A deviated septum occurs when the nasal septum (the internal dividing wall between the right and left sides of the nose) is severely shifted away from the midline. When the bone and cartilage making up the septum is crooked, it causes obstruction of the nasal airways and makes breathing difficult.
The back or posterior two-thirds of the septum is comprised of bone, while the front or anterior one-third is made up of cartilage. The septum is surrounded on each side by a mucosal lining. The mucosal lining covers and protects the cartilage and bone, and helps to keep the inside of the nose moist.
Septal deviations are usually genetic or random but may be the result of injury or trauma to the nose.
The most common symptom of a deviated septum is nasal congestion. Symptoms are usually worse on one side, and sometimes occur on the side opposite the bend. Other symptoms include difficulty breathing, recurrent or repeated sinus infections, frequent nosebleeds, facial pain, headaches, loud breathing, snoring and mild sleep apnea. For some patients, the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.
During your consultation, your ENT (ear, nose, and throat) doctor will ask you about your symptoms and if you ever incurred trauma to your nose or if you ever had previous nasal surgery. Your ENT doctor will then examine the general appearance of your nose, including the position of your nasal septum, using a lighted small endoscope to inspect the nasal cavity from the front all the way to the adenoid area in the nasopharynx. For some patients, CT scans and allergy testing may also be ordered. If the deviated septum is causing troublesome nosebleeds or recurrent sinus infections, surgery may be the recommended treatment. When a deviated septum is determined to be a significant causative factor of nasal obstruction, surgical correction of the deviation may be recommended.
A nasal obstruction can have many causes. For some patients, allergies lead to swelling of the nasal and sinus lining, which causes congestion and blockage. For other patients, the blockage may be due to a simple anatomical obstruction, such as enlarged nasal turbinates, a polyp in the nasal passage, or a deviated septum.
Allergy Treatments and Medications can help alleviate symptoms associated with a deviated septum; however, they do not correct the septal deviation.
A septoplasty is the preferred surgical treatment to correct a deviated septum and improve breathing. It is a minor, minimally-invasive, outpatient procedure. The procedure can frequently be done in the office under local anesthesia with oral sedation. The procedure is performed entirely through the nostrils where the ENT surgeon makes a small incision in the septum and then removes the excess bone or cartilage required to even out the breathing space of the nostrils.
A septoplasty procedure is often recommended for patients who:
For these patients, a septoplasty can have a major, positive impact on nasal breathing, congestion, and quality of life.
A septoplasty procedure is generally recommended for adults 16 years and older. It is generally recommended that a person has completed puberty before a septoplasty is recommended.
If a septoplasty is the only procedure performed, there should be little to no bruising after surgery.
The procedure takes, on average, 1 to 1 ½ hours, depending on the deviation.
Many ENT surgeons perform septoplasty without packing or septal splints. If nasal packing is used, it is inserted to prevent excessive postoperative bleeding. Talk to your ENT surgeon about his/her standard practice.
This procedure can be done using a local or a general anesthetic and is usually done on an outpatient basis.
You can expect to have mild pain, fatigue, nasal stuffiness, and mild nasal drainage after your surgery. The stuffiness typically results from swelling after the procedure and typically starts to improve after the first week. Most patients find that post-operative pain is easily managed with low-dose narcotic medications, such as Tylenol with Codeine or Tramadol, for 1-2 days. After that, they switch to regular or extra-strength Tylenol and ibuprofen (taken together to control both pain and swelling) for another week or so.
Sutures may be used to sew the skin incision site and mucosal flaps together at the end of surgery. Frequently, if an incision is made into the mucosa, sutures are not placed. If sutures are placed, they are typically dissolvable and do not require removal.
After surgery, you may have drainage of some mucus and blood from your nose. This is a normal part of the healing process.
Many patients typically take several days to a week off from work for recovery. During this time, patients are advised to refrain from heavy lifting or vigorous activity for 1-2 weeks.
After surgery, there are no restrictions on eating or bathing. Actually, you may eat whatever you feel like eating.
If a deviated septum is the sole cause for your chronic sinusitis, you can expect improved nasal breathing and airflow, decreased blockage and congestion, diminished dry mouth, and a more complete, restful sleep. Overall, you will experience relief from your symptoms and improved quality of life.
A septoplasty can be frequently combined with turbinate reductions, and/or balloon sinus dilation and functional endoscopic sinus surgery. These procedures should not leave any bruising or facial swelling. A septoplasty can also be performed in conjunction with a rhinoplasty (nose job), and if this happens bruising and swelling are more common. Your ENT surgeon will work in conjunction with a facial plastic surgeon to perform those procedures.
If you are having nasal symptoms and think you may have a deviated septum, contact CT Sinus Center at (203) 574-5997 to schedule a consultation for evaluation, diagnosis, and treatment.
