A frequent medical problem known as a deviated nasal septum (DNS) occurs when the septum, the thin wall that separates the two nasal passageways, is moved to one side. Serious breathing problems, repeated sinus infections, and other problems that interfere with day-to-day functioning can result from this. Some people may have a small deviation with no obvious symptoms, while others may have long-term problems that call for medical attention. For individuals who are impacted, knowing the origins, signs, and available treatments for a deviated nasal septum is essential because, with the right diagnosis and care, it can greatly enhance their quality of life.
Anatomy of the Nasal Septum
- Structure: Bone and cartilage make up the nasal septum. The septum is composed of bone in the back and flexible cartilage in the front.
- Function: The main roles of the septum are to support the nose and control airflow. It allows for optimal airflow by splitting the nasal cavity into two nostrils.
Causes of Deviated Nasal Septum
- Congenital: Some people are born with a deviated septum due to anomalies in fetal development.
- Trauma: Injury to the nose, which can result from sports, accidents, or physical altercations, is a typical cause. Severe birth trauma might also result in septal deviation.
- Aging: As people age naturally, their nasal architecture may alter and result in deviations.
- Chronic Nasal Infections or Inflammation: These conditions can aggravate or cause a deviated septum.
Symptoms of Deviated Nasal Septum
- Nasal Obstruction: Breathing difficulties through one or both nostrils, particularly apparent when afflicted with allergies or a cold.
- Nosebleeds: Frequent nosebleeds can result from the septum’s surface becoming dry and damaged.
- Pain on the Side of the Face: Some persons feel pressure from the deviation on their face.
- Sinus Infections: Because of decreased drainage brought on by a deviated septum, sinus infections can occur often.
- Snoring or Sleep Apnea: Obstructive sleep apnea and snoring are two sleep disorders that can be brought on by or made worse by the condition.
Diagnosis
- Physical Examination: A medical professional may examine the interior of the nose with a nasal speculum.
- Nasal Endoscopy: To obtain a clearer picture of the septum, a small, camera-equipped tube called an endoscope may be put into the nose.
- Imaging Studies: To determine the degree of the deviation, imaging studies such as CT scans or X-rays may be utilized.
Complications
- Chronic Sinusitis: Chronic infections can result from a deviated septum, which obstructs sinus drainage.
- Sleep Disorders: It can aggravate or cause snoring and sleep apnea.
- Dry Mouth: Nasal obstruction that forces mouth breathing can cause dry mouth, which raises the risk of gum disease and other oral health problems.
Treatment Options
- Non-Surgical Treatments
- Medications:
- Decongestants: These aid in lowering nasal tissue edema, which facilitates breathing. Available as nasal sprays or oral versions, though nasal sprays are not recommended for extended use due to rebound congestion.
- Antihistamines: Helpful if allergies contribute to nasal congestion, also beneficial for symptoms like runny nose and sneezing.
- Nasal Corticosteroids: Sprays that reduce nasal passage inflammation, offering relief from DNS-related symptoms over time.
- Nasal Strips: Temporary relief from nasal blockage by keeping the nasal passages open during sleep.
- Humidifiers: Using a humidifier, particularly in the bedroom, helps reduce dryness and congestion in the nasal passages.
- Medications:
- Surgical Intervention: Septoplasty
- Indications: Recommended for severe symptoms like chronic nasal blockage, recurrent sinus infections, or complications such as nosebleeds and sleep disturbances that do not respond to conservative treatments.
- Procedure:
- Anesthesia: Generally performed under general anesthesia, though local anesthesia with sedation is an option.
- Surgical Technique: Involves an incision inside the nose to access and reshape the deviated portions of the septum, with stitches closing the incision and possibly using packing or splints for support during healing.
- Recovery:
- Immediate Postoperative Care: Most patients return home the same day; pain and swelling are common but manageable.
- Healing Time: Most return to normal activities within a week, though full recovery may take several weeks, with follow-up visits necessary.
- Risks and Complications: Potential risks include bleeding, infection, changes in nose shape, and, rarely, a septal hole.
- Turbinate Reduction
- Context: Often performed alongside septoplasty to reduce the size of turbinates that can further impede airflow.
- Procedure: Techniques include radiofrequency ablation, laser treatment, or surgical reduction, depending on the degree of turbinate hypertrophy and surgeon preference.
- Recovery: Similar discomfort and nasal congestion during initial recovery as with septoplasty.
- Alternative and Complementary Therapies
- Nasal Irrigation: Regular use of neti pots or saline nasal sprays helps clear nasal passages and reduce symptoms.
- Breathing Exercises: Targeting improved nasal breathing and reduced mouth breathing can provide relief for some individuals.
- Lifestyle Adjustments: Managing environmental factors, such as reducing allergen exposure and avoiding smoking, alongside staying hydrated, helps manage symptoms.
- Long-Term Management and Follow-Up
- Symptom Monitoring: Continued observation of symptoms and follow-up with a healthcare provider if they persist or worsen.
- Lifestyle Modifications: Ongoing nasal irrigation, allergy control, and avoiding nasal trauma are vital for long-term management.
- Revision Surgery: Occasionally, additional surgery may be required if initial treatment does not fully alleviate symptoms or complications arise.
When to See a Doctor
- Persistent Symptoms: Consultation with an otolaryngologist (ENT specialist) is recommended for persistent sinus infections, breathing difficulties, or nasal obstruction.
- Sleep Problems: Those experiencing symptoms of snoring or apnea should seek medical advice as DNS may be a contributing factor.
Conclusion
A deviated nasal septum is a common condition that can significantly impact quality of life. While many with mild deviations may not require treatment, those with more severe symptoms often benefit from surgical intervention. With appropriate care, the symptoms of DNS can be effectively managed, leading to improved breathing and overall well-being.
