A deviated nasal septum is a common pathology. Various degrees of deviation of the septum from the median position can lead to various complications. Operations to correct a crooked nasal septum make up a significant part of surgical interventions in ENT hospitals and really help get rid of many problems.

Nasal septum

The nasal septum is a plate made of cartilage and bone that divides the nose into two halves. In the anterior part, the septum is represented by a quadrangular cartilage, and in the rear by a vomer and a perpendicular plate of the ethmoid bone. The nasal septum is inserted into a frame of the frontal bones above, the hard palate below, and the sphenoid and ethmoid bones behind.

Actually, this multicomponent structure is most often the prerequisite for its curvature, since there is uneven growth of the various parts of the septum and the bones that form the “frame” into which the septum is inserted.

The nasal septum is needed for uniform distribution air flows. Dividing the air flow into two parts is necessary for its fastest warming, humidification and cleansing.

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:

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 deformations. 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, ciliated epithelium loses its eyelashes, thereby losing its protective function. The secretion of mucus and the cleansing of the mucous membrane from microbes are impaired. Arises.

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 nasal septum 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 (,), 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, causing oxygen starvation tissues of the whole body. Signs corresponding to this are: chronic fatigue , headache, shortness of breath, bad dream

. In children, this can lead to delays in physical and mental development. Because of this, a person is forced to breathe mainly through his mouth. This leads to dryness of the mucous membrane oral cavity , development , bad smell

from mouth. 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

nasal septum. 90% of people have a deformity of the nasal plate to one degree or another.

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. . 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 constantly drips into his nose, which only aggravates the situation due to the development of vasomotor rhinitis.
2. Frequent acute sinusitis or the presence of 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 natural cleansing eyes, inflammation of the lacrimal sac.
5. 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.
6. Frequent headache.
7. 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. It is usually offered after unsuccessful conservative treatment of these diseases.

Treatment of deviated nasal septum

A crooked nasal septum is an anatomical defect and can only be corrected surgically. Surgical treatment 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.

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

• Regular standard septoplasty(or submucosal resection, the oldest method surgical intervention on the partition). In the nasal cavity, the mucous membrane is cut in an arcuate manner, a section of quadrangular cartilage is isolated and cut off, then the curved bony part of the septum is removed (a hammer and a chisel are used for this). The flaps of the mucous membrane, together with the perichondrium and periosteum, are brought closer to each other and fixed with tampons in the middle position.

• Gentle endoscopic septoplasty– a more modern method, carried out 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.

There are various modifications of both operations. For example, the resected cartilage can be straightened in a special way and placed in its place between the layers of perichondrium. After healing, such a modulated septum occupies a normal physiological position.

Often other surgical procedures in the nasal cavity are performed simultaneously with septoplasty: conchotomy– trimming thickened nasal concha, removing polyps, vasotomy– resection 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 this operation: spicy infectious diseases, heavy chronic diseases, bleeding disorders, old age, mental illness.

Surgery to straighten the nasal septum can be performed free of charge compulsory medical insurance policy. Cost of septoplasty in paid clinics ranges from 20 to 100 thousand rubles. The price depends on the volume of the operation, the qualifications of the surgeon, the category of the clinic, the type of anesthesia, and the length of hospital stay after the operation.

After surgery, tampons are inserted into the nose to hold the septum in the correct position. Tampons are removed after 1-2 days. The patient is discharged on days 5-6, but full recovery usually occurs after 2 weeks.
All this time, observation by an ENT doctor, daily treatment of the nasal cavity with antiseptics, and rinsing with sterile cleansing solutions are necessary.

After 2 weeks, complete healing and restoration of nasal breathing occurs.

As with any other operation, complications may occur after septoplasty:

1. Bleeding. Minor bleeding is acceptable, but within 1-2 days after the operation there is a discharge of ichor - a mucous discharge with blood.
2. Septal hematoma- accumulation of blood between layers of tissue.
3. Perforation of the nasal septum. A fairly rare but unpleasant complication. Occurs when tissues are cut through. As a rule, it heals poorly. Requires further re-operation to restore the nasal septum.
4. Saddle-shaped retraction of the nasal bridge.
5. Suppuration.

Other treatments for deviated septum

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, widespread laser correction 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 for a long time cannot decide 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

normal person

, you begin to smell all the smells, constant headaches and depression go away, life begins to play with new colors. A few words about prevention The only one available to anyone method of preventing deviated septum is

timely appeal

• See a doctor for any nasal injury. This is necessary to exclude or confirm a septal fracture (it is advisable to do a CT scan for this) and, if the septum is broken, to reposition the broken bones in a timely manner.
• Frequent headaches, malaise, constant fatigue and the therapist cannot find the cause? Check to see if you can breathe equally well through both nostrils.
• Do you snore at night? This may also be due to impaired nasal breathing due to a deviated septum.
• The mere presence of curvature is not a reason for concern. Treatment is indicated only when it interferes with life.
• The main method of treatment is surgery.
• You need to decide on surgery, undergo a thorough examination and prepare for at least 2 weeks of incapacity.
• Enjoy your new quality of life and praise yourself for your courage.

Video: deviated nasal septum in the program “Live Healthy!”

- This is not only a cosmetic defect; first of all, it can cause health problems. Therefore, it is necessary to take some action and eliminate the curvature. This is possible not only thanks to surgical intervention; there is also non-surgical treatment, which is quite widely used and has good results.

The traditional method of treating a deviated nasal septum is the use of medications. This method is most relevant for adolescents whose cartilage and bones have not yet fully formed, as well as people with minor deformities. In other cases, the use of medications will help eliminate the symptoms of this defect without resorting to surgery.

This method is determined by the use of nasal drops, rinsing the nasal cavity, and the use of antibiotics.

Did you know? A popular method for straightening a deviated nasal septum is. Thousands of operations have allowed people to restore breathing as nature intended.

Nasal drops for deviated nasal septum - have a high therapeutic effect and are effective for nasal congestion and breathing problems. They do not change the appearance of the nose, but help reduce symptoms and improve well-being. The most common means are:

Deviated nasal septum: how to rinse your nose? In this case, solutions containing sea salt will be effective; regular saline solution can also be used. Among medications, Aqua Maris, Aqualor and others are suitable.

Treatment of curvature with surgitron

The Surgitron device is radio wave and provides non-surgical intervention for various ENT diseases, including a deviated nasal septum.

Thanks to radio waves, high bactericidal effect, tissue healing is accelerated.

Surgitron device

The procedure involves a small dissection of the mucous membrane under the influence of heat, it is completely painless and there is no bleeding. There are no scars left after the procedure and there are no complications.

Methods with a temporary effect for correcting the septum

Without surgical intervention, it is impossible to cure severe deformation of the nasal septum. But there are some methods that have a temporary effect. They are:

1. Warming up helps improve blood supply, reduces swelling and inflammation, so nasal function is restored for a certain time. This procedure is carried out by a physiologist, who mainly prescribe electrophoresis, iontophoresis, phototherapy and more.
2. Antihistamines and antibacterial therapy can also provide temporary relief. Medicines are taken as prescribed by a doctor, according to age and health status.

Straightening using laser septochondrocorrection

Laser septochondrocorrection procedure

Laser septochondrocorrection is a modern non-surgical method for eliminating deformation of the nasal septum. This procedure can only be used for curvature of cartilage; if bone is involved, surgery will be necessary.

• Septochondrocorrection is caused by the effect of a laser on the nasal septum, under the influence of which it becomes mobile and is given the necessary shape.
• The procedure is safe and painless; in addition, the laser has an antimicrobial and bactericidal effect and does not cause bleeding.

Traditional methods

With the help of traditional medicine, it is possible to improve well-being and restore respiratory function. The following methods are used for this:

1. Sodas and saline solutions- are widely used for breathing problems; they are mainly used to wash the nasal passages. For this purpose in warm water dilute one of the components, then use an auxiliary device - a syringe, a teapot, a bulb, and clean the nasal cavity.
2. Chamomile infusion - a dry plant is poured with a glass of boiling water and infused for 30 minutes. Then it is filtered, cooled and used as a nasal rinse.
3. Wormwood decoction is also used for rinsing for rhinitis, nasal congestion and deviated septum. To prepare, you need a little wormwood and boiled water, the ingredients are mixed, infused for 40 minutes and used for their intended purpose.
4. Sage infusion - a glass of water and 1 tsp. Boil the plants for 10 minutes over low heat, then strain, cool and rinse the nasal cavity. It helps well with sinusitis, runny nose, and also in eliminating the symptoms of a deviated septum.
5. Oils help improve breathing and cleanse the mucous membranes. Rapeseed, flaxseed, and olive oils are widely used as drops.

Treatment with massage

Massage helps eliminate signs of a deviated septum and also helps treat nasal congestion. It stimulates the circulatory centers, thereby improving the secretory function of the nose, reducing inflammation and swelling.

This method does not have a direct effect on the nasal septum; it cannot change anything, but massage helps restore breathing for a while and avoid other symptoms of such a defect.

Instructions

Curvature most often develops after injury nose, both in early childhood and in mature age. Bones nose can be injured during the process, which will be unnoticed, but will only manifest itself as a violation of nasal breathing later. The condition suffered in childhood also contributes to disruption of the formation of the bones of the facial skull. Has the meaning hereditary predisposition to the disease, because There are familial cases of congenital curvature partitions nose.

The main symptom of the disease is difficulty breathing through one or both nostrils. In case of severe curvature, breathing with one half nose may be completely absent. At the same time, the outflow of mucosal secretions nose And paranasal sinuses is disrupted, which leads to frequent rhinitis and sinusitis.

When curvature partitions nose the sense of smell deteriorates. This is due to the fact that deformed bone and cartilage prevent air from entering the superior turbinate, the olfactory area.

Curvature may manifest itself as nasality, because cavity resonator function nose in this case it is lost. Additionally, a person with a deviated septum nose noisy, which is especially audible when sleeping.

Deformation of bone and cartilage parts partitions traumatic origin can be seen when comparing the symmetry of the left half of the face. Curvature The lower part of the cartilage can be seen when looking upward at the nasal cavity.

The presence of the disease is best determined by an ENT doctor during an objective examination. Nasal speculums, which are used during rhinoscopy, allow you to examine most of the partitions. An endoscope is used to diagnose small curvatures, as well as deformations in hard-to-reach places.

Related article

« Rickets" - a word familiar to many parents. The disease behind this word affects children in the first two years of life. In Russia, the incidence of rickets is 65%. The standard of living is improving, but the number of diseases is not decreasing. As a rule, children suffering from rickets also have whole bouquet diseases. The main cause of rickets is a lack of calcium intake from food or a lack of calcium formation in the skin under the influence of ultraviolet radiation.

Instructions

Rapid weight gain in the first months of life should alert parents. The faster weight gain occurs in the first months after birth, the more calcium, phosphorus and vitamin D he needs, therefore, the higher the possibility of developing rickets. Signs that should alert parents: - anxiety and increased excitability baby;
- the back of the child’s head;
- increased sweating with a specific sour odor;
- muscle tone;
- poor sleep;
- constipation.

Previously, there was an opinion that rickets went away on its own by the age of four. This is a misconception. If rickets does not occur, persistent bone deformities of the skeleton (scoliosis) and flat feet remain for the rest of your life. Caries develops, first and then permanent teeth. Unexpected bone fractures and growth retardation may occur. A frequent accompaniment of rickets is anemia and myopia at school age. A definite connection has been identified between rickets in infancy and osteoporosis.

Helpful advice

You cannot replace walking with your baby in the park, where the child is in the sun, with sleeping in a stroller on a loggia or near an open window.

Partition nose is a thin plate of bone and cartilage that divides the cavity nose on the left and right sides. Symptoms of a deviated septum nose problems that require surgical correction may include crusting, difficulty breathing, and frequent nosebleeds.

Instructions

You can have an operation that involves removing only curved areas of bone or cartilage. She's a septum resection nose under the mucosa." During surgery, an incision is made inside nose, so the scar will not be visible as a result. In this case, the mucous membrane that covers partition nose, is saved. After this operation, there will be no hole left on the hole itself - it will simply be thinner and consist of fibrous tissue rather than cartilage. In some cases, with severe curvature, a large area of ​​not only cartilage, but also bone is removed. In this case, so that the form nose has not changed on the outside, a flat bone plate from the deepest sections is inserted in place of the cartilage nose. This operation is called septoplasty.

At the end of the operation, the specialist fills the cavity nose sterile gauze swab, pre-impregnated with ointment. This tampon helps to hold the sheets of the mucous membrane and also does not allow blood to accumulate between them. It is removed only two days after the operation.

Septum surgery nose, as a rule, is performed under local anesthesia. At the same time, half an hour before the upcoming procedure, premedication is given, that is, special drugs are administered that reduce the patient’s sensitivity and enhance the effect. local anesthetic. Further, at the beginning of the operation, the mucous membrane is lubricated with an anesthetic, and it is also injected into the partition nose. This provides sufficient pain relief for surgery.

Can you fix it? partition nose using a laser. If you burn cartilage with a laser, it will begin to bend. True, this operation is limited only to cases of curvature of the cartilage itself with an unchanged condition of the bone septum nose, which is quite rare. This procedure is done without detachment of the mucous membrane itself. That is why such an operation can be performed on an outpatient basis. There are also disadvantages to this method of correcting the septum. nose- a severe burn of the mucous membrane, healing for a long time with the formation of massive crusts.

Deformation partitions varying degrees - a fairly common problem. Therefore, questions about how much this affects health and what to do in such a situation are relevant for many people.

This deformation occurs due to several reasons. This may be a hereditary predisposition, uneven development of the facial bones during the period, or injury nose. Curvature may also occur due to the growth of ridges and spines on the septum. Frequent inflammatory diseases can also contribute to the appearance of this. Changes partitions nose can cause serious problems such as difficulty breathing, frequent bleeding from nose, snoring, chronic rhinitis. They also contribute to frequent colds. In severe cases, hearing loss or injury may occur. Inadequate breathing, in turn, contributes to the appearance of other problems - heart function is disrupted, diseases become more frequent respiratory system(up to the appearance of asthma), etc. However, all these problems most likely arise only when the curvature partitions strongly expressed (for example, one of the nasal passages is almost completely blocked). So if you are bothered similar problems, you should definitely consult with an otolaryngologist. Only he can have deformation partitions nose, its severity and how much this deformation affects the condition of your body. It will also decide on the need for treatment. Unfortunately, the main method of treating deformity partitions nose– operational. There is also a laser treatment for this disease, but it is very limited. Mainly the problem of treating nasal partitions is solved by removing the nasal cartilage (complete or partial). This operation is not considered difficult or complicated. It is performed from the age of fourteen, but in particularly difficult cases it can be done even from the age of six. In most cases, it is performed under local anesthesia, although some doctors are inclined to think that general anesthesia is more appropriate in this case. This opinion is due to the fact that the mucous membrane nose contains a lot of receptors and is extremely sensitive, so local anesthesia does not always provide the desired effect. Restoring this will take about a month.

Tip 5: Office partitions: types, materials, installation features

Modern office partitions are not only about delimited space, mobility and comfortable conditions labor. Office partitions are a convenient tool that will help you transform free space to a stylish, comfortable and ergonomic office.

Types of office partitions

All partitions can be divided according to several criteria: functional purpose, by the presence of glazing, by type of glazing and frame. Partitions can also be divided according to noise insulation properties, fire safety and fire resistance.

According to their functional purpose, they are distinguished: mobile, stationary, sliding (modular), folding partitions. As well as solid, combined and transparent tabletop screens. According to the type of glazing, single and double glazing are distinguished. As for the frame, partitions can be divided into: frameless, steel, aluminum, glass and plastic.

It is worth noting that stationary partitions must be fixed to the floor and ceiling. If there is a need to move and change the location of the partition, then it is better to choose modular ones, which do not require fastening and can be moved mobile to any desired location.

Each of listed types has its incomparable advantages.

In addition, great importance should be given to the materials from which the partitions are made. Aluminum partitions have a long service life. The aluminum frame does not rust or corrode. Due to the fact that this metal is a lightweight and quite flexible material, it is possible to produce partitions of any complexity and configuration.

Partitions made of polyvinyl chloride (PVC) are particularly practical. They will provide, especially in combination with high-quality double-glazed windows.

Treatment of deviated nasal septums

Finally, due to a defect in the nasal septum, a person’s physical capabilities are limited. At increased loads he lacks air and develops shortness of breath.

There is an exit!

Septoplasty - straightening the nasal septum - has long become a routine operation in otorhinolaryngological practice. It is performed under local anesthesia when the curvature is slight. If the surgical care is large enough and long enough, a general one is used.

IN general outline The essence of the operation is this: either the deviated septum is removed or the nasal septum is heated using a laser or electric knife. The cartilaginous plate softens and can be easily straightened.

Then tight gauze turundas are inserted into both nasal passages, which support new uniform cartilage. After cooling, it hardens, and the nose retains its shape. And nothing like it was before!

The only thing that is quite unpleasant is that you have to survive the first day after the operation. After all, nasal breathing is blocked, and you have to breathe through a dry mouth. But what a joy it is when the turundas are removed and you can completely freely full breasts!

Sources:

• Website Plasticsurgeon.ru
• Website O-gaimorite.ru
• Website Plastikanos.ru
• Video: Deviated nasal septum

Blood is a symbol of life, energy, strength and power. When a person loses it, they say that he loses his vitality. Consequently, dreams in which a person has there's blood coming out, they talk about the loss of his strength. One of the most popular “bloody” dreams is blood coming from the nose. Its interpretation should be followed different dream books.

Bleeding from the nose. General interpretation

Interpreters of the lunar dream book do not see anything wrong with blood coming from the nose. They believe that this dream speaks of immediate assistance to someone on the part of the dreamer. Moreover, according to the lunar dream book, seeing blood coming from your nose in a dream means a pleasant meeting with relatives. Often such a dream promises some favorable news. Miller's dream book interprets this picture as follows: wiping oneself with one's own blood coming from one's nose means one will soon receive some ill-gotten profit. Getting your clothes stained with blood is a big financial waste. Getting your hands dirty with blood means damage that will be caused by ill-wishers.

If blood coming from the nose is on the dreamer’s palm, then uninvited guests may soon come to him. Most likely, their visit will not cause the owner of the dream much joy. This is what the family says. By the way, such a dream can also indicate that the sleeper has one or another disease. If blood flows from the nose in a stream, then troubles, problems, and sorrows are coming. Perhaps a difficult period is coming in the dreamer’s life. If in a dream it is clearly clear that the blood from the nose is not your own, but someone else’s, then difficult changes are coming in the life of the country: disasters, cataclysms, wars are not excluded.

According to Tsvetkov’s dream book, losing your own blood coming from your nose means getting bogged down in your own own problems. If the dreamer drinks his own blood, then in life he is. Such a person needs to reconsider his views on life, change his behavior in society, and stop being arrogant. According to the dream book, profuse bleeding from the nose may be a harbinger of the loss of some dear person. For people preparing for a wedding, this dream can be a disappointment: their marriage will not happen.

deviated septum The nose not only looks unsightly, but also causes breathing difficulties for its owner. Therefore, people who have such a nose most often want to correct it.

If you are satisfied with all the points agreed upon with plastic surgeon, then you can start taking tests. This is necessary in order to find out if you are allergic to any drug. You will also have to be tested for diseases such as HIV, syphilis, hepatitis, etc. You will need an ECG and

There are also open and closed nasal fractures - in the first case, the integrity of the skin and periosteum (tissue that protects the bones) remains intact, while in the second it is damaged and bone and bone fragments can be seen in the wound. At open fracture nose, blood loss increases significantly - as well as the risk of some kind of infection getting into the wound, which can lead to serious complications.

After receiving an injury, you first need to carefully feel your nose. If you feel severe pain, the nasal bone may actually be broken and requires urgent medical attention. In addition, a fracture of the nose is usually characterized by severe swelling of the damaged area, as well as the subsequent appearance of bruises under the eyes, resembling the shape of a kind of glasses - they usually do not appear immediately, but some time after the injury.

Another characteristic sign of a broken nose is difficulty breathing, which becomes almost impossible with severe fractures. If you suspect such an injury to the nasal septum, you should seek help from a doctor as soon as possible. medical institution, where the doctor will conduct an examination and identify the nature of the injury, prescribing appropriate treatment. During the examination, he will palpate the damaged area, determining the presence of debris by crunching or broken bone structure of the nasal septum, and will also send the victim to an office where an x-ray of the nasal bones will be performed. If the image reveals a displaced fracture, the patient will have the bone fragments repositioned into place and further treatment will be prescribed.

note

Despite the fact that nasal fractures are always accompanied by bleeding, not in all cases nose bleed indicates that the nose is broken.

Helpful advice

When the nasal bone is fractured, the nose often changes shape, moving to the side or sinking into the damaged area.

Experienced craniofacial surgeons say that ideal nasal anatomy does not exist in nature. An insidious disruption of the formation process in early childhood is not noticeable to the naked eye. But in most cases, a crooked nasal septum remains within normal limits and does not create obstacles for physiological process breathing, and sometimes the changes become pathological. There are various reasons for the formation of such an anomaly.

A deviated nasal septum in children and adults can be aggravated by various injuries after suffering inflammatory diseases. In this case, treatment by an otolaryngologist and possibly even plastic surgery is required. Usually, the consequences of a crooked nasal septum can be very disastrous; you can read about what difficulties can arise in this material.

Anatomy, physiology and abnormalities

signs of nasal breathing disorder

If you look at medical statistics, you can see that the bulk of diagnosed cases occur in adolescence (11-15 years). Before the age of 10, it is very difficult to identify an abnormality in the formation of nasal structures. The anatomy and physiology of the upper respiratory tract is such that compensation mechanisms allow even significant deviations from the norm. However, it is in adolescence against the backdrop of the rapid and rapid development of the facial skeleton and hormonal changes such deviations can develop even without the influence of external negative factors.

The anatomy of the nose divides the organ into structural parts:

• entrance paths - nostrils and cavities (air penetrates here, undergoes primary cleaning and heating);
• the nasal passages originate in the lower passage from the cavities, then continue in the middle and upper sections (the tortuous passage allows one to effectively warm and purify the incoming air);
• The choanae precede the exit of air into the nasopharynx.

The nasal septum separates the two nasal passages. It consists of bone tissue in the posterior section and cartilage throughout the rest. Internal cavities lined with mucous membrane, permeated with small blood vessels. There is the ability to form a mucous secretion in order to eliminate pathogenic microflora and dust particles. The area of ​​smell (odor recognition) is located in the upper nasal passage. Therefore, even with mild congestion, the ability to smell is sharply reduced. The paranasal sinuses help the functioning of this organ. Physiological function:

• humidification and purification of air entering the upper respiratory tract;
• protection against pathogenic bacteria and viruses;
• ensuring the sense of smell and recognition of odors.

The role of the nasal septum is difficult to overestimate. It plays the role of a kind of natural barrier that prevents the connection of two air flows. Thanks to this, conditions are created for smooth physiological breathing. A deviated nasal septum disrupts the process of breathing through the nose and creates the preconditions for the development of chronic diseases of the upper respiratory tract.

Causes of a deviated nasal septum - identifying risk factors

When developing measures to prevent various pathologies, we usually identify risk factors and develop a set of measures aimed at neutralizing them. The causes of a deviated nasal septum may include a huge number of factors of external and internal pathogenic influence. Let's try to figure out the main ones:

• the physiological group is associated with a disruption of the development and formation of the facial bone part of the skull;
• traumatic group - these are the consequences of blows, fractures, development of cavities after hematomas;
• compensatory causes of a deviated nasal septum include polyps, sinusitis, adenoiditis, hypertrophy of the nasal sinuses, and chronic rhinitis.

Congenital risk factors are currently being actively studied by scientists. There is a theory of insufficient density of cartilage tissue. Such people suffer from systemic damage to hyaluronic structures. They may have arthritis and arthrosis, osteochondrosis of the spinal column, and ankylosing spondylitis. If parents or older blood relatives have total difficulties with the joints and spine, then the likelihood of a crooked nasal septum in children will be very high. But scientific justification There is no such theory yet.

What are the consequences of a deviated nasal septum?

Most patients think that if there are no external manifestations of a pathological condition, then they can not respond to periodic signals from the body. What can be the consequences of a deviated nasal septum in children and adults? The most diverse, sometimes it is even difficult to compare them with the underlying disease, they are so distant and not directly related.

The main problem is a disruption of the air exchange process through the nasal passages. In simple terms, it becomes difficult to breathe freely through your nose. This is a consequence of the narrowing of one of the passages and a violation physiological dynamics air flow movements.

The second possible negative consequence is a change in the structure of the mucous membrane. It becomes thinner and loses its protective properties. This entails constant viral infections, development of chronic rhinitis, often complicated by sinusitis, frontal sinusitis, sphenoiditis.

In the long term, chronic oxygen starvation of tissues may develop. A bouquet of chronic pathologies of pulmonary and cardiac tissue, the development of migraines, osteochondrosis and constant muscle spasms are all symptoms of such a pathology.

There may also be irreversible changes in the central nervous system. The risk of developing bronchial asthma of neurogenic origin in this category of people is very high. Patients are literally haunted by repeated attacks of suffocation, which are not so easy to relieve with conventional means. At pronounced violation nasal breathing may develop epileptic seizures, convulsive syndrome, migraine headaches. Over time, visual and hearing acuity decreases. In the cavity of the Eustachian tube, conditions are formed for the development of eustacheitis and otitis media.

Diagnosis and symptoms of a deviated nasal septum (with photos)

There are several types of deviated nasal septum, all of which form their own clinical picture. Diagnosis of all of them begins with a visual examination and radiographic examination. Very often there are combined options, when several types of curvature are present at once:

1. thorn or ridge;
2. vertical or horizontal arrangement;
3. posterior or anterior orientation;
4. deformation according to profile S or C;
5. with or without deformation of the vomer bone tissue.

Look at the photo for typical manifestations of various types of deviated nasal septum:

Typical symptoms of a deviated nasal septum, which a specialist pays attention to during the initial examination:

• complaints of difficulty breathing freely through the nose;
• constant feeling of congestion and secretion of mucous secretion (worsens after exposure to cold air);
• allergic reactions that are not typical for a given person, for example, to the smell of citrus fruits;
• periodic bleeding from the nasal passages - they are caused by mechanical injuries and disruption of the blood circulation process in the capillaries;
• feeling of dryness in the nose, snoring during sleep, frequent pain in the throat;
• decreased performance and increased fatigue, headache and dizziness.

A change in the anatomical shape of the nose can be visually determined. During rhinoscopy, the doctor sees the uneven development of the passages and shells. An initial assessment of the uniformity of air flow distribution can be carried out using simple test with cotton wool. A dry cotton wool is brought to one nostril, the second nostril is closed, and the movement of the cotton wool is observed when breathing. The range of motion in both nostrils is then compared. In a similar way, you can test the function of smell using a cotton swab moistened with an aromatic substance.

If a deviated nasal septum is suspected, for the purpose of differential diagnosis, radiography of the skull bones, computed tomography, and endoscopy are performed.

Treatment methods for deviated nasal septum and surgery

The most effective way to correct the patient's condition is surgical intervention. Methods for treating a deviated nasal septum without surgery usually provide only temporary, unstable results. To improve nasal breathing, it is recommended to use vasoconstrictor drops, which in turn negatively affect the condition of the mucous membranes.

An operation called nasal septoplasty is performed. It consists of restoring the normal anatomical structure of the nasal septum. It is prescribed to people with difficulty breathing, headaches, predisposition to bronchial asthma and serious cosmetic defects.

If surgery is scheduled to correct a deviated nasal septum, you should prepare for it in advance. To do this, it is important to stop smoking and eating hot, spicy foods. You should visit the dentist and have all diseased teeth treated. This will ensure the prevention of postoperative complications of an inflammatory nature.

The operation is performed in surgical hospital under general anesthesia. After the intervention, nasal breathing is completely restored within the first week. Working capacity is restored after 21 days.

A deviated nasal septum is a condition that occurs very often. In fact, a perfectly straight nasal septum is a big exception. But its deformations are not always regarded as a pathology and in most cases do not require treatment.

If the curvature of the nasal septum is severe enough, it can lead to a number of complications. In this case, they speak of the presence of a disease. Treatment with an otorhinolaryngologist (ENT doctor) is indicated.

According to statistics, a deviated nasal septum practically never occurs in childhood. Peak detection occurs in adolescents aged 13–18 years – the period when rapid growth body.

Anatomy of the nose

Nasal cavity– initial department respiratory system. Entering the nasal cavity, the air then enters the nasopharynx, from there into the larynx, trachea, bronchial system, and finally into the pulmonary alveoli, where gas exchange occurs between air and blood.

Structure of the nose:

• nostrils– inlets through which air enters the nasal cavity;
• elementary section of the nasal cavity - a space that is divided into right and left halves by the vertical nasal septum;
• nasal passages - located posterior to the initial part of the nasal cavity, there are lower, middle and upper nasal passages, which are respectively limited by the upper, middle and lower nasal concha;
• choanae – two openings through which the nasal cavity communicates with the nasopharynx.

Walls of the nasal cavity:

• Anterosuperior wall formed by the bones of the skull (process upper jaw, nasal bones) and nasal cartilage.
• The lower wall is the bottom of the nasal cavity, - formed by the palatine processes of the upper jaws (hard, or bone, palate), as well as soft palate.
• Lateral walls of the nasal cavity mostly educated ethmoid bone.
• Nasal septum, which divides the nasal cavity in half, is formed in the posterior part by the vomer, and in the anterior part by cartilage.

The inside of the nasal cavity is lined mucous membrane. It is abundantly supplied with blood and secretes a large amount of mucus. In the area of ​​the upper nasal passage in the mucous membrane there are many sensitive nerve receptors - this area is called the olfactory area.

Nasal turbinates- bone formations that are located in the back of the nasal cavity and divide it into three nasal passages - upper, middle and lower. The superior and middle turbinates are processes of the ethmoid bone. Lower turbinate- an independent small bone.

The nasal passages communicate with the paranasal sinuses:

• Superior nasal passage communicates with the posterior sinuses of the ethmoid bone and the sinus located in the sphenoid bone.
• Middle nasal passage communicates with the anterior and middle ethmoid sinuses, with the maxillary sinuses (sinuses located in the bodies of the maxillary bones).

The ethmoid bone contains many small cavities - sinuses, which are usually divided into three groups: posterior, middle and anterior.

The sphenoid bone is located at the base of the skull and is practically invisible from the outside. It has a body in the form of a cube, from which “wings” extend to the sides. Inside the body is air cavity- sphenoid sinus.

Functions of the nasal cavity:

• carrying air into the nasopharynx and larynx;
• humidification of the air with the secretion of glands located in the mucous membrane;
• warming the air flow - the venous plexus located under the mucosa is responsible for this function;
• protection of the respiratory tract from mechanical irritants: hairs and mucus in the nose trap dust particles and bring them out;
• protection against infection: nasal mucus retains pathogens and removes them from the nasal cavity, has bactericidal properties;
• The olfactory region of the nasal cavity is responsible for the reception (perception) of odors.

The main function of the nasal septum is correct distribution air flows between the right and left halves of the nasal cavity. The significance of this mechanism was established through a series of studies using magnetic resonance imaging and computed tomography.

The nasal septum divides the inhaled air into two equal streams, which ensures their linear movement along the respiratory tract. Optimal conditions are achieved for the nasal cavity to perform its functions (warming, cleansing, humidifying the air). If the configuration of the nasal septum is disrupted, these functions are also disrupted.

In a newborn baby, the nasal septum is always straight and even. It is still difficult to distinguish between the bone and cartilaginous parts: almost all of it is cartilage, in which there are several foci of ossification. Gradually they turn into bones and grow together. Violation of this process leads to the occurrence of curvature of the nasal septum. The initial causes of violations that occur cannot always be accurately determined.

Causes of a deviated nasal septum

Classification of causes of deviated nasal septum

Physiological reasons: associated with heredity and impaired growth of the skull bones.	Traumatic causes	Compensatory reasons: the nasal septum is deformed due to the presence of other pathological formations in the nasal cavity.***
Uneven skull growth. The human skull consists of the facial and brain sections. The facial skull is formed from the upper and lower jaw, zygomatic, palatine bones, etc. The brain section of the skull is represented by the frontal, temporal, parietal, occipital, ethmoid, and sphenoid bones. If there is uneven growth of the facial and cerebral parts of the skull, then the size of the nasal cavity also changes. It becomes “tight” for the nasal septum. As a result, the latter has to bend.	According to statistics, a deviated nasal septum is more common in teenage boys and men. This is the population among which skull and facial injuries are most common. As a result of a strong blow, the nasal bones are displaced. It can lead to curvature of the nasal septum, even if it is minor. The most severe deformities are caused by improper fusion of the nasal bones after a fracture.	Hypertrophy(excessive development) of one of the nasal conchas. An enlarged concha puts pressure on the nasal septum and causes it to shift.
Uneven skull growth. The human skull consists of the facial and brain sections. The facial skull is formed from the upper and lower jaw, zygomatic, palatine bones, etc. The cerebral part of the skull is the frontal, temporal, parietal, occipital, ethmoid, sphenoid bone. If there is uneven growth of the facial and cerebral parts of the skull, then the size of the nasal cavity also changes. It becomes “tight” for the nasal septum. As a result, the latter has to bend.		Polyps and tumors of the nasal mucosa. If they reach a large enough size, they interfere with breathing in one nostril. By deforming, the nasal septum tries to compensate for this condition.
Overdevelopment rudiment of Jacobson's organ. This cause of a deviated nasal septum is extremely rare. The Jacobson's organ is developed in reptiles, which with its help are able to literally “taste the air.” Man has only his rudiment, represented by a cluster nerve formations behind the olfactory area. If this rudiment is overdeveloped, then it limits the space for the growth of the nasal septum, and curvature occurs.		Constant stuffiness of one half of the nose. The curvature of the nasal septum in this case is an attempt to adapt to breathing through one nostril, to make it more complete.

***In this case, it is often difficult to figure out whether impaired nasal breathing is the cause of a deviated nasal septum, or its consequence.

Disorders that occur when the nasal septum is deviated

Difficulty in nasal breathing

Pathological mechanisms that lead to difficulty in nasal breathing with a deviated nasal septum:

• Narrowing of the nasal passage on the side of the convex septum. Reducing the volume of space on one side leads to difficulty in the passage of air flow, up to the complete inability to breathe through one nostril.
• Disturbance of air dynamics inside the nasal cavity. Normally, during inhalation, the air in the nose rises and passes through the middle and partially upper nasal passage. During exhalation, it is directed into the lower nasal passage. When the nasal septum is deviated, disruption of air flow even through one nasal passage leads to difficulty breathing. Despite the fact that the other two nasal passages on the same side may have normal clearance.
• Narrowing of the nasal passage and difficulty breathing on the side of the concavity of the deformed nasal septum. Often the symptoms here are even more pronounced than on the side of the convexity. As a result of the expansion of the nasal passage, compensatory hypertrophy (growth) of the nasal concha occurs. Over time, they become so large that they begin to make breathing difficult.
• Reaction nerve endings(receptors) of the nasal mucosa. Normally, the air flow in the nose is uniform. When the nasal septum is deviated, turbulence occurs in it. They irritate sensitive receptors located in the mucous membrane. A reflexive defensive reaction occurs: the vessels of the mucous membrane dilate, swelling occurs, and a large amount of mucus is released.
• Suction of the wing of the nose to the septum. This is often noted when the septum is deviated in the anterior part. The wing of the nose is constantly tightly adjacent to the septum, as a result, the passage of air is greatly hampered.

Changes in the nasal mucosa

Normally, the mucous membrane of the nasal cavity produces a certain amount of mucus, which humidifies the air and performs protective functions. On the surface of epithelial cells there are cilia. They constantly make movements, thanks to which dust and other fine particles removed from the nose.

As a result of turbulence, the air in the nasal cavity constantly hits the mucous membrane in a certain place. Here it thickens, epithelial cells lose eyelashes. The protective functions and the process of cleansing the mucous membrane from foreign particles and mucus are disrupted. The secreted mucus dries, forming crusts.

The mucous membrane of the nasal cavity becomes more vulnerable to pathogens.
Rhinitis develops - runny nose, constant congestion nose

Oxygen starvation of organs and tissues

The supply of sufficient oxygen to the lungs and blood largely depends on how freely nasal breathing is. When the nasal septum is deviated, gas exchange in the pulmonary alveoli is disrupted. There is a general lack of oxygen in the body.

Mouth breathing

Nasal breathing is the only normal way for humans. When it is disrupted as a result of a deviated nasal septum, mouth breathing is activated. It is less complete in many ways.

Disadvantages of mouth breathing:

• Air that is not humidified or warmed enters the lungs: as a result, gas exchange in the alveoli is not as efficient as with nasal breathing. Less oxygen enters the blood.
• The protective properties of nasal mucus are disabled. The likelihood of developing a respiratory infection increases.
• Mouth breathing can eventually lead to adenoiditis - inflammation of the pharyngeal tonsil.

Nervous disorders

When the nasal septum is deviated, constant irritation of the nasal mucosa occurs. This leads to complications that are reflexive in nature.

Reflex disorders due to a deviated nasal septum:

• Bronchial asthma– there is a type of disease, the main cause of which is a neuropsychic imbalance.
• Spasms of the larynx, manifested in the form of short attacks of suffocation.
• Convulsive epileptic seizures.
• Reflex sneezing and coughing.
• Dysmenorrhea in women– violation of the frequency and duration of menstruation.
• Disorders of the eyes, heart and other organs.

Violations from neighboring organs

• Eustachian tube and middle ear disorders. The nasal cavity passes into the nasopharynx, on the mucous membrane of which there are pharyngeal openings of the auditory, or Eustachian, tubes on the right and left. Eustachian tube connects the nasopharynx with the middle ear cavity (tympanic cavity, which contains the auditory bones: incus, stapes, malleus). A chronic inflammatory process as a result of a deviated nasal septum leads to the fact that mucus and infectious agents can enter the auditory tube and tympanic cavity.
• Inflammation of the paranasal sinuses - sinusitis. A direct connection has been proven between a deviated nasal septum and the development of inflammatory processes in the paranasal sinuses. Such patients often develop sinusitis (inflammation of the mucous membrane of the maxillary, or maxillary sinus) and frontal sinusitis (inflammation frontal sinus).
• Inflammation of the tear ducts and lacrimal sac. Tears, which are produced by the lacrimal glands, normally flow into the nasal cavity through the nasolacrimal duct. It can serve as a route for spreading infection.

Types of deviated nasal septum:

• actual curvature of the nasal septum
• crest
• a combination of two or three types of curvature

Varieties of the actual curvature of the nasal septum:

• in a vertical or horizontal plane
• in the front or back of the nasal septum
• one-sided and two-sided
• with the capture of the cartilaginous part of the septum (so-called dislocations of the cartilage occur, when it is torn from the bone), the vertical plate of the ethmoid bone (forms the anterior part of the bony nasal septum) or the vomer (forms back nasal septum)
• S-shaped, C-shaped, in relation to the bony crest of the upper jaw.

The development of complications with a deviated nasal septum depends on the severity and type of deformation. Almost every adult has a slight curvature, but it does not lead to breathing problems. There are cases where significant deformations do not prevent normal air flow.

Deviations of the nasal septum in the anterior part occur more often. The opener located behind is less often caught. The rear edge of the opener is almost always exactly vertical.

The ridges and spikes are usually located along the upper or lower edge of the opener. They may have different lengths, are directed in different directions. Sometimes they protrude into the mucous membrane on the opposite side. Most often, spines and ridges consist only of bone tissue. Sometimes their apices may be represented by cartilage.

But even a slight curvature of the septum in the front part can create air turbulence, which then intensifies and significantly disrupts nasal breathing.

from mouth. 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).

Complaints that patients with a deviated nasal septum make when visiting a doctor:

• Difficulty in nasal breathing. The symptom may be to varying degrees: from minor impairment to complete inability to breathe through the nose (in this case, the patient breathes through the mouth). However, the absence of this complaint is not a sign that there is also no deviated nasal septum. If the deformation occurs at a young age, the body can compensate for it over time. The patient has no complaints of difficult nasal breathing. If the nasal cavity is large, then no difficulties arise either.
• Chronic rhinitis - runny nose. Manifests itself in the form of nasal congestion and constant mucous discharge. Sometimes a patient does not see a doctor for a long time because he believes that he has frequent colds, and it's all about decreased immunity.
• Allergic reactions. The changes that occur in the nasal cavity as a result of the curvature of the nasal septum are always accompanied over time by a violation of local protective mechanisms and immunity. This manifests itself not only in a decrease in resistance to infections, but also in the emergence allergic reactions. Allergic rhinitis is a common problem among people with a deviated septum. Chronic rhinitis is preasthma– a condition against which it often develops bronchial asthma. The patient complains to the doctor that nasal congestion and discharge occur mainly during contact with an allergen, for example, pollen from certain plants.
• Headache. A spike, ridge, or deviated nasal septum may come into contact with the lining of the nose and put pressure on it. Constant irritation nerve receptors leads to the development of reflex headaches.
• Dry nose, discomfort and unpleasant sensations during nasal breathing. A symptom that develops as a result of prolonged irritation and inflammation in the nasal cavity.
• Nosebleeds. They are also the result of irritation of the mucous membrane. On the side where there is a bulge on the nasal septum, the mucous membrane is very thin. Even with minor impact it is easily damaged.
• Snoring at night as a result of impaired nasal breathing.
• Increased fatigue, decreased performance, decreased resistance to physical activity . These symptoms are associated with impaired nasal breathing and insufficient income oxygen into the blood from the lungs.
• Frequent infections that occur with symptoms of acute respiratory infections (runny nose, cough, sneezing), increased body temperature.
• Symptoms of chronic inflammation of the pharynx and larynx: sore throat, dryness and pain, cough.
• Symptoms of inflammation in the middle ear: pain, hearing loss.
• Irregular nose shape. This symptom is characteristic of a deviated nasal septum of traumatic origin.
• IN severe cases the patient and his relatives note periodic convulsive epileptic seizures, blurred vision, heart pain and increased blood pressure, shortness of breath and other symptoms. They can also be associated with deformations of the nasal septum.
• Deterioration of memory, thinking, absent-mindedness. Schoolchildren with a deviated nasal septum experience decreased school performance over time.

Diagnosis of a deviated nasal septum

Diagnosis of a deviated nasal septum by an ENT doctor includes an external examination, rhinoscopy, and the appointment of additional tests and laboratory tests.

Visual inspection

Assess the appearance of the patient's nose. With a traumatic curvature of the nasal septum, it is changed.

Nasal breathing is assessed separately for the right and left nostrils. The patient is asked to close the left nostril with a finger, and a piece of cotton wool or thread is brought to the right. Look at its fluctuation during inhalation and exhalation. Then the manipulation is repeated for the left nostril.

To assess the sense of smell, one nostril is also clamped, and a piece of cotton wool soaked in a solution of an odorous substance is brought to the second. The patient is asked to inhale and name the smell. Usually, when the nasal septum is deviated, the sense of smell is reduced on one or both sides.

Rhinoscopy

Rhinoscopy– examination of the nasal cavity using special instruments.
There are anterior and posterior rhinoscopy. An anterior rhinoscopy is most often performed. Rear - according to indications.

How is anterior rhinoscopy performed?

Anterior rhinoscopy is performed using a special nasal dilator (see picture).
The doctor asks the patient to raise his head slightly, lifts the tip of his nose and inserts the instrument into the nostril. Using a button probe (see picture), the otolaryngologist can better examine the nasal cavity and assess the consistency of the formations inside.
Anterior rhinoscopy is performed separately for each nostril.

Diseases that can be distinguished from a deviated nasal septum during anterior rhinoscopy:

• polyps mucous membrane
• hematomas– hemorrhages under the mucous membrane, which, reaching large sizes, can impede nasal breathing
• tumors in the nasal cavity
• abscess- abscess.

If anterior rhinoscopy is difficult due to severe swelling of the nasal mucosa, the doctor first instills a 0.1% solution of adrenaline into the patient’s nostrils. He narrows it down blood vessels and makes the nostrils free for inspection.

How is posterior rhinoscopy performed?

Posterior rhinoscopy is an examination of the nasopharynx and nasal cavity from the choanae. To do this, the doctor asks the patient to open his mouth, pushes the tongue away with a spatula and inserts a special mirror into the nasopharynx.

Additional instrumental studies for deviated nasal septum

Study	Indications
X-ray of the skull	assessment of the condition of the paranasal sinuses; identification of anomalies in the bones of the skull; identification of existing deformations after a nasal injury.
CT scan	Identification of ridges and spines that are located at the back of the nasal septum and are not visible during rhinoscopy.
Endoscopic examination of the nasal cavity It is carried out using a rhinoscope - a thin probe, at the end of which there is a miniature video camera. It is inserted into the nostril and moved a little deeper. Most patients tolerate the study well. Local anesthesia of the nasal mucosa is performed using anesthetic sprays.	Identification of formations in the nasal cavity that are inaccessible for inspection during anterior and posterior rhinoscopy.

Laboratory research methods for deviated nasal septum

Type of research	Purpose
General analysis blood	A general clinical routine study that allows you to identify signs of the inflammatory process.
Appointed only by special indications:
Bacteriological research nasal swabs and mucus discharge.	Identification of the infectious process and prescription of rational antibiotic therapy.
Cytological examination nasal swabs and mucus	Suspicion of an oncological process.
Allergy tests and immunological blood tests.	Deviated nasal septum, complicated by an allergic condition. Allergen identification.

Treatment of deviated nasal septum

Deviated nasal septum is treated surgically. The main type of operation that is performed in most cases is septoplasty.

Indications for surgery for deformities of the nasal septum:

• Difficulty in nasal breathing on one or both sides. Surgical intervention is absolutely indicated provided that the difficulty in breathing is caused precisely by a deformation of the nasal septum.
• Chronic rhinitis– inflammation of the nasal mucosa.
• Otitis and eustachitis (inflammation of the middle ear and auditory, or Eustachian, tube), the initial cause of which is a violation of the shape of the nasal septum.
• Inflammation of the paranasal sinuses (sinusitis): sinusitis, ethmoiditis (inflammation of the cells of the ethmoid bone). Surgery is indicated if these complications are caused by a deviated nasal septum.
• Frequent, recurring headaches.
• External cosmetic defects. Sometimes, in in rare cases, after fractures, the bridge of the nose is simultaneously straightened and septoplasty is performed.

Contraindications to septoplasty for deviated nasal septum:

• Senile age. With age, breathing problems caused by a deviated nasal septum are partially compensated. Therefore, the symptoms of the disease become less pronounced. In older people, atrophy of the nasal mucosa occurs, so the operation is difficult and the risk of complications is high.
• Blood clotting disorder. For example, septoplasty is contraindicated in people with hemophilia.
• Severe diseases of the cardiovascular system.
• Diabetes.
• Mental illness.
• Malignant tumors.
• Severe infections.
• General serious condition sick.
• Children and people over 48 years of age can undergo surgery, but the indications for it at this age are narrowed.

Preparation for septoplasty

The initial diagnosis of a deviated nasal septum is usually made by an otolaryngologist in a clinic. If the doctor believes that surgical intervention is necessary, he writes the patient a referral to the hospital.

In the emergency department, the patient is examined and a date for hospitalization is set. Before this, you must undergo a standard set of tests. This can be done at the clinic at your place of residence.

A couple of weeks before the upcoming operation, the patient should refuse bad habits, avoid hypothermia and infections. It is necessary to cure diseased teeth and eliminate other sources of inflammation in the body.

During the operation, a large amount of blood may be lost due to the fact that the nasal mucosa is abundantly supplied with blood. For women, it is better to plan surgery 2 weeks after menstruation.

Before the operation in the hospital, you may be prescribed additional examination. If the intervention is planned under general anesthesia, then on the day of the procedure you should not eat or drink in the morning. Within an hour, the patient is given premedication - medications are administered that help prepare the body for anesthesia.

Surgery for deviated nasal septum

Septoplasty(plasty of the nasal septum) can be performed under general or local anesthesia. In children, only general anesthesia is used. The patient is placed on the operating table in the supine position.

The surgical intervention does not involve incisions on the face - access is through the nostril. The surgeon dissects the mucous membrane, separates it from the nasal septum, performs plastic surgery and sutures.

After the operation, turundas (tampons) soaked in a solution of a hemostatic (hemostatic) drug are placed in the nose. The patient must wear them throughout the day.

Today, it is widely practiced to install silicone splints in the nose, which help the new septum maintain the desired shape.

A curvature of the nasal septum in some cases is combined with asymmetry of the ethmoid bone, changes in the shape and size of the nasal turbinates. These disturbances must also be corrected during surgery.

Endoscopic laser septoplasty

Modern methods of surgical correction of deviated nasal septum.

Advantages of laser septoplasty:

• minimal tissue trauma;
• blood loss during surgery is minimized;
• laser has antiseptic properties;
• kept to a minimum rehabilitation measures in the postoperative period.

The main disadvantage of the laser is that it is not able to eliminate all deformations of the nasal septum, especially its bony part.

Postoperative period

For 1–2 days after surgery, the patient is forced to wear turundas in the nose. This causes discomfort, since during this time nasal breathing becomes impossible.

On days 2–4, nasal breathing is completely restored.

After the operation, the otolaryngologist regularly examines the patient, removes dry crusts from the nose, and performs rinsing saline solution or a solution of sea salt, conduct a nasal shower.

If in the postoperative period the patient is bothered by pain, then analgesics (painkillers) are prescribed.

To prevent infectious complications, antibiotic therapy is prescribed.

After the patient is discharged from the hospital, he is observed for a month by an ENT doctor in the clinic.

The most common complications after septoplasty surgery:

• formation of large hematomas(hemorrhages) under the mucous membrane;
• nosebleeds;
• perforation of the nasal septum– formation of a hole or defect in it;
• formation of an abscess under the mucous membrane– abscess;
• purulent sinusitis ;
• nasal deformity– most often the back of the septum becomes retracted as a result of the surgeon resection of the septum too high.

Is it possible to treat a deviated nasal septum without surgery?

To combat the symptoms of complications of a deviated nasal septum, vasoconstrictor drops, antibiotics, sprays, and nasal rinses are used. These methods provide temporary relief, but they cannot eliminate the cause of the problem. It is possible to get rid of it completely and prevent further progression only through surgical intervention.

Is it possible to prevent deviated nasal septum?

The causes of impaired growth of the nasal septum and its deformation cannot always be identified. Therefore on this moment does not exist effective prevention diseases.

How does a deviated nasal septum manifest in children? What are the treatment methods?

A deviated nasal septum is less common in children than in adults. However, this anatomical feature can seriously interfere with the child’s breathing, causing oxygen starvation and causing delayed physical development.

Causes of deviated nasal septum in children:

• Injuries during childbirth;
• A blow to one side of the nose;
• Discrepancy between the growth rates of the bone and cartilaginous parts of the nose in adolescence.

Signs of pathology. Externally, changes may not be visible and both sides of the nose appear symmetrical. Upon examination, the doctor discovers that one side of the child’s nose is narrowed, and there is practically no air circulation in it. This is accompanied by swelling of the mucous membrane of the respiratory tract, which gradually loses its protective properties. Due to a decrease in local immunity, the child suffers from prolonged runny nose and otitis media.

Symptoms of a deviated nasal septum in children:

• Breathing problems on the affected side. Parents note that periodically one nostril is completely blocked. In some cases, this causes the baby to sleep on only one side to optimize breathing.
• Protracted or chronic runny nose . Frequent sinusitis and sinusitis are associated with increased susceptibility of the mucous membranes to infection. Hypertrophied (overgrown and thickened) mucosa is the basis for the formation of a polyp - a growth that blocks the nasal passage.
• Frequent tonsils (adenoids), which can cause snoring and coughing.
• Headache - a sign that the central nervous system is experiencing oxygen deficiency.
• Impaired sense of smell. It develops gradually and is associated with damage to sensitive receptors on the nasal mucosa.

Treatment of deviated nasal septum in children. Not all children with a deviated nasal septum need treatment. Correction of the defect is necessary if the child's breathing is significantly impaired, and there is evidence that the distortion leads to frequent otitis media and sinusitis.

Conservative therapy(treatment without surgery for a deviated nasal septum) is the main focus in children under 15 years of age. Its goal is to restore impaired breathing and the functions of the mucous membrane of the respiratory tract.

• Intranasal glucocorticosteroids (Mometasone, Fluticasone, Beclomethasone) eliminate allergic rhinitis and medicinal rhinitis caused by prolonged use of vasoconstrictor drops. Use once a day better in the morning.
• Cromony . Cromoglin - cromoglycic acid in the form of a spray is used to treat allergic rhinitis 4 times a day.
• Antibacterial drugs (Isofra, Polydex, Bioparox) – local application Antibiotics stop the growth and reproduction of bacteria on the mucous membranes and sinuses.
• Mucolytic sprays – (Sinuforte, Rinofluimucil) are used to thin mucus and facilitate its removal from the sinuses.
• Moisturizing sprays – (Salin, Aqua-Maris) moisturize the mucous membrane, cleanse it of microorganisms, and help strengthen local immunity.
• Vasoconstrictor drops and sprays – (Naphthyzin, Farmazolin, Noxprey). They constrict blood vessels, reducing swelling of the mucous membrane, and restore nasal breathing. Drops reduce swelling of the nasal tissues, increasing the lumen through which air passes.

Surgical treatment of deviated nasal septum in children. In childhood, they try to avoid surgery, fearing that it may affect the formation of the nose in the future. Doctors recommend postponing surgery until age 15-16. The earliest age of patients is 6 years. Surgery is resorted to when it is not possible to restore nasal breathing by other methods.

The operation is preceded by a thorough examination, blood and urine tests, x-rays or tomography, endoscopic examination,cardiography.

Choice of anesthesia depends on the age of the child and the extent of the operation. As a rule, children under 5 years of age require general anesthesia. For children school age The operation is performed under local anesthesia.

The essence of the operation. The surgeon makes an incision inside the nose. On one side, it separates the mucous membrane from the cartilage. The cartilage itself is then separated from the bone and adjusted. If necessary, bone defects are corrected: spines, growths, bone ridges, and space is created for the installation of cartilage. Finally, the surgeon returns the cartilage, perichondrium and mucosa to their place, after which the wound is sutured.

In some cases, when the cartilaginous part of the septum is thinned and is unable to maintain the shape of the nose, there is a risk of sagging of the nose or drooping of its tip. In this case, the cartilage fragments are attached to a special polydioxane mesh, which serves as a support for them. The mesh is not felt by the patient in any way and dissolves on its own after about a year. During this time, the cartilaginous septum restores its density and can independently maintain the shape of the nose.

The procedure itself lasts 30-45 minutes. It is quite unpleasant, but painless thanks to anesthesia. After the operation you will have to spend 1-2 days in the hospital. During this time, medical personnel must ensure that recovery is proceeding as planned and there is no risk of complications.

Treatment of deviated nasal septum with laser. Due to the fact that in children the curvature mainly occurs in the cartilaginous part, the best option are endoscopic laser operations. They are practically bloodless and low-traumatic. The laser heats the cartilage to a temperature of 70 degrees, after which the cartilage becomes plastic and is leveled. Special tampons are inserted into the nasal passages, which give the septum correct form. However, this treatment has only been practiced for a few years, so there is no data on how heating can affect the condition of the cartilage in the future.

Another option for laser plastic surgery is a traditional operation, which is performed using a laser scalpel. This allows you to reduce blood loss and minimize the risk of developing infectious complications. In addition, the laser tool causes less damage nerve fibers, so the child suffers less pain in postoperative period.

Laser surgeries have a significant disadvantage - they are performed only in large medical centers and their cost often exceeds $1000.

What is the cost of surgery for a deviated nasal septum?

Surgery to straighten the nasal septum can be done for free. To do this, you need to go to the clinic at your place of residence, where the doctor will give you a referral to the hospital. At the ENT department, you will be put on a waiting list and after the examination, the operation will be performed free of charge, as part of compulsory medical insurance (compulsory health insurance). However, even in this case, there may be costs for anesthesia and medications necessary for the operation. In urban and district hospitals We employ both surgeons with extensive experience and high qualifications, as well as novice doctors. This must be taken into account when choosing a specialist who will perform the operation, since the result of treatment largely depends on the work of the surgeon.

In private ENT clinics and medical centers where highly qualified specialists (surgeons of the highest category and professors) operate, the price of surgery for a deviated nasal septum depends on the qualifications of the doctor. Thus, the operation, together with a preliminary examination, anesthesia and stay in a 1-2-bed ward, will cost 300-700 USD.

Price laser surgery in private clinics it ranges from 500 to 2000 USD. Laser treatment for a deviated nasal septum is bloodless and low-traumatic method, after which the patient can almost immediately return to to the usual way life. However, it has one significant drawback - laser septoplasty can only be used if the cause of breathing problems is a curvature of the cartilage of the nasal septum. This happens very rarely in adults. In 90% of cases, cartilage deformations are combined with bone growths, and in this case the laser will not be enough.

Cost of radio wave septoplasty reaches 1000 USD A radio wave beam is used instead of a scalpel high frequency, which vaporizes soft tissue cells like a laser. The radio wave scalpel coagulates blood vessels, preventing bleeding and has a bactericidal effect. According to the technique, this intervention is no different from traditional surgery, and the same surgical instruments are used to correct cartilage and bone.

Aesthetic correction Deviated nasal septum (rhinoplasty) costs from 600 to 4000 USD, depending on the clinic and the scope of the operation. Plastic surgery are not included in the compulsory medical insurance list, so they are paid in all medical institutions.

How does it feel after surgery on a deviated nasal septum?

The patient’s sensations after surgery on a deviated nasal septum depend on the drugs used for anesthesia and the degree of intervention. Thus, a person who had the cartilaginous part of the septum corrected under local anesthesia will endure the postoperative period much easier than a patient who had to undergo surgery under anesthesia. bone structures nose

When to see a doctor:

• rebleeding;
• severe pain in the nose 5-7 days after surgery;
• temperature increase;
• purulent nasal discharge.

Inform your doctor about any health problems - this will help you take timely measures and prevent possible complications.