Dr. Harold Heah explains the issues surrounding a nose condition which may affect one’s breathing. He is an otolaryngology (ENT) – head and neck surgeon.
The nasal septum is a structure in the nasal cavity dividing the left and right sides. It is primarily made up of hyaline cartilage and bone and covered by nasal mucosa. The nasal septum is deemed deviated if it is not straight, with curvature to either side or spurs which protrude from it.
This results in narrowing of the airway passages on either side of the nasal cavity and can impede airflow through the nasal cavity.
Trauma can lead to a deviated nasal septum, usually resulting from an impact to the nose. It can also be developmental in nature, occurring as one grows from infancy to adulthood.
Microfractures sustained during the birth process and in infancy can cause weakness of the nasal septal cartilage on either side, resulting in curvature and an irregular surface of the septum as the person grows.
Most people with mild deviated nasal septum do not experience any symptoms. However, those with more severe deviated nasal septum may be at risk or experience the following:
A deviated nasal septum need not always be treated. As many as 1/3 to 80% of the population may have a nasal septum that is deviated to a certain degree. Treatment should be initiated in patients who exhibit symptoms resulting from a deviated nasal septum such as persistent and recurrent nasal obstruction or any of the symptoms mentioned.
If the severity of the septal deviation is mild, the patient may respond well to medical therapy such as with the use of intranasal steroid sprays or nasal decongestants.
Surgical intervention can be considered should the patient fail to improve with medical therapy or if he would like a permanent solution without having to rely on medications in the long term.
Surgical treatment for deviated nasal septum is called “septoplasty” and it involves correcting the curvature or irregular protrusions such as spurs in the nasal septum.
The procedure is usually done under general anesthesia and a plastic splint is usually placed to hold the corrected septum in position post-operatively.
The risks of septoplasty are bleeding, infection, perforation and weakening of the external nose support causing a “saddle-nose” deformity. However, these are rarely encountered when performed by an experienced surgeon. Most patients are discharged on the day after the procedure and will be on medical leave for 1-2 weeks.
