The nasal septum is a structure that is located in the anterior part of the nose, its function is to separate the nostrils and give shape to the nasal pyramid. It is made up of a soft tissue called cartilage in its anterior part and a hard bone structure in its posterior and lower portion.

The septum is usually located in the midline, when it is displaced from its normal location it is called a deviated septum .

This can be verified by viewing the inside of the nostrils, a procedure called rhinoscopy. Imaging studies, such as radiographs in special projections and paranasal sinus tomography, allow better visualization of the septum in its entirety, being able to determine the impact on the normal flow of air through the compromised nostril.

Causes of a deviated nasal septum

The deviated septum is a condition that can have several causes:

  • Congenital Some people may have this problem from birth. The cause is found in trauma during fetal development or at the time of delivery.
  • The main cause of deviated septum is trauma, especially direct blows to the nose that can occur from punches or blunt objects, as well as blows due to trauma to the face during falls or accidents. Septum deviation is common in people who play contact sports.
  • Less frequently, chronic or recurrent infections that affect the lining of the nose can affect the septum causing it to drift.

Symptoms of a deviated septum

Nasal septum deviation can be present without causing any discomfort and be diagnosed as a finding on medical evaluation of the patient. This is common in cases of mild deviation and does not warrant treatment.

The more pronounced deviations affect the normal architecture of the nostrils, leading to a hole having a larger diameter than the other side. It is possible that the nose shows a curvature on its back, or even that the tip of the nose is deviated from the midline .

The severe deviations can cause obstruction of drain holes sinus. This, in addition to being an aesthetic problem, can give rise to symptoms that include:

  • One-sided nasal obstruction, corresponding to the smallest diameter nostril.
  • Nasal congestion.
  • Recurrent sinusitis in the same paranasal sinus.
  • Deformity of the nose.
  • Nasal bleeding due to dry mucosa.
  • Sleep disorders due to obstruction that is usually aggravated by lying on the side on which it is present.

Deviated septum treatment

Here are some of the most effective treatments for a deviated septum .

Treatment of symptoms

The nasal obstruction that accompanies the deviation of the nasal septum may merit the use of medications or natural remedies with decongestant effects, this allows to increase the diameter of the nostril and facilitate the drainage of secretions. This measure does not completely resolve the feeling of obstruction.

In the case of nasal bleeding associated with the dryness of the mucosa, it may be necessary to place solutions that keep the mucosa moist, this prevents the formation of cracks that cause new nosebleeds.

When complications such as sinusitis occur, it is necessary to indicate courses of antibiotics. Usually, sinus infection can occur on a recurring basis.

Definitive correction of the deviation

Definitive treatment of nasal septum deviation is carried out by surgery.

The surgery performed for this purpose is known as a septoplasty. It is a procedure that seeks to align the septum again. It is indicated in cases where the deviated nasal septum produces symptoms, has a very negative aesthetic impact, or is accompanied by complications such as recurrent sinusitis.

In cases of mild deviation of the septum, or when there are no bothersome symptoms, surgical treatment is not necessary .

Depending on the severity, it may be based on correcting the curvatures or removing part of the septum followed by repositioning the cartilage. Severe cases may warrant interventions on the bone portion of the septum.

This surgery can cause some discomfort in the postoperative period, mainly nasal obstruction and bleeding. These symptoms disappear completely after a few days. A complication of this procedure is perforation of the nasal septum.

The result of the surgery is the disappearance of the associated symptoms, especially nasal obstruction, as well as an improvement in the aesthetic appearance of the nose.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses. He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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