Deviated nasal septum: leave it or fix it?

A deviated nasal septum is a very common deviation that occurs in children and adults. Normally, the septum is located in the middle and separates the left and right halves of the nose. When curved, the shape of the cartilaginous plate changes; it deviates to the right or left, which changes the division of air between the cavities of the nose and disrupts its functions. Nasal breathing becomes difficult, snoring appears, inflammatory changes develop in the mucous membrane, and the help of a specialist is required.

At CELT you can consult an otorhinolaryngologist.

• Initial consultation – 3,000
• Repeated consultation – 2,000

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How is the nasal septum structured?

The nasal cavity is the beginning of the respiratory system and has a rather complex structure. It is a channel shaped like a prism. A plate passes exactly in the middle of the cavity and separates the passages. The anterior part of the septum is represented by cartilaginous tissue, mobile and soft, which protrudes outward and forms the nose. The back part is formed by bone plates.

Ideally, the nasal septum should be strictly in the middle, but in almost 80% of adults and children it deviates to one side or the other. This is due to the fact that the anterior part of the septum is easily displaced and is susceptible to injury. In many patients, the cartilage plate is curved, and deviations such as spines, humps and ridges are formed.

In the nasal cavity, air moves in an arc; when you inhale, it flows from top to bottom to the internal passages, and when you exhale, it is removed by the lower nasal passages. When the nasal septum is changed, nasal breathing changes. In the case of significant curvature of the cartilaginous plate, negative pressure is created in the cavity, which leads to the fact that the septum is pressed against the wings of the nose. In this case, one nasal passage is completely excluded from the respiratory process. Displacements of the septum can be physiological, post-traumatic, or compensatory.

Types of deviated nasal septum

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

The following types of deviated nasal septum are known:

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

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

Configuration of the nasal septum and turbinates with a deviated 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.

About physiological factors

In newborns, the nasal septum consists mainly of cartilage with small areas of ossification. As it develops, bone tissue is formed and its posterior part is transformed. The nasal plate is finally formed by the age of 10; as a rule, it is perfectly smooth. With age, the cartilaginous septum can become deformed due to physiological factors.

• Imbalance between bone and cartilage tissue. During development, tissue formation may be uneven. Such curvatures are manifested by a displacement of the cartilaginous septum to the side or the appearance of characteristic ridges and pronounced spines.
• The bones of the skull develop unevenly. This can lead to changes in the size of the nasal cavity and the septum does not have enough space and becomes deformed.

Contraindications to septoplasty:

• coagulopathies (insufficient blood clotting with increased bleeding);
• chronic liver and kidney diseases;
• infections in the active stage;
• allergy to anesthetics;
• somatic diseases in the stage of decompensation (diabetes, heart disease, etc.).

Important! Since the septum is the “centre of growth” of the nose, correction of its shape is not recommended for girls under 16, and for boys under 17–18 years old. In these cases, surgery is performed only for emergency reasons, for example, after a nasal injury or to correct developmental abnormalities.

Characteristic symptoms

Severe deformation of the nasal septum significantly impairs the quality of life and requires surgical treatment. Most often, patients are concerned about the following symptoms:

• Regular swelling and “stuffiness” of the nose on both sides or only on one.
• Impaired nasal breathing.
• Disturbing snoring and snoring at night.
• Frequent nosebleeds, which occur due to the fact that the mucous membrane becomes significantly thinner.
• Violation of facial aesthetics due to the asymmetrical shape of the nose. Quite often, along with the cartilaginous plates, its back is also bent.
• Increased incidence of illnesses, persistent cough, runny nose, high temperature, sore throat.
• Dryness in the nasal cavities.
• Hearing acuity decreases.
• Olfactory functions decrease.
• Absent-mindedness appears, memory suffers, and performance decreases due to the fact that nasal breathing is impaired and less oxygen enters the blood.

A patient who notices these symptoms should come to an appointment with an otolaryngologist. Neglecting your own health leads to the fact that the immune system, cardiovascular, respiratory, etc., suffers.

Patients suffering from chronic sinusitis, sinusitis and other diseases of the paranasal sinuses should definitely consult a specialist about the need to straighten the nasal septum.

Causes of a deviated nasal septum

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

Reasons for the formation of deviated nasal septum:

• Physiological reasons. The uneven growth of the brain and facial parts of the skull, as well as different parts of the septum, leads to the fact that the septum bends in one direction or another, some parts of it thicken, and bone growths appear - spines and ridges. Such defects form most intensively in adolescence (12-16 years), but congenital deformities that arise in the prenatal period also occur.
• Injuries. This is the most common cause of septal deformation. Most often these are nasal fractures. For obvious reasons, they are more common in adolescents and men (fights, sports injuries). But sometimes even a minor injury to the nose without a fracture, received in childhood and passing almost unnoticed, can subsequently cause a significant curvature of the septum. The reason is the displacement of the growth zones, which are located at the border of the cartilage and bones of the septum. In children, septal displacement can occur during childbirth, especially with facial presentation.
• Compensatory reasons. It happens that the septum shifts under the influence of some factor that puts pressure on it. This could be an overgrown nasal concha, a polyp, or a tumor.

Curvature forms

Deformations of the nasal septum are divided into several types:

• A shift to one side or the other from the median position. The arching of the nasal plate can be S-shaped or C-shaped, in different planes.

• Spines are pointed projections of the bony part of the septum.
• Ridges are elongated bone growths.
• A combination of two or three types of deformities. This type is the most common.

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

How does a deviated nasal 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 and the cleansing of the mucous membrane from microbes are impaired. Chronic rhinitis occurs.

Our nose also communicates with other organs. In each nasal passage, the natural anastomoses 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 hampered, cleansing and aeration (air exchange) of the paranasal sinuses and middle ear cavity are disrupted. Diseases such as sinusitis (sinusitis, frontal sinusitis, sphenoiditis, ethmoiditis), acute and chronic otitis, dacryocystitis (inflammation of the lacrimal sac) occur.

Chronic sinusitis is a common consequence of a deviated nasal septum.

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

The nasal septum may be so deviated that it touches the side of the nose, causing irritation to the sensory branches of the trigeminal nerve. This causes constant headaches, reflex spasm of the respiratory tract, coughing, and frequent sneezing.

The narrowing of the nasal passages leads to less air entering the respiratory tract, resulting in oxygen starvation of the tissues of the entire body. Signs corresponding to this are chronic fatigue, headache, shortness of breath, poor sleep. In children, this can lead to delays in physical and mental development.

Due to impaired breathing through the nose, a person is forced to breathe mainly through the mouth. This leads to dryness of the oral mucosa, the development of chronic pharyngitis, and bad breath. Air that does not enter the respiratory tract through the nose is not cleaned and warmed 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 nasal septum

At first glance, man is a symmetrical creature. However, ideal symmetry does not exist in living organisms; too many factors influence their development. Same with the nasal septum. 90% of people have a deformity of the nasal plate 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 in any way relate their complaints to this defect.

The severity of symptoms is not directly dependent on the degree of curvature. It happens that a person with a severe curvature does not feel any discomfort at all. Conversely, even a slight deviation of the septum can cause complications.

There are no specific (pathognomonic) symptoms characteristic only of a deviated nasal septum.

But we can identify a number of symptoms with which patients most often go to the doctor; upon examination, they are diagnosed with a deviated nasal septum, and after correcting this defect, these complaints disappear.

1. Nasal congestion . This is perhaps the most common complaint of patients with a deviated nasal septum. A person cannot breathe normally through his nose for a long time; he continually drips vasoconstrictor drops 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 disruption of the natural cleansing of the eye and inflammation of the lacrimal sac.
5. Snore.
6. Impaired sense of smell. In the area of ​​the upper nasal passage there is the olfactory zone. If the curvature is localized in the upper part of the septum, the patient may not feel odors.
7. Frequent headaches.
8. Nosebleeds.
9. Hearing loss.

Pain in the nasal septum is not typical for uncomplicated curvature, unless it is a recent injury. So, if the nasal septum hurts, you need to look for other causes - sinusitis, boil, neuralgia of the nasociliary nerve.

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

Treatment of deviated nasal septum

A crooked nasal septum is an anatomical defect and can only be corrected surgically. Surgical treatment of curvature is indicated only if there are complaints. If there is a curvature without any clinical symptoms, surgery is usually not indicated.

Surgery to correct the nasal septum is suggested in cases where this defect is combined with long-term nasal breathing disorders, frequent sinusitis, and otitis media.

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

• Conventional standard septoplasty or submucosal resection, the oldest method of surgical intervention on the septum.

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

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

The operation to straighten 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, and you need to be examined by a therapist.

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

It is not recommended to correct the nasal septum in children under 18 years of age, however, if a child has severe difficulty in nasal breathing, this operation can be performed at an earlier age, from 5-6 years.

Other treatments for deviated septum

Recently, laser straightening of the nasal septum has been increasingly advertised. The advertising is really tempting: the operation is almost painless, bloodless, performed on an outpatient basis, lasts 15 minutes, recovery period is 1-2 days.

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 ranges from 20 to 50 thousand rubles.

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

Is it necessary to straighten a deviated nasal septum?

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

But there is also such a thing as quality of life. According to reviews from patients who underwent septal alignment, only after the operation did they understand that this quality may vary. When you breathe like a normal person, you begin to smell all the smells, constant headaches and depression go away, life begins to play with new colors.

Otorhinolaryngologist L.V. Ledova.

Literature: Otorhinolaryngology. Edited by Karpishchenko S.A.

Short course of otorhinolaryngology. V.T. Palchun, M.M. Magomedov, A.V. Gurov

Practical skills in otorhinolaryngology. G.M. Partenko

How is diagnosis carried out?

At the CELT clinic, a thorough examination of the patient by an otolaryngologist is carried out. During the preliminary examination, the ENT doctor assesses the effectiveness of nasal breathing, examines the nasal cavity and the state of smell. Using special instruments, rhinoscopy is performed to assess the degree of curvature of the nasal septum.

Anterior rhinoscopy is performed using nasal dilators as well as probes. This method helps to detect tumors, polyps, various hematomas and inflammatory processes. Posterior rhinoscopy involves examining the nose from the oral cavity. For examination, diagnostic mirrors and spatulas are used.

In addition to rhinoscopy, MRI of the skull can also be used to assess the degree of curvature. Computer diagnostics helps to establish the anatomical features of the nose and identify head injuries that could lead to a deviated septum.

Is it necessary to have septoplasty if nothing bothers you?

Be careful: even with a deviated septum, your nasal breathing may not change in a way that you will notice. In this case, you must follow all the instructions of your treating otolaryngologist.

In such cases, loss of nasal breathing function may occur after several years, when compensation from other structures has passed.

The sooner you find out whether you have a deviated septum or not, the better for your health.

Are there any other ways to treat a septum?

No, the curvature can only be corrected through surgery. The only difference is that the surgery can have different volumes, determined by the doctor during diagnosis.

When is surgery necessary?

Surgical straightening of the nasal plate is performed only if the problem cannot be solved with medication. The operation is called septoplasty, and it is performed from the age of 18 (by this age the septum is finally formed).

The operation is indicated in the following cases:

• With severe impairment of nasal breathing.
• When curved areas clog the exits from the sinuses and cause the development of sinusitis and sinusitis.
• During operations to improve the shape of the nose (rhinoplasty).

Treatment methods

There are no conservative ways to straighten the nasal septum. The only way to get rid of the defect is a surgical operation called septoplasty. Surgeons at the GALAXY Beauty Institute perform this intervention using endoscopic techniques. This does not require external incisions: all manipulations are performed directly inside the nasal passages.

The operation is not carried out blindly: visual control is carried out using a backlit video camera, which is inserted into the nasal passages along with instruments. The image from it is displayed on the monitor, and a significant increase allows you to see everything in great detail. Thanks to this, surgeons at the GALAXY Beauty Institute correct even complex curvatures.

If necessary, septoplasty can be performed simultaneously with rhinoplasty, i.e. correction of the shape of the nose. This allows you to correct both medical and aesthetic problems in one operation. After completing the rehabilitation period, the patient gets the opportunity to live life to the fullest, forgetting about snoring, bleeding, impaired sense of smell and other troubles.

A deviated nasal septum is a pathology that is rarely noticeable to the naked eye. Moreover, the problems it causes are much worse than purely aesthetic defects. Today there is no need to put up with snoring, poor sleep and headaches. Sign up for a consultation at the GALAXY Beauty Institute and trust our surgeons. Thanks to modern endoscopic technologies and the enormous experience of doctors, we are able to eliminate defects of any complexity without external incisions or scars.

How is surgery to correct a nasal septum performed?

At the CELT clinic, minimally invasive surgery to correct the nasal septum is performed by experienced otolaryngologists and plastic surgeons. The intervention is performed under general anesthesia, and the patient is discharged home on the same day. Alignment of the plate occurs by removing the curved part, shifting it to the middle, or straightening it using special equipment. After correcting the shape, the partition is securely fixed in the correct position.

Detailed information about septoplasty is posted on the corresponding page of our website. The operation is completely safe and effective; surgical intervention allows the patient to permanently relieve nasal congestion and cosmetic defects.

Take care of your own health, make an appointment with CELT otorhinolaryngologists right now to diagnose and treat the problem.

Rehabilitation after septoplasty

At the Pirogov Clinic, the patient is discharged after septoplasty the very next day! At the very end of the operation, tampons will be placed in your nose to help fix the new septum in the desired position. After some time (depending on the complexity of the surgical intervention), they will be removed for you (it won’t hurt as much as before), and then you will remember what it means to “breathe deeply.”

It is worth noting that tampons have also changed: if previously they were long and homemade (from bandages), now small tampons are used that absorb blood, but at the same time heal the mucous membrane. Also, modern tampons enlarge and occupy the nasal cavity, thereby squeezing the vessels to prevent bleeding.

You should not put any strain on your body for 1-2 weeks, although you will not need bed rest. For a quick recovery, it is important to correctly follow all the instructions of your treating specialist.

Our services

The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7

All services

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

Possible complications:

Photo: Allergy & rhinology (Providence, RI) / Open-i (Attribution-NonCommercial-NoDerivs 3.0 Unported)

• uncontrolled bleeding;
• infection;
• perforation of the septum;
• changing the shape of the nose;
• impaired sense of smell;
• temporary numbness of the gums of the upper dentition;
• hemorrhage under the mucous membrane of the septum.

Postoperative care and observation

• — in a hospital, postoperative care includes, first of all, the regime and observation by a doctor of the healing process. The patient does not perform any actions independently without the recommendation of the surgeon.
• — after discharge from the hospital, the patient spends the first week at home. It is recommended to maintain a home regime, avoid increased physical activity, crowded places, and follow the recommendations. Often, nasal rinsing with large volumes of saline solution, up to 1 liter (Dolphin, Aqua-Maris, etc.) is prescribed.
• — after returning to work, the patient must gradually enter the natural rhythm of life, slowly increasing physical activity to the usual level. Significant, exhausting loads, visits to the pool, baths, saunas, exercise in the gym, flights, business trips are recommended to be postponed for 1 month after the operation for normal recovery of the body. Often, the surgeon will schedule a follow-up examination 2-4 weeks after surgery to monitor the recovery process.

Types of anesthesia

The operation is performed only under general anesthesia - general anesthesia.

• This type of anesthesia is more gentle on the patient’s mental state.

(the patient is asleep, does not feel anything and has good dreams