Reasons of Nasal Septum Deviation

The deviation of the nasal septum may be present at birth (infants may be born with deviation of the nasal septum due to the curvature of the septum during fetal development in the womb) or may occur as a result of trauma in childhood or adulthood during birth, falls, crashes, sports injuries, traffic accidents) or can also be caused by a deviation that is mild during normal aging.

What are the complaints of nasal septum deviation?

Some of the septum deviations (without serious curvature, not block the nasal air passage) do not cause any complaint, and the person is not even aware of the septum deviation. However, the most frequent complaint of patients with severe curvature of the septum deviation is difficulty breathing through the nose.  This can be unilateral or double-sided or sometimes right or sometimes left-sided blockage. When patients with slight deviation experience an upper respiratory tract infection (URTI), their symptoms become intensified and they experience more nasal blockage than those without deviation. In addition, URTI increase nasal blockage even more in people with nasal allergy and nasal blockage due to allergies. In addition to nasal blockage, septum deviation causes problems such as open mouth sleep, dry throat, recurrent pharyngitis and sinusitis, more severe and long-lasting infection, sometimes pain in the face, headache, post-nasal drip, snoring, poor sleep (tired waking), sound breathing in the sleep, bad breath. In summary, deviation of the nasal septum, which requires treatment, leads to poor quality of life and work performance in humans and health problems.

Diagnosis

After Otolaryngology and Head-Neck Surgery Specialist listens to your complaints and receives the necessary information from you, he examines your nose with the help of instruments and light which makes it easy to see the inside of the nose. This examination provides information about the structure of the nasal septum, the degree of curvature, and the condition of your nasal polyp and nasal mucosa. Endoscopy instruments and camera system are used to examine the structures of the nasal tunnel and the sidewall and conchas in more detail. These procedures are part of routine nasal examination and are comfortable, short-term and painless. Another important issue to keep in mind when examining is nasal valve problems. Nasal valve problems are present in about 15-20% of patients who have problems breathing through the nose, and often are escaped from the attention during examination. Even when patients who still have problems despite the septoplasty are examined, there are mostly nasal valve problems in addition to deviation.  If the anatomical structure of the nose valve and the sidewall is developed to narrow the nose tunnel and the nasal wings collapse during breathing, there is nasal valve narrowness. When the nose wing is pulled out and stretched or manoeuvres supporting the tip of the nose (nasal side wall is removed from the septum) are performed, the patient expresses that she/he can breathe easily.

Treatment

Firstly medical examination with decongestant, nasal steroid sprays, and antihistamines is recommended if your nose blockage is accompanied by allergy in addition to a slight deviation, nasal polyp growth (concha hypertrophy) or polyps after examination. Surgical intervention should always be the last option. Surgery is recommended if there is no response from the treatment, or if your complaint concludes that your symptoms are due to septum deviation after the first examination. The treatment of septum deviation is surgical and there is no treatment with medication.  Septoplasty is performed as a surgical procedure.

Septoplasty is a surgery performed under general anaesthesia (closed), lasting for approximately 30-40 minutes, in which the curved cartilage and bones in the nose are permanently corrected. In addition to the deviation of the septum, there is usually growth (lower concha hypertrophy) in the nasal polyps, called concha, on the sidewall of the nose and it is also intervened in the same operation. If there is nasal valve narrowness (nose valve narrowness, collapse of the nose wings), surgical procedures for nasal sidewall support are performed at the same time.  If there are diseases such as chronic sinusitis and nasal polyps, endoscopic sinus surgery is performed during the same operation and all necessary interventions for nasal health are performed in the same session.

If the procedure performed in septoplasty is simple, no tampon is used. If more complex procedures are performed, silicones tubes are used that support the middle section and allow you to breathe for several days. These silicones, which serve as post-operative tampons, are comfortable for the patient and do not cause pain when taken.  There are no complaints such as pain, swelling, bruising under the eyes in postoperative and patients are sent home at that they if they want.

Patients are invited to control in the 2nd-3rd day in general and medical dressing of intranasal is made. If there is a tamp, it is removed and patients can return to normal life in about 5 days, after about 2 weeks they can do sports.