Surgery to deviate the nasal septum in children. Deviated septum in a child

The nasal septum is a plate that performs a separating function, dividing the nasal cavity into passages: right and left. It consists of bone and cartilage tissue, covered with a mucous membrane. Quite often there is such a problem as the curvature of the nasal septum. In the article, we will consider how to identify and treat this pathology in children. The opinions of doctors on the advisability of surgery for deviated septum of the nose will be of interest to parents of children with a similar problem.

What causes a deviated septum in children?

Causes of deviated septum in children:

• Physiological . These causes of septal curvature are associated with deviations in the growth of the bones of the skull or congenital anomalies.
• Compensatory. The presence of pathological formations in the nasal cavity, such as hypertrophy of the nasal concha or tumors and mucosal polyps, lead to a violation of the respiratory function, which compensates for the nasal septum due to deformation and displacement.
• traumatic. Various injuries, especially fractures, are the most common cause of a deviated septum. It can be both, and lifetime.

Specialists distinguish 3 types of pathology of the nasal septum: ridge, spike, curvature . According to the type of deformation, the curvature of the nasal septum can be:

• C-shaped;
• S-shaped;
• curvature relative to the crest of the upper jaw;
• combined types of deformations.

If the curvature of the nasal septum is insignificant, then otolaryngologists do not consider this phenomenon as a pathology. It is somewhat difficult to identify the curvature of the nasal septum in a child at an early age, since the facial bones are still being formed. Most often the diagnosis of "deviation of the nasal septum" is made at the age of over 12 years, when the facial bones of the skull are almost fully formed.

How to detect a deviated septum in a child?

A deviated septum can cause a child to:

• Labored breathing.
• Nosebleeds.
• Snoring and noisy breathing.
• Frequent colds.
• Asymmetric nasal congestion.
• Violation of the shape of the nose.

Diagnosis of this pathology includes:

• An examination by an ENT doctor who will conduct a visual examination and rhinoscopy.
• Additional surveys. Sometimes a doctor to clarify the diagnosis can refer the child to an X-ray examination of the skull, magnetic resonance and computed tomography of the head. These studies are conducted for children strictly according to indications.

What methods are used to treat a deviated septum in children?

1. Surgical intervention. The procedure for straightening the septum is called septoplasty and is performed after the full formation of the bones of the skull, that is, at the age of 16 years and older. In exceptional cases, it is permissible to perform this operation in children older than 6 years. Modern methods of nasal septum correction include laser procedure. , during which the laser reduces the volume of cartilaginous tissues and straightens the septum. This method has established itself as the least traumatic method with a quick postoperative recovery period and minimal undesirable consequences.
2. Drug therapy . In childhood, this pathology is corrected with the help of the following medicines aimed at improving respiratory function:

• glucocorticosteroids used to eliminate allergic rhinitis;
• antibacterial drugs used to prevent bacterial infections;
• mucolytics used to facilitate the removal of excess mucus;
• moisturizing sprays ;
• vasoconstrictor drugs used to reduce mucosal edema with.

In order to facilitate breathing and the general condition of the child, it is necessary to monitor the climatic conditions in the room. The air should be moist and cool. It is also undesirable for the child to catch a cold, as this will aggravate the respiratory function, which is already difficult.

Opinions of specialists on the methods of treatment of a deviated nasal septum

ENT surgeon of the International Clinic MEDEM I.A. Tikhomirov:

I must say that there are a lot of myths around the topic of the curvature of the nasal septum. To begin with, there are no direct partitions. Everyone has this or that curvature, there is one or another crest of the septum. They operate only in the case when the function of nasal breathing is impaired. For example, a huge ridge on the septum, but it does not interfere with nasal breathing - nothing needs to be done. Or vice versa, a small but significant ridge (or curvature) that covers a narrow opening leading to the maxillary sinus. Such a person suffers from sinusitis all the time - of course, this needs to be corrected. Another thing to consider is that the nasal septum grows throughout life. It consists of several parts, and different parts grow at different rates, so with age, the problems associated with its curvature may be more pronounced.
And finally, often difficult nasal breathing is not due to the fact that the nasal septum is curved. The fact is that a large contribution to the difficulty of nasal breathing is made by hypertrophy of the nasal conchas, when the tissues of the lower nasal conchas grow, the breathing lumen narrows and poor nasal breathing occurs. The man goes to the ENT, and he says that it's a crooked nasal septum. It is corrected, but the nose still does not begin to breathe. There are many such situations. And in this case, the excess part of the tissue can be removed with a laser. This can also be done under local anesthesia on an outpatient basis. The correction of the nasal septum must be approached very strictly: from the point of view of preserving the function (breathing or not breathing the nose), weighing the benefit-risk ratio and taking into account the age of the patient.

Otolaryngologist, PhD N.V. Bozhko:

With regard to surgical intervention for an uneven septum (septoplasty), there are some limitations. So, up to 18 (and according to some authors - up to 20-25 years), they try not to perform septoplasty. This is due to the ongoing growth of bone and cartilage tissue, and sometimes it is impossible to predict how the operated septum will behave. However, with gross deformities of the septum, septoplasty can be recommended at any age. As far as this intervention is shown to your child, only the doctor can answer after a direct examination.

The nasal cavity is internally divided by a relatively flexible cartilaginous septum covered with mucous tissue. Normally, the structure of the nose is symmetrical, the septum has a straight shape without bends to the side. For various reasons, the shape of the septum may be far from ideal, deviating in one direction or another, up to the complete blocking of the nasal passage on one side. The shape of the curvature can be "C" or "S"-shaped or have a more complex character. Deformation in this case can affect not only the cartilage, but also the bones of the face.

Often invisible from the outside, a deviated nasal septum can cause unwanted symptoms in both adults and children. Depending on the severity of the pathology, babies may experience:

1. Labored breathing through the nose due to narrowing or blockage of the nasal passage

• Lack of oxygen leads to headaches, excessive fatigue, cognitive decline
• Heart problems due to disruption of the nasal breathing process
• In severe cases, oxygen deficiency due to an impaired breathing process leads to delays in the mental and physical health of the child.

2. In children, the pathology of the nasal septum, not detected in time, in some cases during the period of active growth provokes asymmetric development of facial structures-both bones and muscles

3. Regular secretion of mucus in a child from the nose (vasomotor rhinitis caused by disruption of the blood vessels of the nose). Vasomotor rhinitis in a child is easy to confuse with other pathological conditions, as it looks like a common allergic or catarrhal rhinitis.

4. Chronic inflammation in the ear

5. Frequent nosebleeds

Reasons why the nasal septum in a child may be curved

The pathology of the formation of the bone tissue of the nose in the prenatal period provokes a septal defect already in a newborn child. Also, in some cases, the pressure exerted on the facial bones of an infant during the passage of the birth canal leads to deformation of the soft cartilage.

Changing the shape of the septum in the nose of a child is not always congenital. Sometimes the defect is acquired and can occur in the following cases:

• With mechanical damage to the nose from a blow or fall, the cartilage of the septum can not only change shape, but also break. Incorrect cartilage fusion in this case not only makes nasal breathing difficult, but also complicates the correction of the natural shape of the septum.
• If there are neoplasms (tumors, polyps) that were not detected and removed in time in the nasal cavity, the septum may begin to strive to take a shape in which the pressure on the surrounding tissues becomes minimal.
• The uneven rate of growth of nasal tissue during adolescence often leads to asymmetry of the septum.

Treatment of deviated septum in children

Correction of a deviated septum in both children and adults is performed surgically, mainly under local anesthesia. The operation aimed at correcting the shape of the septum in the nose of a child is called septoplasty.

External incisions for the implementation of the operation, as a rule, are not required and therefore there are no scars after the surgical intervention.

Content

A person who fights endlessly with rhinitis, suffers from colds or flu several times a year, suffers from insomnia and loss of smell, may not realize that the problem is not only in the immune system and nervous system. Deviated septum is a diagnosis that is rarely made, but is present in the majority, although urgent correction is required mainly in severe forms: a spike, a ridge. Is treatment possible without surgery and why is this problem dangerous?

What is a deviated septum

The central even thin plate that divides the air flow into equal parts, due to which it is processed and delivered harmoniously, is the nasal septum, consisting of cartilage and bone tissue. If the air begins to pass unevenly, the doctor may say that there is a displacement of the nasal septum (its cartilaginous sections), or its deformation in the form of a spike or ridge in the bone area. Curvature occurs in 95% of people, but with varying degrees of severity, so you may not know about it until the end of your life.

Symptoms

A deviated nasal septum can make itself felt both externally and through internal changes in the body. If there has been a deformation of the cartilaginous tissues close to the front, or at the top of the bridge of the nose (bone section), it will be visible due to the loss of symmetry of the nose. The internal curvature is mainly expressed in:

• frequent nosebleeds, provoked by thinning of the mucous membranes in the narrowed nostril;
• difficulties with nasal breathing (feeling that air is not coming in at all);
• snoring if a person sleeps on their back;
• frequent overwork (due to hypoxia due to difficulty in nasal breathing);
• a decrease in immunity, which entails acute respiratory infections, influenza, and other diseases that are difficult to tolerate;
• chronic diseases of the ENT organs (mostly doctors focus on the appearance of chronic rhinitis in patients with a deviated septum).

Why is a deviated septum dangerous?

If timely and complete air purification does not occur, sufficient oxygen does not enter the blood and brain, immunity and brain activity gradually decrease, and blood vessels suffer. Following the curvature of the septum entails inflammation of the mucosa and chronic hypoxia, which can give rise to constant headaches, and can cause male impotence.

Symptoms of the disease gradually develop into chronic disorders, and the result is:

• polyps of the nasal cavity;
• problems with olfactory function;
• hearing impairment;
• occurrence of allergic rhinitis.

Types of curvature

There are 2 classifications of deformation of the nasal septum - according to the prerequisites for its appearance and according to the type that the plate takes. Curvature of the anterior opener is predominantly observed, and even if there is a defect in the posterior opener, its edge remains even. The most commonly used classification of septal curvature by doctors is as follows:

• Thorn- the appearance of a process of bone tissue, can be unilateral or bilateral. Depending on the length and direction, it can provoke irritation of the mucous membrane of the opposite wall, injure it.
• Crest- local thickening of the nasal septum at the site of the bend, associated with its deformation, can also injure the membrane of the nasal cavity, going into it.
• Classical curvature of the nasal plate- C-shaped deformation, in which a slight deflection appears mainly in the central part. Such minor curvatures are very common, but not always a person knows about their existence, since they may not manifest themselves in any way.
• Combination of all 3 types- the most difficult variant of the curvature, since it is already guilty not only of breathing difficulties, but often of its complete absence (if the deformity is bilateral, there is a displacement of the anterior and middle sections).

Causes of deviated septum

Doctors subdivide the entire list of prerequisites for deformity of the nasal septum into 3 categories:

• traumatic. Due to blows to the facial zone of the skull, this cause is mainly found in males. Even with minor injuries, the curvature of the nose is not excluded if the fusion of broken bones and cartilage tissue did not occur correctly.
• Compensatory. They are the result of pathologies of the nasal cavities, including polyps, tumors, and even permanent rhinitis, due to which a person, imperceptibly, due to the obstruction of one of the nasal passages, learns to breathe only free and thereby provokes a curvature of the septum. Separately, compensatory hypertrophy is distinguished, in which one of the turbinates, due to its increased size, presses on the septum and can displace it. In compensatory curvature, the cause and effect often change: even a doctor cannot always tell what arose earlier - deformation of the plate or breathing problems due to an increase in bone formations that divide the nasal cavity into zones.
• Physiological. Associated with the congenital features of the structure of the skull - mainly the uneven development of its bones. In rare cases, there is such a physiological curvature of the septum as the development of a rudiment behind the zone of smell, pressing on the nasal dividing plate. This deviation is rare.

The child has

The nasal septum in children under 10 years of age is predominantly a cartilaginous plate: more flexible than bone, and more vulnerable. Doctors mention cartilage fractures in children more often than in adults, and this often causes septal deformity. If time does not attach importance to the violation of proper breathing after an injury, the plate will stiffen over time (when the child gets older), and the curvature will no longer be as easy to straighten as in childhood.

However, there are several more prerequisites for this problem in babies:

• birth trauma;
• uneven growth of the bones of the skull (minor curvature, eliminated independently);
• cartilage inflammation.

Diagnostics

An attempt to confirm or refute the diagnosis of "deviated septum" begins with an examination of the patient by an otolaryngologist, who first evaluates the appearance of the facial part of the nose. With serious deformations of the nasal septum, they will be visible already at this stage. After the breath of each nostril is checked separately, the results are correlated: if there is no curvature of the nasal septum, the force of inhalation and exhalation is the same for the left and right parts. The last one is the smell test.

If suspicions that the nasal septum is curved are getting stronger, the doctor may prescribe:

• Rhinoscopy- consists in examining the nasal cavity (left and right) using a special tool that expands the nostrils. Next, a thin probe is inserted into the lumen to probe the mucosa, evaluate neoplasms (if any): these are polyps, tumors, abscesses. Additionally, hypertrophy of the posterior ends of the turbinates can be detected when examining the curvature through the oral cavity.
• endoscopy- a more informative examination, which should be performed with local anesthesia of the nasal mucosa. The assessment of her condition is carried out through a probe with a "video camera". Thanks to the endoscopic method, the lower shell is clearly visible, where mucus accumulates.
• skull x-ray- a picture is needed to say if there are formations in the paranasal sinuses, to confirm or refute the presence of traumatic deformity, congenital bone anomalies of the skull, which could provoke a curvature.
• Computed tomography- helps to examine in detail the back of the nasal cavity, to determine the presence or absence of spikes and ridges on the septum.

Treatment

A crooked nasal septum is an anatomical problem, so it is impossible to align the plate medically. If, during its deformities, respiratory and hearing disorders are noted, a disorder of smell develops, the middle shell is additionally enlarged, or hypertrophy of the lower one is observed, we will definitely talk about surgical interventions, mainly traditional ones - septoplasty or endoscopic surgery. In rare cases, a deviated septum can be corrected with a laser.

Treatment without surgery

Conservative therapy can be aimed at eliminating the chronic inflammatory process, polyps, adenoids (a consequence of the curvature of the septum), helping to alleviate the condition in allergic diseases, restoring breathing and strengthening the immune system. However, correction of the curved septum is impossible, so the effectiveness of such treatment by doctors is questioned. Mostly experts can advise:

• removal of adenoids, polyps;
• osteopathy (manual therapy);
• a long course of drugs to eliminate puffiness.

Operation

The doctor may recommend surgical correction of the curvature in case of serious abnormalities in the development of the cranial bones, which provoke a large number of complications: among them are hypertrophy of the conchas, persistent sinusitis, and the inability to breathe in a narrowed nostril. Surgical intervention is performed only in persons over 16 years of age (exceptions are possible). Resection of the nasal concha can be performed with an endoscope, which is less painful. In case of severe injuries, rhinoplasty is performed simultaneously with the classical surgical intervention.

Laser chondroseptoplasty

Classical septoplasty is performed only in case of severe forms of curvature, and for minor deformities, the doctor may suggest laser treatment. This method is used only if it is necessary to align the cartilage tissue - the laser will not perform resection of the spines and correct the bending of the bone tissue, nor will it help with traumatic curvature. According to reviews, the procedure is painless, but it is not recommended for children and the elderly.

Rehabilitation after surgery

If it was necessary to perform a surgical correction of a deviated nasal plate, after it, tampons are inserted into the patient's nostrils, and silicone retainers are required. The next day they are removed, if there is no heavy bleeding, the patient returns home, but he may stay in the hospital for 4 days. However, completely normal breathing is restored only 3 weeks after the septum is straightened. During rehabilitation you need:

• during the first week, daily clean the nasal passages at the ENT doctor to remove crusts, prevent the appearance of pathogenic microorganisms;
• do breathing exercises that will prevent adhesions from forming;
• use wound healing agents for external use (they must be prescribed by a doctor).

Possible complications after surgery

Doing septoplasty, according to doctors, is relatively safe (even from an aesthetic point of view - photos of people who have undergone it prove that there are no scars): blood loss is minimal, traumatization too. However, any operation is accompanied by risk, therefore, after septoplasty, they can:

• abscesses, hematomas form;
• appear prolonged nosebleeds in the rehabilitation period;
• observed fusion of cavities, narrowing of the lower course;
• develop purulent sinusitis, perichondritis.

Treatment at home

If the nasal septum is not so curved that the doctor insists on an operation (resection of the ridges, removal of spikes, correction of the consequences of a fracture is not required), but causes problems, you can do procedures on your own that make breathing easier, expel mucus, but this will only relieve symptoms. Home therapy may include:

• Corticosteroids.
• Silver preparations.
• Antiseptics.
• Compositions for washing the nasal passages (combating a common symptom of a crooked septum - rhinitis).

Prevention

You can protect yourself from deformation of the central nose plate only if it is initially even, or the curvature is slight. For this it is recommended:

• avoid activities that are accompanied by fractures of the skull bones (traumatic sports, etc.);
• prevent ENT diseases from developing to polyps and adenoids;
• strengthen immunity.

Video

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

Discuss

What is dangerous deviated septum of the nose, causes, treatment and rehabilitation

The nasal septum divides the nasal cavity into two symmetrical parts. Newborn babies have a flat and straight plate. Its structure is completely cartilaginous tissue, on which there are minor ossifications. With the growth of the body, the bone foci pass into the bones, fuse into one bone. This process of formation ends by the age of 10.

For an adult, the following structure is characteristic: the anterior part of the plate is cartilaginous tissue, and the posterior part is a thin bone. Both sides are lined with mucous membrane. But an even partition is extremely rare. Most often, it is curved, and this can happen for various reasons.

Causes in adults

Before prescribing treatment, the doctor is obliged to conduct an external examination of the patient, as well as to determine the fundamental factor that caused the pathology. Today these reasons are varied.

In the photo - curvature of the nasal septum in adults

Physiological

These causes are interrelated with the growth of the bones of the skull or birth defects. The most common include:

1. The bone of the brain and facial parts of the skull grew unevenly. With the active development of the brain section, the nasal cavity narrowed, resulting in a curvature of the plate.
2. Uneven development of bone and cartilage tissue of the nasal septum. This suggests that the bone tissue was actively growing, while the nasal plate, consisting of cartilaginous tissue, yielded to deformation.
3. Enhanced growth of Jacobson's rudimentary organ. It is concentrated in the olfactory part of the nose. Presented as an accumulation of nervous tissue. If it grows actively, then this is a direct path to a limited space for the normal formation of the nasal plate and, as a result, to its curvature.

On the video, the causes of the curvature of the nasal septum:

Compensatory

These reasons for the development of pathology are due to the fact that various formations are formed in the nasal cavity, which include:

1. Hypertrophy. There is an enhanced formation of one and nasal conchas. As a result, the enlarged shell presses on the plate, causing its deformation.

   In the photo - nasal hypertrophy

2. The presence of polyps and tumors on the nasal mucosa. If the neoplasms expand greatly, then they obscure one of the nostrils. Thus, nasal breathing is disturbed, and the plate itself is deformed, as it tries to eliminate this condition.

traumatic

These causes depend on the injuries that led to the displacement of the nasal bone and the curvature of the plate. Most often, pathology is diagnosed in boys in adolescence and men. This is the category of people in whom skull and face injuries are most common.. Due to a strong blow, a displacement of the bones of the nose is observed.

This leads to deformation of the nose plate, and it can occur even if the blow was not too strong. Incorrect fusion of the bones of the nose after a fracture can affect the development of the most severe deformities.

What influences the development of deformity in children

Difficulty inhaling air through the nose is a problem that is often diagnosed in infants. Since the baby has not yet learned to breathe through his mouth, there is a violation of the feeding process, and at night he sleeps very badly.

Many parents associate nasal congestion in their child with dry air in the room, frequent colds and air pollution. Of course, these factors have their effect when the baby inhales air through the nose. But they are temporary.

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But when nasal congestion is observed for a long period of time, then most often it is associated with this pathology, like a deviated septum.

As mentioned earlier, this is a plate that consists of cartilage and thin bone. She will divide the nose into 2 parts. Only in children, this plate is more elastic and soft, making it susceptible to injury and injury. And, as you know, children love active games, as a result of which blows or falls on the face occur.

On the video, what affects the development of nasal septal deformity in children:

The nasal septum begins to develop completely by the age of 10 years. If there is a slight deformation, then this is the norm. At the same time, the child fully breathes through the nose and does not feel any pronounced symptoms.

The following factors can influence the development of pathology in children:

• trauma during childbirth;
• uneven development of the bones of the skull due to the rapid formation of the cartilaginous tissue of the nasal cavity;
• the presence of a polyp or other neoplasm that grows in the nose and presses on the plate;
• inflammation, which leads to a thickening of the nasal plate in the cartilage zone;
• curvature of the nose after injury - a fracture.

An uneven septum can be detected in a child at any age, so age is not a hindrance here. It all depends on the severity of the symptoms. A baby can live normally throughout childhood with an uneven septum without visible symptoms. But already, as an adult, the clinical picture becomes more pronounced.

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Degrees

There are several classifications of septal curvature, among which the type of pathology is distinguished according to the nature of its severity. Thus, the curvature of the plate can be 1, 2 or 3 degrees. For the first degree, the deformation from the conditional line of the middle of the nose is insignificant. In the second degree, the protruding plate occupies half the distance from the midline to the lateral surface of the nasal cavity. But the third degree involves almost touching the edge of the septum on the side of the nasal cavity.

On the video degree of curvature of the nasal septum:

If a patient is diagnosed with a pathology of the 1st degree, then special treatment is not necessary here. This condition occurs in most people. But already a deformation of 2 or 3 degrees requires therapy, as they are characterized by severe symptoms and complications. Moreover, it is not worth delaying the treatment, because this can lead to the fact that neighboring organs will be involved in the pathological process.

A variety of reasons can influence the development of a curvature of the septum. But among the most common are trauma or a birth defect. In any case, it is necessary to see a doctor so that he can assess the extent of the pathology. If during the diagnosis it was found that a deviated septum does not prevent a person from working and living fully, then no steps will be taken towards treatment.

Deviated septum is a common pathology. Different degrees of deviation of the septum from the median position can lead to various complications. Operations to correct the crooked septum of the nose make up a significant part of surgical interventions in ENT hospitals and really help get rid of many problems.

Nasal septum

The nasal septum is a plate of cartilage and bones that divides the nose into two halves. In the anterior part, the septum is represented by a quadrangular cartilage, and in the back by a vomer and a perpendicular plate of the ethmoid bone. The nasal septum is, as it were, inserted into the frame of the frontal bones at the top, the hard palate at the bottom, and the sphenoid and ethmoid bones at the back.

Actually, such a multicomponent structure is most often a prerequisite for its curvature, since there is an uneven growth of various parts of the septum and bones that form the "frame" into which the septum is inserted.

The nasal septum is needed for uniform distribution of air flows. The division of the air flow into two parts is necessary for its fastest warming, humidification and purification.

Causes of deviated septum

A deviated septum is present to a greater or lesser extent in 90% of people. However, for the most part, it goes unnoticed and does not cause any inconvenience.

Causes of the formation of curvature of the nasal septum:

Curvature forms

Deformities of the nasal septum are divided into several types:

• Offset to one side or the other from the middle position. The bowing of the nasal plate can be S-shaped or C-shaped, in different planes.

• Spikes - pointed protrusions of the bony part of the septum.
• Crests are elongated bony growths.
• Combination of two or three types of deformations. This type is the most common.

Also, curvature can be one- or two-sided.

How does a deviated septum affect our body?

When the nasal septum is displaced, the lumen of the nasal passage decreases, and air passes through the narrowed nasal passage with difficulty. In addition, the resulting pathological air turbulence dries out the mucous membrane, the ciliated epithelium loses its cilia, thereby losing its protective function. The secretion of mucus is disturbed, the cleansing of the mucous from microbes. Arises.

Our nose has communications with other organs as well. In each nasal passage, the natural fistulas of the four paranasal sinuses, the auditory tube (communication with the tympanic cavity of the middle ear), and the lacrimal canal open. It happens that the nasal septum is curved in such a way that it blocks these natural openings. The outflow of contents is difficult, cleansing and aeration (air exchange) of the paranasal sinuses and the middle ear cavity are disturbed. There are diseases such as (,), dacryocystitis (inflammation of the lacrimal sac).

Chronic sinusitis is a common consequence of a deviated septum.

A long-standing deviated septum can lead to compensatory thickening (hypertrophy) of one or more turbinates on the side opposite to the deviated septum. This leads to aggravation of problems with nasal breathing, not on one, but on both sides.

The nasal septum may be deviated so much that it may touch the side wall of the nose, causing irritation of the sensory branches of the trigeminal nerve. This causes constant headaches, reflex spasm of the airways, coughing, and frequent sneezing.

The narrowing of the nasal passages leads to the fact that less air enters the respiratory tract, oxygen starvation of the tissues of the whole organism occurs. Signs corresponding to this are chronic fatigue, headache, shortness of breath, poor sleep. In children, this can lead to a lag in physical and mental development.

Because of this, a person is forced to breathe mainly through the mouth. This leads to overdrying of the oral mucosa, development, bad breath. Air that enters the respiratory tract not through the nose is not cleaned and warmed up properly, and this can cause inflammatory diseases not only of the upper, but also of the lower respiratory tract (bronchitis, pneumonia).

Symptoms of a deviated septum

At first glance, man is a symmetrical being. However, there is no ideal symmetry in living organisms; too many factors affect their development. So with nasal septum. 90% of people have nasal plate curvature to one degree or another.

But most do not even suspect that they have such a pathology. Basically, people with a crooked nasal septum either do not have any complaints, or do not relate their complaints to this defect in any way.

The severity of symptoms is not directly related to the degree of curvature. It happens that a person with a strong curvature does not feel absolutely any discomfort. Conversely, even a slight deviation of the septum can cause complications.

There are no specific (pathognomonic) symptoms that are characteristic only for the curvature of the nasal septum.

But it is possible to single out a number of symptoms with which patients most often go to the doctor, during the examination they reveal a curvature of the nasal septum, and after correcting this defect, these complaints disappear.

1. . This is perhaps the most common complaint of patients with deviated septum. A person for a long time cannot breathe normally through his nose, drips endlessly into his nose, which only aggravates the situation due to the development of vasomotor rhinitis.
2. Frequent acute sinusitis or the presence of a chronic inflammatory process in one or more sinuses.
3. Acute or chronic otitis media.
4. Dacryocystitis. Violation of the outflow of tear fluid through the nose leads to a violation of the natural cleansing of the eye, inflammation of the lacrimal sac.
5. Smell disturbance. The olfactory zone is located in the region of the upper nasal passage. If the curvature is localized in the upper part of the septum, the patient may not smell.
6. Frequent headache.
7. Hearing loss.

Pain in the nasal septum is not characteristic of an uncomplicated deformity, unless it is a fresh injury. So, if the nasal septum hurts, you need to look for other causes - sinusitis, boils, neuralgia of the nasociliary nerve.

It is always quite difficult even for a doctor to associate these symptoms with a deviated septum, especially in patients with concomitant pathology (chronic vasomotor rhinitis, allergic rhinitis), turbinate hypertrophy. usually offered after unsuccessful conservative treatment of these diseases.

Treatment of deviated septum

A crooked nasal septum is an anatomical defect and can only be corrected surgically. Surgical treatment of curvature is indicated only in the presence of complaints. In the presence of a curvature without any clinical symptoms, surgery is usually not indicated.

An operation to correct the nasal septum is offered in cases of a combination of this defect with a long-term violation of nasal breathing, frequent sinusitis, otitis media.

Surgery to straighten the nasal septum is called. There are two types of septoplasty:

• Plain standard septoplasty(or submucosal resection, the oldest method of surgical intervention on the septum). In the nasal cavity, the mucous membrane is cut in an arcuate manner, a section of the quadrangular cartilage is isolated and cut off, then the curved bone part of the septum is removed (for this, a hammer and a chisel are used). Mucosal flaps, together with the perichondrium and periosteum, are brought closer to each other, fixed with tampons in the middle position.

• Sparing endoscopic septoplasty- a more modern method, carried out using endoscopic equipment. During this operation, under the visual control of the endoscope, a thorough revision of the nasal cavity is carried out and only those areas that narrow the nasal passage are removed with special gentle micro-instruments.

There are various modifications of both operations. For example, the resected cartilage may be specifically straightened and placed in its place between the layers of the perichondrium. After healing, such a modulated septum occupies a normal physiological position.

Often, simultaneously with septoplasty, other surgical manipulations in the nasal cavity are performed: conchotomy– trimming of the thickened turbinate, removal of polyps, vasotomy- resection of the choroid in chronic vasomotor rhinitis.

The operation of straightening the nasal septum is performed in a hospital. Before the operation, it is necessary to undergo an examination. General blood tests, urine tests, biochemical blood tests, ECG, fluorography are prescribed, the state of the coagulation system is determined, you need to be examined by a therapist.

There are contraindications to such an operation: acute infectious diseases, severe chronic diseases, blood clotting disorders, old age, mental illness.

The operation to straighten the septum of the nose can be carried out free of charge under the MHI policy. The cost of septoplasty in paid clinics ranges from 20 to 100 thousand rubles. The price depends on the volume of the operation, the qualifications of the surgeon, the category of the clinic, the type of anesthesia, the length of stay in the hospital after the operation.

After surgery, tampons are inserted into the nose to hold the septum in the correct position. Tampons are removed after 1-2 days. On the 5-6th day the patient is discharged, but a full recovery usually occurs after 2 weeks.
All this time, it is necessary to observe an ENT doctor, daily treatment of the nasal cavity with antiseptics, rinsing with cleansing sterile solutions. After 2 weeks, complete healing and restoration of nasal breathing occurs.

Complications of septoplasty

As with any other operation, complications may occur after septoplasty:

1. Bleeding. Slight bleeding is acceptable, within 1-2 days after the operation, there is a discharge of ichor - a mucous discharge with blood.
2. Septal hematoma- accumulation of blood between layers of tissues.
3. Perforation of the nasal septum. Quite rare, but an unpleasant complication. Occurs when tissues are cut through. Heals, as a rule, badly. Requires a further operation to restore the nasal septum.
4. Saddle retraction of the back of the nose.
5. Suppuration.

Other treatments for deviated septum

Removal of curvature with a laser is carried out by heating the curved part of the cartilage and giving it the desired shape. The cost of laser septum straightening is from 20 to 50 thousand rubles.

However, despite all the advantages over conventional surgery, the widespread use of laser nasal septum correction is limited. The fact is that only the cartilaginous part of the septum can be deformed by the laser, which is very rare. The most common type of curvature is a combination of deformation of both bone and cartilage parts.

Do I need to straighten a deviated nasal septum?

Many patients for a long time can not decide on surgery to remove the curvature of the septum. Many get used to a constantly stuffy nose, chronic sinusitis and other consequences of the curvature. Yes, indeed, the pathology is not fatal, you can live like that. And any operation is a risk.

But there is still such a thing as quality of life. According to the feedback of patients who underwent septal alignment, only after the operation did they realize that this quality can be different. When you breathe like a normal person, you begin to feel all the smells, constant headaches, depression disappear, life begins to play with new colors.

A few words about prevention

The only one available to anyone a method for preventing a deviated septum is a timely visit to a doctor for any injury to the nose. This is necessary to exclude or confirm a septal fracture (it is advisable to do a CT scan for this) and, if the septum is broken, to reposition the broken bones in time.

Main conclusions

• If you have a stuffy nose all the time, a runny nose after a cold does not go away for months, you cannot live without naphthyzinum, get an examination by an otolaryngologist and check if this is due to a deviated nasal septum.
• Frequent headaches, malaise, constant fatigue and the therapist cannot find the cause? Check if both nostrils are breathing equally well.
• Do you snore at night? This may also be due to a violation of nasal breathing due to the curvature of the septum.
• In itself, the presence of a curvature is not yet a reason for excitement. Treatment is indicated only when it interferes with life.
• The main method of treatment is surgery.
• You need to decide on the operation, carefully examine and prepare for at least 2 weeks of disability.
• Enjoy a new quality of life and praise yourself for being brave.

Video: deviated septum in the program “Live great!”