Correction of deviated septum without surgery. Deviated septum - symptoms of how the operation is performed. Incorrect growth of the bones of the facial skull

Deviation of the nasal septum (deviation, deformation) is a persistent deviation of its shape from the midline, causing a violation of breathing through the nose. With severe deformation, the blood supply to the brain worsens, the normal functioning of the heart and the gastrointestinal tract becomes difficult.

If the pathology manifests itself in early childhood, the child develops a characteristic appearance (due to a decrease in the supply of oxygen to the body): a parted mouth, pale skin, asthenic constitution (due to the development of hypoxia and anemia).

It should be borne in mind that the nasal septum grows throughout life. Since it consists of several parts that grow at different rates, with age, the problems caused by its curvature may become more pronounced.

An ideally straight nasal septum in an adult is extremely rare due to numerous factors, injuries during life. More precisely, there are no direct partitions, everyone has some kind of curvature, some kind of ridge of the partition. However, operations are indicated only in violation of the respiratory function. For example:

• There may be a huge ridge on the septum, but it does not interfere with nasal breathing at all - an operation is not needed.
• In the case of a small curvature (or a small but significant ridge) that overlaps a narrow opening leading to the maxillary sinus, which is fraught with frequent sinusitis, this must be corrected.

What is the nasal septum

In its anterior part, it is formed by quadrangular cartilage, and in the back it is represented by bone tissue (vomer, ethmoid bone and upper jaw). Its deformation can develop in the bone, and in the bone-cartilaginous, and in the cartilage departments.

Nose functions

• sense of smell - the ability to perceive odors;
• purification of inhaled air- large dust particles are retained with the help of hairs in the nostrils, and small ones are deposited due to electrodynamic attraction to the mucous membrane. All foreign particles with mucus enter the stomach and, like a conveyor belt, are removed from the body;
• warming and humidifying the inhaled air- the air is heated to body temperature, its humidity rises to 100%. Also, during exhalation, moisture and heat from the exhaled air are retained in the nasal cavity, thus preventing the development of dehydration and hypothermia.

Reasons for the development of deformation

Consequences of injuries

• In 50% of patients with septal deviation, various injuries of the nose and facial skull are detected during their lifetime. Especially dangerous are traumatic situations in childhood and adolescence.
• Curvature of the septum of post-traumatic origin is characterized by peculiar deformations, sharp fractures.
• Birth injuries also belong to this category: cases are described when, due to rapid delivery or incorrect tactics of an obstetrician-gynecologist, pathology was detected even in newborns.

Incorrect growth of the bones of the facial skull

• This reason is relevant in 30% of the examined patients.
• Very often, the structures of the nose grow and develop inconsistently, causing a deviated septum.

Various diseases (compensatory deformity)

In 10% of patients, pathology may occur due to:

• nasal neoplasms (polyps);
• sinus hypertrophy.

hereditary predisposition

Modern research has proven that this pathology can be inherited and be congenital.

Jacobson's organ hypertrophy

It is also called the vomeronasal organ. Olfactory cells are concentrated in it. In nature, it is found in animals for mating, as it perceives pheromones (specific odorous substances secreted by the male and female). In humans, Jacobson's organ is atrophied. In rare cases, the vomeronasal organ can enlarge (hypertrophy), causing deformity of the nasal structures.

Degrees of severity and types of curvature

• light - slightly deviates from the median axis;
• medium - deviates to the side approximately to the middle of the sinus;
• severe - the curved septum is practically in contact with the side wall of the nose.

Classification of curvature according to Mladin:

• Comb-shaped curvature in the anterior part of the septum, small in size, unilateral, not interfering with breathing through the nose.
• Pronounced ridge-like deformity in the anterior part of the nose, disrupting the function of breathing.
• Rib-like deviation, unilateral, in the posterior septum.
• S-deformity of the septum - two ridge-like curvatures located in the right and left sinuses of the nose.
• Deviation of the type of "Turkish saber" - comb-shaped, in the back of the nose.
• Comb-shaped deformities in the horizontal plane, in both nostrils.
• "Crumpled" septum - a lot of curvature in different planes.

What form can a deformed septum take (according to Lopatin)

Almost every adult has a slight curvature of the nasal septum, which does not interfere with the normal flow of air. But with a more significant defect, complications appear, which depend on the type and severity of the deformation.

• More often there are deformations in the anterior part, while even a slight curvature can create air turbulences that significantly impair nasal breathing.
• The ridges and spikes, as a rule, are located along the lower or lower edge of the vomer and consist of bone tissue (tops of cartilage), have different lengths, can be directed in different directions or go into the mucous membrane on the opposite side.

Main symptoms, complaints

Modern statistics show that this pathology is detected in 90% of adults during examination. However, not everyone complains about it. In many cases, it is asymptomatic. The main complaints of the disease include:

Rhinitis and sinusitis

With this pathology, the patient is much more likely to experience sinusitis (, ethmoiditis, sinusitis, sphenoiditis), when the infection enters the paranasal sinuses than in a person without such a defect. And also in 3% of cases allergic rhinosinusopathy develops, in 15% vasomotor rhinitis.

• nasal congestion;
• secretions of a mucous or mucopurulent nature;
• tearing and sneezing;
• nasality of voice.

Snoring, the phenomenon of sleep apnea

• Often, patients with this pathology complain about the presence of snoring (according to statistics, men are 2 times more likely than women).
• However, snoring is not only a hindrance to the sleep of those around you. In such patients, during sleep, there are short episodes of respiratory arrest - apnea (see).
• Patients often complain of daytime sleepiness, headache, poor performance at school and at work (due to impaired blood supply to the heart and brain).

Difficulty in nasal breathing

This sign can be expressed in varying degrees, from a slight violation of nasal breathing to its complete absence, when a person is forced to breathe through his mouth. There are frequent cases when nasal breathing is difficult not because of the curvature of the nasal septum, but in the presence of hypertrophy of the turbinates. In this case, the tissues of the lower nasal conchas grow, and as a result, the lumen narrows, and weak nasal breathing occurs. A person turns to an ENT, and he diagnoses a crooked nasal septum (because it is curved in most people). After the operation, the nose still does not breathe. In such cases, the excess tissue should be removed with a laser.

Other symptoms

• Decreased sense of smell- impaired ability to perceive odors, up to a complete lack of smell.
• Bleeding from the nose- deformation causes thinning of the mucous membrane, especially in the lower part, where the vascular plexuses are concentrated. As a result, any injury, even banal picking in the nose, can cause profuse bleeding.
• Frequent sore throats and bronchopulmonary diseases- when breathing through the mouth, the air is not cleaned of dust and microbes, which allows them to enter the lungs and provoke frequent SARS, as well as bronchial asthma.
• Dryness of the nasal mucosa- the reason for the appearance of dryness in the nose is as follows: with a strong curvature of the nasal septum, the mucous membranes can come into contact with each other, disrupting the functioning of the cilia and cells that secrete mucus.
• Recurring headaches- are reflex in nature, associated with irritation of the mucous membrane.
• Tinnitus, tinnitus, hearing loss- due to the spread of the inflammatory process to the middle ear through the Eustachian tube. In neglected states, hearing loss may develop.
• Dry mouth - if a person is forced to breathe through the mouth (with severe deformation), while moisture evaporates from the mucous membrane, and dry mouth appears.
• Cosmetic defects- in children, due to pathology, an adenoid type of face develops - a slightly open mouth, malocclusion, nasal voice. Cosmetic defects of the nose are also possible after injuries and bruises.

How is pathology detected?

When is surgery necessary for a deviated septum?

It is not difficult to guess that the treatment of the curvature of the nasal septum is possible only by surgery. The indication for surgical intervention is not the fact of the curvature of the nasal septum, but the operation is necessary if the curvature is pronounced and leads to the patient having difficulty in nasal breathing, discomfort, and concomitant diseases. To change the nasal septum should be approached very strictly:

• whether the nose breathes or not - that is, whether the function of the nose is preserved
• weigh the risk versus benefit in each case
• take into account the age of the patient.

In recent years, doctors have come to the conclusion that it is not advisable to perform surgery on children under 4-5 years old. For a child older than 5 years, surgery is performed only if there are complaints. The operation to reconstruct the nasal septum is called rhinoseptoplasty.

Modern surgery for the correction of a deviated nasal septum is much more gentle than a similar operation 20-30 years ago. Today, only a small interfering ridge on the septum is to be removed, and no one removes the entire septum, as was done before.

How to prepare for rhinoseptoplasty?

Rhinoseptoplasty does not require special preparation. 2 weeks before surgery, you should give up bad habits, minimize the risk of infection and hypothermia. It is also advisable to visit a dentist and cure bad teeth, eliminate possible other foci of inflammation in the body. Before surgery, the patient is recommended to conduct standard studies:

• general clinical blood test;
• study of the hemostasis system ();
• testing for HIV and syphilis;
• consultation of the therapist and anesthesiologist.

Since significant blood loss is possible during the operation, it is more expedient for women to carry it out in the middle of the cycle (2 weeks after menstruation). The patient is usually prescribed a cleansing enema for the night, they ask him not to eat after 18.00 on the eve of the operation. An hour before the intervention, the patient is given premedication - the introduction of drugs that help prepare the body for anesthesia.

Are there any contraindications for rhinoseptoplasty?

There are no absolute contraindications to surgery. The relative ones are:

• elderly (over 65 years) age (patients are more difficult to tolerate anesthesia);
• pregnancy, lactation;
• decreased blood clotting (since there is a high risk of bleeding);
• malignant neoplasms (cancer, sarcoma);
• high blood pressure (risk of heart attack and stroke);
• acute respiratory infections (operation is possible not earlier than a month after recovery);
• during the flowering of herbs (during the exacerbation of allergic rhinitis).

Rhinoseptoplasty technique

The operation is performed under general endotracheal anesthesia (introduction of an endotracheal tube into the trachea and the supply of anesthetic gas) and under local anesthesia (injection of local anesthetics - novocaine, lidocaine). There are several types of rhinoseptoplasty:

Endoscopic septoplasty

This operation is indicated for patients with non-traumatic curvatures. The use of a fibroendoscope helps to prevent complications such as the development of bleeding and the formation of hematomas.

Laser septochondrocorrection

The operation is bloodless and safe for patients. It is based on the fact that cartilage under the action of laser radiation can change its shape. The operation is performed on an outpatient basis, does not require hospitalization in the ENT department. Its advantages:

• minimal blood loss
• minimal tissue trauma
• rehabilitation and postoperative period are much milder
• the laser has antiseptic properties

The disadvantage of the laser is that it is not able to correct all deformations of the nasal septum, especially the bone part.

Resection-reimplantation technique

Curved sections of cartilage and bone are cut out, then straightened on a special flattener and implanted back under the mucosa. The advantage of the operation is that own tissues usually take root well and restore the septum, preventing the development of perforation.

Classic submucosal resection according to Killian

The operation is rather outdated, its essence lies in the removal of a curved bone and cartilage layer of the septum. This resection has many side effects:

• the septum becomes mobile and can vibrate when breathing;
• the nose can sag, taking on a saddle shape;
• in patients after surgery, complaints often do not disappear (nasal congestion, mucous discharge);
• the septum may be perforated.

Possible complications after surgery

• the formation of postoperative adhesions, synechia;
• perforation of the nasal septum;
• allergic reaction to anesthesia (swelling of the larynx, drop in blood pressure,);
• paralysis of the oculomotor nerves, blindness;
• injury to the cribriform plate, which threatens to leak cerebrospinal fluid from the nasal cavity;
• the formation of a hematoma or abscess between the layers of the mucous membrane;
• impaired sense of smell up to its complete absence;
• deterioration of mucosal function (degenerative changes).

In the postoperative period, patients are usually recommended:

• washing with saline solutions (aqua-maris,) from 2-3 days - to moisturize the mucous membrane;
• avoid heavy physical exertion;
• do not fly in airplanes (due to a sharp change in atmospheric pressure);
• within 2-3 months, do not be exposed to sudden changes in climate, do not overcool or overheat, do not visit baths and saunas.

Can a deviated septum be prevented?

Unfortunately, there are no special preventive measures for this pathology. Doctors advise that if you get a nose injury, you should immediately contact the emergency room for timely reposition of bone fragments. Athletes are encouraged to wear special face masks to prevent injury.

Recently, cases of curvature of the cartilaginous septum of the nose in Russians have become more frequent.
Many ENT doctors note that people are more likely to complain of difficulty in nasal breathing (especially in the autumn-winter season), unpleasant aching pain in the nose, radiating to the back of the head, swelling of the sinuses and other manifestations associated with pathology.

Nasal breathing is a very important process for the human body, which allows you to warm and moisten the air entering the lungs, filter it and saturate it with oxygen.

With difficulty in nasal breathing, this result cannot be achieved: severe pain and discomfort will not allow a person to breathe through the nose for a long time, ultimately, he will switch to mouth breathing, which is dangerous with potential hyperventilation.

Is it possible to eliminate the deformation of the nasal septum in the safest possible way?

Is it possible to correct this defect inoperably, that is, with the use of folk remedies? And how can the symptoms of this disease be alleviated?

Reasons for violation

In childhood, these manifestations are practically imperceptible, but in the puberty period, when a teenager experiences rapid growth and restructuring of the body, unpleasant pains in the nose begin, interfering with proper breathing and causing an acute feeling of discomfort.

The main causes of this disease can be divided into three groups:

• physiological, when the curvature of the cartilaginous membrane occurs due to a genetic predisposition to impaired growth of the cranial bones;
• traumatic, when the deformation occurs after a severe injury;
• compensatory, when the disease is only a manifestation of another disorder.

The first group includes such reasons as the uneven growth of the bones of the skull, which is characteristic of many modern adolescents, and leading to the fact that the shape and size of the nasal septum change to an abnormal development of the vomeronasal organ responsible for smell.

The second group includes mechanical damage resulting from injuries.

This reason is typical for teenage boys and men who take part in martial arts, fighting sports, and also who enter into fights.

Also, deformation of the septum can occur after a fracture and improper fusion of the nasal cartilage and bones.

The third group is also very common. The development of this anomaly can be affected by a constant runny nose, tumors in one of the nostrils or polyps, as well as hypertrophy of the turbinates.

Signs of deformity of the septum

Many patients are negligent in solving the problem of nasal septal deformity due to the fact that they consider it “not serious”.

However, it can lead to a number of unpleasant symptoms and even diseases of the internal organs:

Types of pathology

ENT doctors have compiled a classification of types of septal curvature: a deformed membrane can take the form of a spike, ridge, or a combination of these types, be S- or C-shaped.

On the page: opian methods of treating inflammation of the sinuses with folk methods.

The curvature can be unilateral, affecting one sinus, or bilateral, appear in the front or back of the nose, in the vertical or horizontal part.

Even a slight curvature contributes to the effect of a swirl of air entering the nasal cavity, which provokes pain and makes breathing difficult.

Curvature symptoms

How to identify the symptoms of this disease before going to the doctor? There are generally accepted signs:

• Difficulty in nasal breathing, discomfort when inhaling.
• Chronic runny nose (symptoms described).
• Allergic reactions.
• Severe headaches of a permanent nature.
• Severe dryness or, on the contrary, nasal congestion with protective mucus.
• Bleeding due to mucosal irritation.
• Night snoring, otherwise.
• Frequent infections, including acute respiratory infections, manifested by a runny nose and how.
• Deformation of the nose, changing its contours.
• Strong fatigue.

Diagnosis

If there is no certainty that it is the deformation of the nasal septum that is determined by the symptoms, then it makes sense to turn to the help of diagnostic methods.

In modern clinics, all types of diagnostics are widely used - from a simple external examination to posterior rhinoscopy.

• Visual inspection. The easiest and fastest way to medically determine the presence of a curvature of the membrane.

  First, the doctor evaluates the contours of the nose.
  Secondly, the breathing assessment procedure allows for an accurate diagnosis..

  To do this, you need to pinch one nostril with your finger, and bring a cotton swab dipped in an odorous substance or thread to the other. The doctor evaluates the fluctuations of the nostrils, as well as the sharpness of the sense of smell (read about the reasons for the loss at the address). If there are violations of oscillations and a decrease in the perception of odors, then it is possible to determine the curvature of the septum with an accuracy of 90%.

• Anterior rhinoscopy. This is a method of examining the mucosa with the help of special instruments - nasal dilators or small bellied probes.
• Posterior rhinoscopy - differs from the above method only in that a spatula with a mirror is used for examination, and the doctor himself assesses the condition of the nasopharynx from the choanal side.

Methods of non-surgical treatment

So far, no definite answer has been given by doctors to this question.

Of course, most doctors will say that it is better to give preference to rhinoplasty or laser surgery than to experiment with folk remedies.

However, the cost of operations and their effectiveness, which is not always achieved, deter most patients.

Which therapy is best

Let's try to figure out which is better - home treatment or surgery, what are the advantages and disadvantages of both methods of treatment?

Surgical intervention

The nasal septum is a thin, extremely fragile organ, consisting of cartilage and bone, which is a membrane. It is almost impossible to straighten it by mechanical reduction or massage.

You can also perform septoplasty using video endoscopic equipment, which allows you to simplify and speed up the operation as much as possible.

The operation is performed under local anesthesia, all instruments are sterilized, and surgeons perform their work with maximum precision.

folk methods.

A deviated septum causes severe discomfort to patients and makes it difficult to breathe properly through the nasal cavity.

That is why they are looking for the most rational way to solve this problem, for example, traditional medicine.

They do not help to radically correct the shape of the nose, but reduce the symptoms of the disease, improve nasal breathing and eliminate swollen areas, relieve headaches and help relieve discomfort in the sinuses.

They can be divided into several types:

Let's take a look at how these methods work.

Treatment with special devices

As practice has shown, special ultrasonic devices help to remove unpleasant symptoms.

These include "Vitafon", which produces a vibroacoustic effect on the affected area, "Fairy", "Atmos Antirhinitis", etc.

The “Nebulizer” apparatus, which is written in detail, designed to treat the respiratory system, effectively helps with a runny nose.

Procedures with these devices should be carried out strictly according to the instructions attached to them. For example, for the treatment of the nose, "Vitafon" should be applied to the sinuses in mode 2 for 10 minutes.

Treatment with folk remedies

You can relieve swelling due to the curvature of the nasal septum with the help of therapeutic massage. To do this, you need a cream based on propolis, which is applied to the area of ​​\u200b\u200bthe cheeks close to the nose.

It must be massaged into the skin and performed on the sinus area with constant circular movements. It is effective to carry out this procedure in the evening.

They help relieve the symptoms of curvature of the “dunk-spit” exercise.

To do this, warm filtered water is diluted in a cup with a pinch of sea salt. The resulting solution should be drawn in first with one nostril, then with the other, held a little in the nasopharynx, and then sharply “spit out”.

If you repeat the procedure several times in a row, it will completely relieve the unpleasant pain, and its regular implementation will become better prevention of rhinitis.

Essential oils of eucalyptus, fir and vetiver are the best helpers in the fight against swelling of the sinuses.

For procedures with them, you should literally add a drop of one of the oils to a cup of water and moisten a round cotton pad in it, after which the wet pads are pressed against the sinus area and left for 10 minutes. The procedure should be done every day in the morning and evening..

Even ordinary black tea can effectively relieve pain and tightness in the sinuses. To do this, strong black tea is brewed (at least 3 teaspoons per 0.5 liters of boiling water), and the patient then breathes through his nose over a bowl of hot liquid.

In order for the tea not to cool down, you should cover yourself with a large towel.

Drops of beetroot juice or sea buckthorn oil will help improve the condition of the mucosa and relieve pain symptoms.

But there is one warning: in no case should you rinse your nose with an enema: this can lead to inflammation of the Eustachian tube and even more discomfort.

Treatment with breathing techniques

Breathing exercises are incredibly effective for relieving discomfort in the nasal cavity.

Thanks to the correct execution technique, it is possible to achieve the removal of edema, the restoration of the functioning of the mucosa, and the relief of nasal breathing.

The body should be relaxed, hands in a prayerful gesture.

This exercise is performed every day in the morning and in the evening for 10 sets.

It will also be effective to take frequent breaths through the nose, the so-called “sips”, drawing in small portions of air, and then exhale deeply. This exercise can be done an unlimited number of approaches.

Instead of a conclusion

The curvature of the nasal septum occurs for many reasons and, at times, it is not possible to correct this defect, even in an operable way.

But you can relieve pain and discomfort, reduce the risk of a runny nose or headaches by using folk remedies. The age-old wisdom that made it possible to select the best of these folk remedies will help you effectively cope with the task of relieving discomfort with minimal financial losses.

While watching the video we offer, you will learn the details of laser treatment for a deviated septum.

How to treat a deviated septum without surgery. What medicines to use?

The human nose has a complex internal structure, the main function of which is the redistribution of the "primary" air flow into the lungs and the removal of the "secondary" flow from them.

The nasal septum is one of the most important parts of this structure, consisting of three segments that develop independently of each other, but then grow together, dividing the nose into two equal parts - right and left.

However, a number of reasons can cause a pathology in which a deviated nasal septum overlaps one side of the nose, which causes:

• bad breath;
• loss of smell;
• nosebleeds;
• headaches, etc.

The reasons

After the diagnosis is made, the question arises - is it possible to treat the nasal septum without surgery. Before making a decision, doctors clarify what exactly caused this pathology.

Factors causing pathology of the nasal septum can be both physiological and pathological:

Physiological factors that lead to the need for nasal septum treatment without surgery just two:

1. Genetically determined dysplasia of the skull bones
2. Aging causing changes in bone structure throughout the body

Pathological causes are:

1. Nose injury
2. Formations (benign and malignant) in the nasal cavity
3. Uneven development of the nasal turbinates (when one develops normally and the other is too large)
4. Curvature caused by persistent respiratory problems that cause the person to try to breathe through one side of the nose

Click: Nasal septum laser treatment

Treatment

Having found out the cause of the pathology, doctors determine whether it is possible to correct the curvature of the nasal septum without surgery, that is, they begin treatment by eradicating the very cause that led to the disease.

Usually we are talking about two pathologies:

1. Neoplasm in the nasal cavity - the primary task of doctors is to remove the tumor; and after the neoplasm is removed, treatment of the deviated septum without surgery is possible.
2. Permanent nasal congestion - since this phenomenon is caused by an allergic reaction of the patient to any allergen (dust, microbes, etc.), accordingly, the treatment is mainly aimed at combating allergies.

Drug therapy

When treating a deviated septum without surgery, the same set of pharmacological agents is prescribed, and these are:

1. Decongestants (naphthyzine, tizin, nazol, etc.) are drugs that reduce swelling of the nasal tissues, when using which the respiratory tracts are open on both sides.

Decongestants are available as tablets or nasal spray. However, it should be remembered that long-term use of such sprays causes dependence, expressed in the fact that as soon as a person stops using them, the symptoms become even more severe than before the start of treatment. In addition, these drugs can lead to side effects such as:

• nervousness;
• increase in blood pressure;
• tachycardia.

1. Antihistamines (suprastin, tavegil, claritin, etc.) are drugs that prevent allergic attacks, including runny nose and obstruction. There are also possible side (unwanted) effects, such as:

• drowsiness;
• uncoordinated actions;
• Bad mood.

Click: Causes of deviated septum

Therefore, these drugs are categorically not recommended for drivers, machinists, pilots, etc.

1. Nasal steroid sprays (flixonase, aldecine, amaves, etc.) - reduce the inflammatory process in the nasal passages, as a result of which the airways "open" and the person begins to breathe freely. To achieve the greatest effect, these drugs should be taken for one to two weeks (depending on the doctor's recommendation).

Note. If, after a certain period, the treatment of the curvature of the nasal septum without surgery is not successful, the issue of surgical care for this patient is decided.

The nose is a very important organ that performs several important tasks. Our nose warms and moistens the inhaled air, traps dust particles brought with the air, and neutralizes bacteria entering from outside. In addition, thanks to the olfactory region of the nose, we perceive and differentiate different odors.

nasal septum

The nasal septum performs an important function in our nose, ensuring an even distribution of air flows between the right and left lobes of the nose. With the help of the nasal septum, the harmonious fulfillment of the following conditions is achieved: warming, cleansing, moisturizing. With a curvature of the nasal septum, these functions are violated.

Deviated septum of the nose - one of the most common diseases of the nasal cavity.

According to statistics, a deviated septum is quite rare in young children, most often almost half of all adults suffer from this disease, and in men, a deviated septum is much more common than in women.

In a baby, the nasal septum is even and straight. Almost all of it consists of cartilaginous tissue, in which there are islands of ossification. Over time, the nasal septum is converted into bone, and the bones fuse together. With the growth of a person and the violation of certain processes in the body, the nasal septum begins to curve.

Causes of deviated septum

• uneven growth of the bones of the skull, which leads to the fact that the size of the nasal cavity also changes, the nasal septum becomes crowded in the nasal cavity, and it has to bend;
• traumatic causes (most often they are typical for boys and men): as a result of a strong blow, the bones of the nose are displaced, the nasal septum is deformed and the bones are not properly fused, which leads to a curvature of the nasal septum;
• the presence of polyps and tumors of the nasal mucosa, which leads to respiratory failure in one of the nostrils, and then to the curvature of the nasal septum;
• hypertrophy (uneven development of one of the nasal conchas), which puts pressure on the nasal septum.

Deviation of the nasal septum. Symptoms.

The curvature of the nasal septum can "give itself out" with the following symptoms:

• asymmetrical shape of the nose (especially noticeable when the nasal septum is deviated as a result of injuries);
• persistent chronic runny nose (impaired nasal breathing, mucous discharge from the nose);
• reflex headaches resulting from constant grazing of the nasal mucosa with a deviated nasal septum;
• loud snoring at night
• nosebleedsappearing due to thinning of the mucous membrane in the direction of the curvature of the nasal septum;
• reduced performance, increased body fatigue due to reduced oxygen supply to the blood;
• discomfort during nasal breathing;
• frequent acute respiratory infections with cough, sneezing, runny nose, fever;
• perspiration, sore throat, cough;
• hearing loss as a result of an inflammatory process in the ear;
• decrease in olfactory abilities;
• distraction of attention, memory impairment.

Types of curvature of the nasal septum

The vast majority of adults have slight curvature of the nasal septum. But they do not interfere with proper air circulation through the nostrils and proper breathing.

The following types of curvature of the nasal septum are known:

• deviated nasal septum;
• crest;
• a combination of various types of curvature.

Most often, people have a curvature of the nasal septum in the front. Deformities of the posterior part of the nasal septum are less common.

The configuration of the nasal septum and turbinates with a curvature of the septum: a - slight curvature of the nasal septum; b - S-shaped curvature of the nasal septum; c — curvature of the nasal septum at an angle.

Diagnosis of the nasal septum

To find out if you need surgery on the nasal septum, you need to undergo a comprehensive diagnosis. Diagnosis includes an external examination by an ENT doctor, rhinoscopy, the use of additional laboratory tests and tests.

External examination by an otorhinolaryngologist allows you to determine the type of nose. In addition, the doctor evaluates nasal breathing. By bringing cotton wool separately to each nostril, the fluctuation of the villi during inhalation and exhalation is examined.

A person's sense of smell is also assessed for each nostril separately. The patient must, with his eyes closed, determine the smell on the cotton. If there is a curvature of the nasal septum, then the sense of smell is usually reduced.

Thanks to rhinoscopy, an examination of the nasal cavity is achieved using special instruments. In his examination, the doctor can use anterior and posterior rhinoscopy.

Anterior rhinoscopy used to better examine the nasal cavity and the formations present there. It is performed using a nasal dilator and a special probe. With the help of anterior rhinoscopy, nasal polyps, hematomas, abscesses and tumors in the nasal cavity can be seen.

Posterior rhinoscopy - This is an examination of the nasopharynx and nasal cavity from the side of the mouth. Produced with a spatula and a special mirror.

Why do you need nasal septum surgery?

Indications for surgery to correct the nasal septum may be as follows:

• external cosmetic defect;
• difficulty breathing through the nose;
• rhinitis in a chronic form;
• inflammation of the middle ear (otitis media) resulting from a deviated nasal septum;
• persistent headaches;
• sinusitis, ethmoiditis, which appeared due to a deviated nasal septum.

Treatment of deviated septum of the nose

Is surgery necessary for a deviated septum? If you are very worried about its consequences, then it is better to decide on this operation.

In our clinic, a low-traumatic correction of the nasal septum is possible using various modern techniques.

Surgical treatment, for example, laser surgery for curvature of the nasal septum, is carried out in order to normalize nasal breathing, restore the anatomy of the nasal cavity. In our clinic, a septoplasty operation is performed, which consists in the partial removal of deformed cartilage, and, if necessary, the bone part of the septum. Correction of the nasal septum with the help of surgery allows for the alignment and thinning of the curved cartilage, i.e. modification. The modified cartilage becomes flexible and pliable, allowing the surgeon to put it back in place and straighten the nasal septum.

With local curvature of the nasal septum (thorn, ridge, tubercle), it is possible to perform minimally invasive endoscopic septoplasty. Laser surgery to straighten the nasal septum is also considered one of the sparing techniques.

In cases where a patient with a deviated septum complains of an external deformity of the nose, rhinoplasty may be performed.

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The price for surgery for a deviated septum of the nose is.

Deviation of the nasal septum is a persistent deviation from the median plane of its cartilaginous or bony parts. This pathology is widespread. Almost every person has some kind of deformity of the nasal septum, which does not cause them any concern. That is why those curvatures that lead to difficult nasal breathing and diseases of the nasal cavity or ears are considered pathological. Deviation of the nasal septum begins to form at the age of 5-7 years. This can continue until the end of growth and development of the bone skeleton of the maxillofacial region.

The causes of this pathology

1. hereditary predisposition.
2. Uneven growth of the cartilage and bone part of the septum.
3. Chronic obstruction of nasal breathing from childhood.
4. Violation of the development of bone tissue in rickets.
5. Polyps.
6. Unilateral turbinate hypertrophy.
7. Tumor.
8. Injury to the nose with a fracture of its cartilage.
9. Underdevelopment of the bones of the upper jaw.
10. Gothic hard sky.

Types of curvature

1. The actual curvature.
2. Ridge deformity.
3. Spike deformation.
4. Combined curvature.

Clinic

Curvature of the nasal septum can occur in its various departments, have a different shape and length. Clinical manifestations cause not only significant curvature of the septum, but also its small deformations, especially located at the entrance to the nose. They can dramatically impede the movement of air through the nasal passages. Usually, patients with this pathology go to the doctor with complaints of difficulty breathing through the nose and its congestion.

In addition, from time to time they may experience discharge from the nose of a mucous or mucopurulent nature. In some cases, there may be congestion and tinnitus, headache (reflex in nature, occurs in response to irritation of the mucous membrane at the point of contact of the curved part of the septum with the wall of the nose), decreased sense of smell, snoring. Sometimes deformations of the septum can provoke reflex attacks of bronchial asthma, epilepsy, and some disorders in the genital area. With deformations of traumatic origin, the shape of the external nose changes and a cosmetic defect appears.

A decrease in the airiness of the sinuses on the side of the lesion can lead to their inflammation. Some patients develop vasomotor rhinitis involving the auditory tube and middle ear. The pathology of nasal breathing leads to the fact that some functions of the internal nose are excluded, such as moisturizing, warming, disinfecting the air flow. What contributes to the occurrence of laryngitis, tracheitis, bronchitis and their transition to a chronic form.

In children, school performance may decrease due to a decrease in concentration and memory due to oxygen starvation.

Course of the disease

There are two main variants of the course of the curvature of the nasal septum. Some patients adapt to this defect. This variant develops with the possibility of a mixed type of breathing (through the mouth and through the nose). However, constant breathing through the mouth leads to frequent and tonsillitis.

In another part of the patients, adaptation does not occur and the curvature provokes local and general reactions of the reflex type.

Diagnostics

The doctor can suspect the deformation of the nasal septum on the basis of the clinical picture, the history of the disease. An examination of the nasal cavity with the help of special instruments (rhinoscopy) helps to confirm the diagnosis. If the review of the posterior parts of the nasal cavity causes difficulties, then the mucous membrane is chipped with a 1% solution of adrenaline. To clarify the nature and extent of the deformity, endoscopic examination with a different viewing angle is used. Rhinomanometry is also used (allows you to objectively examine nasal breathing), skull radiography (makes it possible to assess the condition of the sinuses), computed tomography.

Be sure to carry out differential diagnosis with tumors, hematomas, abscesses of the nasal septum.

Medical tactics

The main method of treating this pathology is surgical, which usually includes submucosal resection of the septum and its subsequent plasty. The intervention is performed endonasally, no incisions are made on the skin of the face. Other techniques can be used, such as partial resection of the septum, its mobilization, laser endoscopic surgery, radio wave septoplasty, etc.

The type and extent of intervention is determined by the doctor, assessing the nature and extent of the curvature. Surgical intervention is performed in the presence of symptoms that reduce the quality of life of the patient, and complications. Accidentally detected curvature of the nasal septum, which does not disturb the patient, does not require treatment.

Before surgery, the patient undergoes an examination to assess the general condition of the body, identify existing diseases and possible contraindications to this type of treatment. After that, all existing foci of chronic infection are sanitized. The operation is usually recommended in adolescence and adulthood, in children it is less common. In the elderly, surgical correction of the deformity is not recommended, since patients get used to their condition and, in the presence of atrophic changes in the nasal mucosa, septal defects often form in the postoperative period, which worsens their condition.

Indications for surgery

• Severe difficulty in nasal breathing;
• chronic inflammatory diseases of the nasal mucosa;
• chronic,;
• cosmetic defects of the external nose in combination with pathological symptoms.

Postoperative complications

• Nose bleed;
• deformation of the external nose;
• perforation of the septum;
• synechia (lintels and adhesions between the side wall of the nose and the septum);
• atresia (wide adhesions that close the lumen of the nasal passages).

Reconstructive operations on the nasal septum are technically complex and must be performed by a qualified specialist with special care. It is also important to properly manage the postoperative period, when the daily toilet of the nasal cavity is carried out, and physiotherapy is applied. Nasal breathing normalizes in two weeks, full recovery lasts about three months.

Conservative treatment is symptomatic, prescribed in addition to surgery, or used when it is impossible to perform an operation. For this, vasoconstrictor nasal drops, saline and antiseptic nasal rinses, antihistamines, local corticosteroids, antibiotics, etc. are used.

Physiotherapy

It is prescribed 10-14 days after surgery or if surgical correction of deformities is impossible to reduce the symptoms of the disease. It is aimed at reducing inflammation, eliminating infection, accelerating recovery and recovery after surgery.

The main physical methods used to treat this pathology:

1. Ultrasound therapy on the nose and paranasal sinuses (helps cleanse the pathological focus from cellular detritus and microorganisms, improves microcirculation and metabolic processes, stimulates regeneration).
2. (reduces inflammation, improves tissue nutrition and repair).
3. UV-irradiation of the nasal mucosa (has a bactericidal effect).
4. Endonasal calcium medicinal products.
5. Local (causes the death of pathogenic microorganisms).
6. UHF therapy (reduces the activity of inflammatory mediators, reduces vascular permeability, activates metabolic processes).
7. Microwave therapy (increases local blood flow and lymph flow, promotes the resorption of the inflammatory focus).

Conclusion

Deviated septum is a pathology that can cause a lot of problems, provoking the development of various diseases of the nasal cavity, paranasal sinuses, ears, upper respiratory tract, etc. That is why, in the absence of contraindications, surgical treatment is recommended. There is no other effective way to fix this problem. Medical and physiotherapeutic treatment does not cure, but gives only temporary relief.

Channel "VrachTV", the specialist answers the question "How dangerous is the curvature of the nasal septum?":