Nasal septum deviation is a physical disorder of the

nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next pass ...

, involving a displacement of the nasal septum. Some displacement is common, affecting 80% of people, mostly without their knowledge.

Signs and symptoms

The nasal septum is the bone and cartilage in the nose that separates the

nasal cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal ...

into the two

nostril A nostril (or naris , plural ''nares'' ) is either of the two orifices of the nose. They enable the entry and exit of air and other gasses through the nasal cavities. In birds and mammals, they contain branched bones or cartilages called t ...

s. The cartilage is called the quadrangular cartilage and the bones comprising the septum include the maxillary crest, vomer and the perpendicular plate of the ethmoid. Normally, the septum lies centrally, and thus the nasal passages are symmetrical. A deviated septum is an abnormal condition in which the top of the cartilaginous ridge leans to the left or the right, causing obstruction of the affected nasal passage. It is common for nasal septa to depart from the exact centerline; the septum is only considered deviated if the shift is substantial or causes problems. By itself, a deviated septum can go undetected for years and thus be without any need for correction. Symptoms of a deviated septum include

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable d ...

s of the sinus and

sleep apnea Sleep apnea, also spelled sleep apnoea, is a sleep disorder in which pauses in breathing or periods of shallow breathing during sleep occur more often than normal. Each pause can last for a few seconds to a few minutes and they happen many tim ...

, snoring, repetitive sneezing, facial pain, nosebleeds,

mouth breathing Mouth breathing, medically known as chronic oral ventilation, is long-term breathing through the mouth. It often is caused by an obstruction to breathing through the nose, the innate breathing organ in the human body. Chronic mouth breathing m ...

, difficulty with

breathing Breathing (or ventilation) is the process of moving air into and from the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen. All aerobic creatures need oxygen for cell ...

and mild to severe loss of the ability to

smell Smell may refer to; * Odor, airborne molecules perceived as a scent or aroma * Sense of smell, the scent also known scientifically as olfaction * "Smells" (''Bottom''), an episode of ''Bottom'' * The Smell, a music venue in Los Angeles, Californ ...

. Only more severe cases of a deviated septum will cause symptoms of difficulty breathing and require treatment.

Causes

It is most frequently caused by impact trauma, such as by a blow to the face. It can also be a

congenital disorder A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities c ...

, caused by compression of the nose during childbirth. Deviated septum is associated with genetic connective tissue disorders such as Marfan syndrome, Homocystinuria and Ehlers–Danlos syndrome.

Diagnosis

Nasal septum deviation is the most common cause of nasal obstruction. A history of trauma to the nose is often present including trauma from the process of birth or microfractures. A medical professional, such as an

otorhinolaryngologist Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical a ...

(ears, nose, and throat doctor), typically makes the diagnosis after taking a thorough history from the affected person and performing a physical examination. Imaging of the nose is sometimes used to aid in making the diagnosis as well.

Treatment

Medical therapy with nasal sprays including decongestants, antihistamines, or nasal

corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are in ...

sprays is typically tried first before considering a surgical approach to correct nasal septum deviation. Medication temporarily relieves symptoms, but does not correct the underlying condition. Non-medical relief can also be obtained using nasal strips. A minor surgical procedure known as septoplasty can cure symptoms related to septal deviations. The surgery lasts roughly one hour and does not result in any cosmetic alteration or external scars. Nasal congestion, pain, drainage, or swelling may occur within the first few days after the surgery. Recovery from the procedure may take anywhere from 2 days to 4 weeks to heal completely. Septal bones never regrow. If symptoms reappear they are not related to deviations. Reappearance of symptoms may be due to mucosal metaplasia of the nose. Currently, the most gentle and effective treatment is laser septo-

chondroplasty Chondroplasty refers to surgery of the cartilage, the most common being corrective surgery of the cartilage of the knee. Surgery known as thyroid chondroplasty (or ''tracheal shave'') is used to reduce the visibility of the Adam's Apple in Transwo ...

for the septal cartilage segment deformity and

ultrasound Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies fr ...

septoplasty – effective for the septal cartilage and bone deformation.

Complications of septoplasty

* Nasal septum perforation due to bilateral trauma of the mucoperichondrial flaps opposite each other. *Incomplete correction with persistent nasal symptoms *External nasal deformity *Septal hematoma and septal abscess. *Scarring inside the nose and nose bleeding *Adhesions and synechiae between septal mucosa and lateral nasal wall * Saddle nose due to over-resection of the dorsal wall of the septal cartilage *Dropped nasal tip due to resection of the caudal margin

References

External links

{{DEFAULTSORT:Nasal Septum Deviation Nose disorders Injuries