Deviated Septum

5 mins read

Introduction
Deviated septum is a physical condition that commonly affects the nasal passage. The condition is characterized by the deviation of nasal septum separating the nostrils. Consequently, the one of the two nasal passages becomes narrowed that results in difficulty in breathing. In addition, the blocking of the nasal passage results in bleeding in some of the individuals.

Causes
Deviated septum, also refers to as nasal septum deviation, is a physical disorder  that can result from either inflammation of the tissues lining the nasal passage, deviation of the septum dividing the nostrils, or trauma to the nose. The condition can be congenital, which can result from the compression or pressure on the septum during child birth. However, the congenital factor is quite rare. Various studies have pointed out the association  of septum deviation with other disorders, including homocystinuria and Ehlers–Danlos syndrome.

Symptoms Of Deviated Septum
In most of the patients, the condition presents no apparent symptoms; however, in some individuals, following symptoms may appear.

1. Nose Bleeding
Deviation in the septum may result in drying of the tissues lining the nasal passage and the septum itself. This increases the risk of nose bleed in some patients.

2. Loud Breathing
Usually observed in infants and young adults. The inflammation of the septum often causes loud breathing during sleep. However, in adults or elderly, these symptoms are rarely apparent.

3. Pain
However, rare, facial pain is reported by many individuals with deviated septum. The pain or inflammation is mostly restricted to cheek bones, upper jaw, and around the region of upper nasal passage.

4. Difficulty In Breathing
The condition intensifies with other prevalent infections such as pneumonia, upper-respiratory tract infections, lung disorders, and flu.

Besides, symptoms such as repeated nose bleeding, sleep apnea, snoring, intense and frequent sneezing, and reduction in smell are some of the other presentations associated with deviated septum.

Diagnosis
Physical examination is the only method to diagnose deviated septum. In this procedure, septum is held apart with the help of an instrument, and using bright light, the deviation is determined. In addition, the tissues lining the nasal septum are also inspected following the application of decongestant spray.

Besides, occurrence of symptoms such as repeated nose bleeding, difficulty in breathing, or loud snoring is often correlated with deviated septum.

Treatment Strategies In Deviated Septum
Mild symptoms are usually treated with sprays or decongestants; however, in acute condition, surgery is often recommended.

Nasal Sprays
These sprays contain corticosteroids that reduce the inflammation of the septum. Sprays are effective in reducing the difficulty in breathing, pain, and enhances sleep quality in patients.

Decongestants
They are effective in opening the nasal passage on both sides, thereby enhancing the flow of air. Additionally, they reduce the inflammation in the passage linings. Decongestants are usually administered in the form of oral medications and sprays.

Antihistamines
These are used to prevent allergies or infection associated with the condition. Besides, antihistamines have been found to be quite effective in reducing nose bleeding in most of the patients. However, adverse effects such as dizziness, nausea, etc. have been reported.

Surgery Or Septoplasty
Surgery is recommended when the patient is either non-responsive toward the medications or in acute form of deviated septum. Septoplasty is performed by opening the nasal passage and straightening of the deviated septum. Outcomes of surgery are typically defined by the level of deviation or severity of the condition.

Complications
In most of the patients, deviated septum does not cause any difficulty; however, in severe cases, following complications are observed.

Sleep Pattern
In most of the severe cases, changes in sleep pattern are observed due to difficulty in breathing, snoring, or sleep apnea.

Rashes And Dryness
Due to obstruction in the nasal breathing, switching to mouth breathing results in dryness in throat, regions around the mouth, irritation, and redness.

Infection
Various respiratory infections are associated with severe nasal septum deviation.

Conclusion
Deviated septum is a physical disorder that is characterized by difficulty in breathing, snoring, and sleep apnea. In this condition, septum, separating the nostrils, is deviated from its original location. Medications such as decongestants and nasal sprays or surgery are typically recommended in the treatment of deviated septum. The disorder should be effectively diagnosed and managed in severe cases as it often leads to recurrent infections, excessive  nose bleeding, and change in sleep patterns.

Read More:
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References
1. Ibrahim A, Balakrishnan R, Ebenezer V, et al. Combating nasal septum deviation in le fort 1 orthognathic surgery complications, with submental intubation. J Clin Diagn Res. 2014 Jun;8(6):ZC46–8.

2. Aaronson NL, Vining EM. Correction of the deviated septum: from ancient Egypt to the endoscopic era. Int Forum Allergy Rhinol. 2014 Nov;4(11):931–6.

3. Fettman N, Sanford T, Sindwani R. Surgical management of the deviated septum: techniques in septoplasty. Otolaryngol Clin North Am. 2009 Apr;42(2):241-52, viii.

4. Cantrell H. Limited septoplasty for endoscopic sinus surgery. Otolaryngol Head Neck Surg. 1997 Feb;116(2):274–7.

5. Podoshin L, Gertner R, Fradis M, Berger A. Incidence and treatment of deviation of nasal septum in newborns. Ear Nose Throat J. 1991 Aug;70(8):485–7.

6. Núñez-Fernández D, Vokurka J. Surgical treatment of anterior septal deviations. Acta Medica (Hradec Kralove). 1998;41(3):141–4.

7. Rettinger G. Risks and complications in rhinoplasty. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2007;6:Doc08.

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