Usually, the nasal septum is straight, lying about in the middle of the two nostrils. Occasionally, it may be bent (deviated) because of a birth defect or injury, and positioned so that one nostril is much smaller than the other. Nasal septum deviation is a common physical disorder of the nose, involving a displacement of the nasal septum. Most people have some minor deviation of the septum so that one nostril is tighter than the other. A minor deviation usually causes no symptoms and requires no treatment.
However, if severe, a deviation may cause one or more of the following:
* Blockage of one or both nostrils
* Nasal congestion, sometimes one-sided
* Frequent nosebleeds
* Frequent sinus infections
* At times, facial pain, headaches, and postnasal drip
* Noisy breathing during sleep (in infants and young children)
In some cases, a person with a mildly deviated septum has symptoms only when he or she also has a "cold" (an upper respiratory tract infection). In these individuals, the respiratory infection triggers nasal inflammation that temporarily amplifies any mild airflow problems related to the deviated septum. Once the "cold" resolves, and the nasal inflammation subsides, symptoms of a deviated septum often resolve, too.
Deviated Septum
Patients with chronic sinusitis often have nasal congestion, and many have nasal septal deviations. However, for those with this debilitating condition, there may be additional reasons for the nasal airway obstruction. The problem may result from a septal deviation, reactive edema (swelling) from the infected areas, allergic problems, mucosal hypertrophy (increase in size), other anatomic abnormalities, or combinations thereof. A trained specialist in diagnosing and treating ear, nose, and throat disorders can determine the cause of your chronic sinusitis and nasal obstruction.
After discussing your symptoms, the primary care physician or specialist may inquire if you have ever incurred severe trauma to your nose or sinus areas and if you have had previous nasal or sinus surgery. Next, an examination of the general appearance of your nose will occur, including the position of your nasal septum. This will entail the use of a bright light and a nasal speculum (an instrument that gently spreads open your nostril) to inspect the inside surface of each nostril.
Surgery may be the recommended treatment if the deviated septum is causing troublesome nosebleeds or recurrent sinus infections. Additional testing may be required in some circumstances.
Septoplasty
Septoplasty is a surgical procedure performed entirely through the nostrils. No bruising or external signs occur. The surgery might be combined with a rhinoplasty, in which case the external appearance of the nose is altered and swelling/bruising of the face is evident. Septoplasty may also be combined with sinus surgery.
The time required for the operation averages about one to one and a half hours, depending on the deviation. It can be done with a local or a general anesthetic, and is usually done on an outpatient basis. After the surgery, nasal packing is inserted to prevent excessive postoperative bleeding. During the surgery, badly deviated portions of the septum may be removed entirely, or they may be readjusted and reinserted into the nose.
If a deviated nasal septum is the sole cause for your chronic sinusitis, relief from this severe disorder will be achieved.