What Is a Deviated Septum?
A deviated septum, essentially, is discussing the nasal septum, which is the cartilage and bone that divides the two sides of the nose.
It can either develop during growth of the facial skeleton or it can be a result of trauma.
The septum and the cartilage and bone of the septum is responsible for supporting the tip of the nose. If the tip of the nose is struck with some sort of force, it can cause a deviation or a fracture in the septum.
Those patients, although they may have had a nasal trauma and the external nose looks fine and looks normal, inside the nose, the septum can be significantly deviated and can result in those symptoms of difficulty breathing through the nose and nasal
airway obstruction.
When I take a look in the nose, I can see that the septum does not appear to be in the midline and is deviated toward one side
Deviated Septum Symptoms
Most of the times when I see a deviated septum, I just mention it to the patient. If they're not having any symptoms of that, then it doesn't require any treatment.
But over the course of the next few years, if you start to realize that you're having nasal airway obstruction more on one side or more on the other side, then that's something that you can keep in the back of your mind to know that there is a potential
solution to that problem.
One of the most common complaints that I see in patients in my office is difficulty breathing through the nose. There are, obviously, many things that can lead to this with the deviated septum being the one of the most common.
I have some patients with deviated septum who have difficulty exercising because they can't breathe adequately through the nose.
Additionally, to that patients can have difficulty sleeping because they have difficulty breathing through the nose and wind up snoring and such.
Deviated Septum Treatment
We usually treat deviated septums based on the severity.
The medical treatment of this is essentially to widen the nasal airway or improve the nasal breathing without surgery. Usually, we do that with nasal sprays to try to reduce some of the swelling in the nose, whether that be from allergens or other inflammatory
factors to try to get the patient to compensate for the deviation that they have.
If I have a patient where the nasal airway is almost completely obstructed on one side from the deviation, generally, that's a patient who's going to require surgery.
If the patient's deviation is such that it can be corrected just with an incision on the inside of the nose, then generally that would be the best method of treatment because that's least invasive.
The patient's completely asleep. We make a small incision on the inside of the nose and then remove the deviated portion of bone of the septum. They go home the same day. I usually recommend patients to take about a week off of work because there is some
nasal congestion afterwards. Then I see them a week back postoperatively to remove some splints that I usually place in the nose
Patients that require a little bit more extensive improvement in their nasal airway would undergo a little bit more extensive procedure of what we call an open rhinoplasty. Where we need to take some of that septal cartilage and rebuild the structure of the nose so that they can breathe better from that standpoint.
If the deviation is in an area that is not supportive of the tip of the nose, we can really just remove that cartilage or bone and then it removes the deviation. In patients who have a deviation in the front of the nose and the portion of the septum
that's responsible for support of the nasal tip and the appearance of the nose, we actually need to remove that cartilage, straighten it, and then put it back into the nose to replace it. That's why those patients require a little bit more extensive rhinoplasty procedure to make sure that the nose looks as good as it can and breathe as well as it can after the surgery.
