only considered deviated if the shift is substantial or causes problems. By itself, a deviated septum can go undetected for years and thus be without any need for correction. and possibly headaches. Only more severe cases of a deviated septum will cause symptoms of difficulty breathing and require treatment.
Causes
A deviated septum is most frequently caused by unequal growth of the septum, causing it to lean more to one side than the other. It can also be a congenital disorder, in which the septum is unequal at birth. This can get worse with age as the septum continues to grow. A deviated septum can also be caused by impact trauma, such as by a blow to the face during contact sports or a car accident. Injuries such as a broken nose can also contribute to septal deviation, but is does not always accompany a septum injury. Deviated septum is associated with genetic connective tissue disorders such as Marfan syndrome, homocystinuria and Ehlers–Danlos syndrome.
Diagnosis
Nasal septum deviation is the most common cause of nasal obstruction. A history of trauma to the nose is often present including trauma from the process of birth or microfractures.
Treatment
Medical therapy with nasal sprays including decongestants, antihistamines, or nasal corticosteroid sprays is typically tried first before considering a surgical approach to correct nasal septum deviation. and temporary swelling of this mucosa can exaggerate the apparent severity of septal deviation. Such edema may result from allergic rhinitis, upper respiratory tract infections, chronic rhinitis, or acute sinusitis. Addressing these conditions and conducting nasal endoscopic examinations at different times can help in assessing the actual structural deviation more accurately.
A minor surgical procedure known as septoplasty can cure symptoms related to septal deviations. The surgery lasts roughly one hour and does not result in any cosmetic alteration or external scars. Nasal congestion, pain, drainage or swelling may occur within the first few days after the surgery. Recovery from the procedure may take anywhere from two days to four weeks to heal completely. Septal bones never regrow. If symptoms reappear they are not related to deviations. Reappearance of symptoms may be due to mucosal metaplasia of the nose. There are times also when the surgery also may be unsuccessful, leading to a continuation of the symptoms.
A randomised controlled trial found that people who had septoplasty had a greater improvement in their symptoms and quality of life after 6 months than people who managed their nasal airway obstruction with nasal sprays.
Complications of septoplasty
- Adhesions and synechiae between septal mucosa and lateral nasal wall
- Dropped nasal tip due to resection of the caudal margin
- External nasal deformity
- Ashley Tisdale
- Josh Hutcherson
- Cameron Diaz
- Ed Miliband
See also
- Nasal septum perforation