Nasal Bone Curvature
Nasal Bone Deviation The nasal septum, also known as the middle partition of the nose, divides the nasal cavity into two halves. The front part of the septum is made of cartilage, while the back part is made of bone.
Ideally, the septum should be in the midline, and the right and left nasal cavities should be equal width. However, the septum is not perfectly centered in most individuals, and mild deviations exist. These mild deviations do not usually cause any symptoms. When the entire septum or a portion of it is significantly curved and deviates from the midline, affecting breathing, it is called a deviated septum. The greater the deviation and the more anterior it is, the more severe the nasal congestion becomes.
The nasal cavity is not a hollow tube; it contains three structures called turbinates on each side. If there are both deviations of the septum and growth or swelling of the turbinates, nasal congestion becomes more pronounced. This condition is known as concha hypertrophy and requires treatment.
What Causes Septal Deviation?
Septal deviation can be present from birth as a structural abnormality or due to trauma during passage through the birth canal. In childhood, injuries falls, and accidents can lead to septal deviation even without symptoms. Differences in the growth rate of the bone and cartilage portions of the septum during the developmental period can also result in deviation. Some individuals may have deviated septum that becomes more apparent in adulthood due to genetic factors.
What are the Symptoms of Septal Deviation?
The most common septal deviation symptom is difficulty breathing through the nose. It can cause difficulty in breathing through one or both nostrils. In individuals with mild septal deviation, the symptoms may only occur during sleep, seasonally, or colds. Nasal obstruction significantly affects a person's quality of life. Some individuals may have been unable to breathe through their noses since childhood and may not be aware of the complaint. Waking up with a dry mouth in the morning or resorting to mouth breathing during exertion can be indications. The symptoms of septal deviation generally include:
Chronic nasal congestion
- Difficulty breathing through the nose
- Nasal blockage or obstruction, especially on one side
- Frequent sinus infections or sinusitis
- Snoring or sleep apnea
- Headaches, especially in the forehead or facial pain
- Reduced sense of smell
- Dry mouth in the morning
It is essential to consult a medical professional for an accurate diagnosis and appropriate treatment options for septal deviation.
How is Septal Deviation Diagnosed?
Septal deviation is diagnosed through a detailed examination of the nose. If other problems are present, such as sinusitis, turbinate swelling, or allergies, additional tests, such as tomography and laboratory investigations, may address those issues.
How is Septal Deviation Treated?
Surgery is the only treatment option for correcting a deviated nasal septum. No medication can straighten a curved nose. The curvature of the nasal bone is corrected through a surgical procedure called septoplasty. This surgery can be performed under local or general anesthesia, although general anesthesia is often preferred for patient comfort.
The duration of the operation, excluding anesthesia, is typically around 30-45 minutes. The incision for the surgery is made inside the nose, in an area that is not visible from the outside. The obstructing bones that block the nasal airway are removed, and if feasible, any deviations in the cartilage are corrected and repositioned. If there is swelling in the nasal turbinates, it can also be addressed during the same procedure. The airway is opened up. Nasal packing is usually applied after surgery, but nowadays, airway-channeled silicone packing is often preferred. With these packings, the patient can breathe comfortably and have a smoother postoperative period.
Since the packings are silicone, their removal process is quite comfortable. There is no external skin incision or change in the shape of the nose as a result of this surgery. Bruising or swelling under the eyes is not observed.
