Curvature of the septum

Synonyms in a broader sense

Medical: septal deviation

Crooked / crooked nose, broken nose

Definition

Curvature of the nasal septum is a change in the nasal septum (septum nasi). In most cases, the nasal septum is laterally displaced from birth or has been displaced from its normal position due to an injury to the nose (e.g. a blow to the nose).

causes

Most often there is no causal cause for the curvature of the nasal septum, so that one speaks of a hereditary component. Thus, most of them have been affected by the respective symptoms since their birth or childhood and it is not uncommon to find family members with similar problems when asked.

Curvatures of the nasal septum caused by accidents involving violence are rather the minority. The degree of curvature is very variable and depends on the degree of external force. A typical example of an acquired curvature would be a blow to the nose, which shows an immediate visual change in the nose as well as a noticeable functional change in breathing.

An acquired curvature of the nasal septum can also result from chronic inflammation of the nasal mucosa. In most cases, the turbinates are enlarged on one side (hyperplasia of the conchae nasalis). Free nasal breathing is then hardly possible through the affected nostril.

Read more on the topic: Inflammation of the nasal mucous membrane

Symptoms

The main symptom of the curvature of the nasal septum is the impaired nasal breathingwhich is felt to be very stressful, especially subjectively. Only one or both nostrils can be affected and possibly an additional one Swelling of the mucous membrane Cause problems. Those affected often notice first that they breathe more through their mouths and thus have a dry mouth. Especially during exertion or sport, you can only breathe effectively through your nose for a very short time before the feeling of a "stuffy nose" arises and you automatically breathe through your mouth. This assumption that the nose is closed also explains why some people have the feeling that they smell less.

But also at night it can cause complaints like sleep disorders or snoring come so that the curvature of the nasal septum can cause a variety of symptoms that need to be interpreted and examined individually.
In the worst case, when the nasal septum is particularly crooked and the turbinates are enlarged, it can even be too shortness of breath (Dyspnea) coming.

It should not be neglected that a curvature of the nasal septum is sometimes only caused by it Secondary diseases notices. Thus caused by the lack of ventilation the affected side of the nose often Inflammation sinuses, throat, or middle ear, which often recur (relapse). Therefore, especially with recurring "banal" infections of the ear, nose and throat tract, one should always think of a curvature of the nasal sheath wall.

How do you recognize a curvature of the nasal septum?

In order to recognize a curvature of the nasal septum you should first look at your nose in the mirror and see if it is Misalignment the nose can already be seen from the outside. To find out more, you can bend your head back and pull the tip of your nose upwards so that you can look better in front of the mirror. There should always be a Equality of sides Be careful as any irregularity regarding Size of the nostrils and visible Consistency There are indications of a warpage. In addition to the visual inspection, the nasal breathing should finally be tested by simply closing one nostril for a few seconds and comparing the nasal breathing directly. It is also important to observe the subjectively perceived symptoms, for example to allergy as a trigger of disturbed nasal breathing.

therapy

If you experience the above symptoms, your ear, nose and throat doctor will advise you to have one Correction of the nasal septum (Nasal septoplasty, septal resection). The troublesome, crooked parts of the nasal septum (septal cartilage and septal bones) are removed and reinserted in a straightened position.

Depending on the severity of the curvature of the nasal septum, this is carried out on an outpatient basis or in a clinic with a few days of inpatient stay.
Must the Ear, Nose and Throat Doctor (ENT) In addition to laying bone tissue in addition to the cartilage tissue, hospitalization is usually required.

Treatment with nasal spray

To treat a impaired nasal breathing, as it occurs with a curved nasal septum, is often used Nasal sprays. The improved nasal breathing is brought about by the fact that the active ingredient in the nasal spray the Narrow vessels in the mucous membrane makes and thus a Decongestion this is caused by a reduced blood flow. But this also explains that the Nasal spray just acts symptomatically and doesn't fix the cause.

Therefore it should only be used as bridging (i.e. for maximum 10-14 days with application according to the instruction leaflet) and for severe symptoms. Because the risk of nasal spray dependent becoming is and remains a problem.

Please also read our topic: Dependence on nasal spray

The greatest danger besides physical and psychological dependence through habituation effects is that irreversible destruction of the nasal mucosa. The underlying mechanism is that excessively applied nasal spray first leads to the mucous membrane drying out due to the reduced blood flow, which favors small tears and this in turn leads to the development of inflammatory processes. In the worst case, this results in the destruction of tissue, which is then perceived as an unpleasant odor and then as a clinical picture of the so-called "Smelly nose" referred to as.

Find out more about the here Smelly nose

Therefore, nasal spray should only be used in moderation and for early symptoms of excessive use such as one painful dry mucous membrane or frequent nosebleeds be respected. The use of homeopathic remedies such as a nasal rinse or a nasal spray based on seawater should also be considered as an alternative for long-term use.

Operative therapy

A curvature of the nasal septum (septum deviation), i.e. a deviation of the nasal septum to the side, is more or less pronounced in almost 80% of people.
Most of the time, however, this deformation remains symptom-free.
However, should symptoms occur, such as:

an obstructed nasal breathing
chronic infections (sinus infections, tonsillitis, or throat infections)
Sleep disorders (usually associated with snoring)
Nosebleeds (nosebleeds with headache)
a headache

then a correction of the curvature of the nasal septum is necessary.

Read more on the topic: Nasal septum OP

This correction is done surgically. The prerequisite for an operation on the nasal septum to be performed is that the Growth of the patient already completed because otherwise there is a high risk that the nasal septum will shift again over time. There are no upper limits to age, as the restriction due to symptomatic curvature of the nasal septum is considered to be very significant at any age. However, one should know that there is a risk of complications from the procedure in the presence of other diseases such as:

Diabetes mellitus
Obesity

Smokers and occasional drinkers also have a higher risk of thrombosis.

In principle, a curvature of the nasal septum can be corrected in local anesthesia or in general anesthetic respectively.
However, most patients choose general anesthesia in order not to hear the noises and not to have to consciously experience the operation. The disadvantage of general anesthesia, however, is that an inpatient stay of at least 1 to 2 days is always necessary.
Otherwise, the operation can also be carried out on an outpatient basis, whereby nursing care at home for at least 2 to 4 days is recommended.
Depending on the degree of displacement of the nasal septum, it takes The procedure takes about 30 to 120 minutes.

One differentiates:

a Septoplasty (here the straight course of the nasal septum is restored)
a Septal resection (depending on the individual case, more or less large parts of the nasal septum must be removed)

However, these can also be used in combination.
Of the surgical approach usually takes place over the nostrils, less often by mouth. The following steps are taken:

Of the Nasal cartilage is separated from the bone.
Then the crooked parts of the nasal septum are either removed or, if possible, straightened.
In some cases, it is also necessary to correct the turbinates or to shift bone tissue.
Finally, the nasal septum is reassembled.
Special tamponades are inserted into the patient's nostrils. These contain small air tubes inside, which enable the person affected to breathe effectively through the nose again immediately after the operation. The tamponades serve to minimize any occurring Secondary bleeding intercept.

Other complicationsthat may occur after surgery are:

Infections (to avoid them for about a week antibiotic should be taken)
Swelling, some of which may be bloodshot
Numbness of the nasal region
Tears of eyes
continued obstruction of nasal breathing

Notes on surgery of the curvature of the nasal septum

Whether the correction was successful can only be assessed some time after the operation, when everything has swollen again.

If the operation is successful, the person will not need to undergo any further correction for the rest of their life.

Following the correction of a curvature of the nasal septum, the patient should take some time off after consulting their doctor. This means that one should be very careful with activities that involve moving the nose, such as:

Clean the nose
Brush teeth
Sneeze
Sleep on the side
wearing glasses
Exercising and so on.

As a rule, you are able to work again after two to four weeks.

If the curvature of the nasal septum has impaired health, its correction is usually covered by health insurance.
However, to be on the safe side, it is advisable to find out beforehand. If, due to cosmetic aspects, an operation is only carried out at the request of the person concerned, the person concerned usually has to bear the costs himself, which are usually in the lower four-digit range depending on the scope of the operation.

Read more on the subject below: Surgery of a curvature of the nasal sheath wall

Complications

If there is already a Curvature of the septum exists, it can worsen in the sense of a vicious cycle. More germs automatically accumulate in the less ventilated, narrow and warm nose. These are mostly viruses and bacteria.
The nasal mucous membrane reacts to this with increased mucus production. It comes to one sniff (Rhinitis). In this moist environment, the few bacteria like to proliferate and drive the mucus production of the nasal mucosa more and more.
Does the cold or the cold too long, the neighboring mucous membranes soon become inflamed throat and the Sinuses. There is now one Throat inflammation (Pharyngitis) or to a Sinus infection (Sinusitis). If you look at your throat in front of the mirror, you will see a strong reddening and sometimes whitish mucus running down the wall of the throat.

If this condition is not treated now, the patient will suffer from the fact that he can barely breathe through his nose for days and nights and will constantly have his mouth open slightly to breathe. This creates a new problem again. The air inhaled through the mouth is neither heated nor filtered and thus reaches the tonsils, the throat (pharynx) and the bronchi of the lungs.
Together with the slimy throat caused by viruses and bacteria in the respiratory tract, the cold and dusty air can cause new inflammation in the neighboring tissues. Anyone who notices swallowing difficulties already has one Inflammation of the tonsils (Tonsillitis), a slight cough indicates irritation or Inflammation of the bronchi (acute bronchitis).

The already difficult nasal breathing leads to difficult falling asleep and staying asleep and possibly to snoring at night. During the day you feel exhausted, tired or have a headache.

Frequency distribution

If you were to examine all people to see what their nasal septum is like, you would find 80% of the people an easy one Curvature of the nasal septum (Septal deviation).
A slight displacement of the nasal septum can therefore be regarded as normal (physiological) and usually does not affect people.