Types and causes of curvature of the nasal septum, ways to solve the problem, types of septoplasty, rules for preparing for surgery, possible complications and features of the recovery period. The importance of unobstructed nasal breathing cannot be overemphasized. The curvature of the nasal septum plays an important role in this process. Breathing is not always disturbed for this reason, but it is the curvature that can provoke all sorts of inflammation and exacerbation. In any case, today this problem can be corrected only by the method of surgical intervention. Septoplasty is an operation to correct and correct a deformed nasal septum.
Causes of the curvature of the nasal septum
The main problem with the deformation of the septum is that in this case the nose is divided into two canals of different diameters. In one of them, increased air resistance is observed, which disrupts aerodynamics during nasal breathing. This can provoke the development of many diseases, which often have nothing to do with the nose at all.
The causes of curvature can be either congenital or acquired. However, they all fall into three groups:
- Physiological … This includes all deformations resulting from the growth and development of the organism. Uneven growth of bone and cartilage tissue in adolescence most often provokes curvature of the nasal septum. In this case, it is characterized by a shift to the side, the formation of thorns and ridges.
- Traumatic … This group includes all deformations that were formed under mechanical stress. Often, this curvature is accompanied by bone fractures. In children, in some cases, the displacement of the septum can develop due to dislocation of the cartilage during childbirth.
- Compensatory … Changes in the shape of the paranasal structures can lead to an increase in the shells (hypertrophy). This problem, in turn, provokes a curvature of the nasal septum from constant contact with the concha.
Depending on the type and cause of the curvature, the doctor chooses the preferred and safest method of surgical intervention for correction.
Types of nasal septum deformities
In general, medical practice distinguishes four types of deformity of the nasal septum:
- C-shaped … In a simple sense, this is a hump (Greek profile). The most common cause is a genetic predisposition. It is observed in many inhabitants of the East and some peoples of Europe.
- S-shaped … The most common type of offset. It is mainly formed after injury, but in some cases it can also develop due to heredity.
- Back-anterior S-shaped … Congenital curvature, which is much more difficult to correct than other types. For correction, several operations are performed, since in this case it is important to establish not only the respiratory function, but also the olfactory and speech functions.
- Deformity towards the upper or lower jaw … Straightening of such a defect is carried out only with an integrated approach. In some cases, bite correction may additionally be required.
Regardless of the type of deformity, the only way to correct and align the nasal septum is by surgery.
Indications for nasal septoplasty
Septoplasty is not only a prevention of health problems, but also a way to make the nose look aesthetically pleasing and symmetrical. However, surgery can only be performed if there are appropriate indications:
- Difficulty in nasal breathing … It can extend to both nostrils or touch only one. It depends on the type and degree of curvature.
- Snoring (noise when inhaling or exhaling through the nose) … Can provoke the development of hypoxia (lack of oxygen in the blood).
- Chronic inflammation in sinuitis (sinusitis, frontal sinusitis, ethmoiditis) … Constantly stuffy nose and frequent runny nose.
- Allergic rhinitis … Most often formed as a result of compensatory deformation. Usually accompanied by hypertrophy of the nasal concha.
- Aesthetic problem … In this case, septoplasty is combined with rhinoplasty. In medical practice, this type of surgical intervention is called septorhinoplasty.
Not directly, but indirectly, surgery may be necessary for migraines, hearing problems, in particular, ear congestion, loss of smell, often flowing blood from the nose, swelling and dryness of the mucous membrane inside. But these problems can arise not only from deformation of the nasal septum, therefore, it is imperative to pass tests and consult with an ENT in order to diagnose curvature.
Contraindications to nasal septoplasty
In some cases, even with serious indications, the operation may be prohibited. The reason for this may be, for example, minority. Until the age of 14-16, the growth and development of bone and cartilage tissue continues. Surgical intervention at this stage can lead to disruption of the normal and symmetrical development of the face. Therefore, septoplasty for children is performed only in the most extreme cases, for example, with incurable chronic sinusitis. In addition, contraindications for such an operation include:
- Cancer disease;
- Pathology of the cardiovascular system in decompensation;
- Diabetes;
- Acute infectious inflammation;
- Mental disorder;
- Poor blood clotting.
Before deciding on the feasibility and necessity of straightening the nose with septoplasty, you need to be examined by an ENT specialist and pass all the necessary tests.
Varieties of nasal septum septoplasty
Today, the correction of the nasal septum can be performed in two ways: classical (endoscopic septoplasty) and using laser equipment. Each of these options has advantages and disadvantages. Less commonly, but still, methods of ultrasound or radiosurgery are used. By the type of operation, the operation can be carried out by a closed and open method. The first is more traumatic due to the incision in the columella area, and therefore is used only in case of serious deformation. In the second case, doctors make small incisions through which access to the cartilage and bone tissue opens.
Features of endoscopic nasal septoplasty
This type of surgical intervention is the most gentle because of the excision inside the nose, and therefore there are practically no marks on the skin. The advantages of this method lie not only in its effectiveness and aesthetic result. The postoperative period in this case is faster and much smoother.
Today in medicine, endoscopic septoplasty is practiced by resecting small sections of the septum and changing its position, which ensures symmetry and normal functioning. With traumatic deformities, it may be necessary to extract some areas of the cartilage.
Methods for laser septoplasty of the nasal septum
In rhinosurgery, the laser beam has been used not so long ago, but every year it gains more and more popularity. In this case, there are two methods for performing laser septoplasty:
- Septochondrocorrection with a laser beam … In this case, only the cartilaginous tissue of the septum is corrected. During the operation, the problematic cartilaginous part is heated until it becomes plastic. After that, she is given the desired shape. This method is limited, because isolated cartilaginous deformity is an extremely rare occurrence. Septochondrocorrection takes place without blood and pain, but it is used less often than classical laser straightening. The reason for this lies not only in the limited area of influence, but also in the fact that the method is relatively new, and therefore the consequences have not yet been fully studied.
- Classic … This type of surgery is virtually indistinguishable from traditional endoscopic septoplasty. Only here not a scalpel is used, but a laser beam, which has significant advantages. The main advantage is the immediate coagulation of blood vessels after resection, which reduces blood loss and the rehabilitation period.
Technology for classical septoplasty of the nose
The duration of classical (endoscopic) septoplasty is usually 40-60 minutes. The operation is performed under local, general or combined anesthesia.
Preparation for nasal septum septoplasty surgery
In the preoperative period, it is necessary to undergo not only a superficial examination, but also more serious studies, which will be prescribed by an otolaryngologist. The main methods for analyzing the deformation of the septum and developing a correction technique are anterior and posterior rhinoscopy, endoscopic examination, and rhinomanometry.
Computed tomography and laboratory diagnostics allow the doctor to get a complete picture of the problem and choose the best method for solving it.
When preparing for surgery, it is important to observe the following rules:
- For 15 days before the septoplasty, you need to stop smoking or reduce the usual dose of nicotine to a minimum.
- For women, surgery is performed only when at least two weeks have passed after the critical days.
- Do not use non-steroidal anti-inflammatory drugs and blood thinners before the operation.
- No food should be taken 12 hours before the procedure.
Compliance with these rules will facilitate and reduce the postoperative period, as well as reduce the likelihood of complications.
Scheme for classical septoplasty of the nose
Surgical intervention by the endoscopic method consists in introducing an endoscope with a diameter of 0.3-0.4 cm into the nasal cavity, as a result of which an image is displayed on the monitor and the doctor can observe the progress of work.
Simultaneously with septoplasty, other operations can be performed:
- Vasotomy … It is necessary for patients with chronic vasomotor rhinitis. It involves resection of the thickened mucosa.
- Conchotomy … It consists in trimming the hypertrophied nasal concha.
- Sinusotomy … Manipulations are performed in the affected sinus.
- Polypectomy … With this intervention, the growths of the nasal mucosa are removed.
- Rhinoplasty … Aesthetic correction of the asymmetry of the nose.
Not in all cases it is possible to carry out several manipulations at the same time. It depends on the individual characteristics of the patient and the difficulty of straightening the septum.
As for laser septoplasty, it is carried out in several stages: anesthesia, correction itself, suturing, tampon placement, plaster cast.
Possible complications and consequences of septoplasty of the nose
With a professional medical approach and proper preparation, the risks of complications in this operation are reduced to zero. Usually, nasal breathing does not function for several days after the operation. This is a temporary phenomenon that cannot be avoided today.
In this case, less often, but the following consequences are possible: bleeding and blood clots, deformation of the nose, perforation or abscess of the septum, suppuration, hematomas, otitis media.
Recovery after nasal septum septoplasty
To reduce and minimize discomfort during your rehabilitation period, remember the following:
- Drink plenty of fluids (juice, mineral water). This will help relieve dry mouth.
- Bed rest is not necessary at all, but you need to walk less, especially on the street.
- Avoid hot food and drinks for the first few days.
- Measure the temperature in the morning and evening for the first few days. For prolonged increases, consult a doctor.
- Don't tilt your head again. Try to sleep on your back.
- Put a lot of saline in your nostrils. It will soften the crusts and help drain mucus.
- Full working capacity is restored in 10-14 days.
- After the operation, it is recommended to avoid serious physical activity for at least 1 month.
- It is not recommended to visit the bathhouse, swimming pool, beach, solarium.
- Do not use vasoconstrictor drops.
- In some cases, doctors use polyamide or catgut sutures for suturing. If pieces of thread fall out during washing, do not worry, this is normal.
How to do septoplasty of the nose - watch the video:
The successful conduct of the operation and the result depends not only on the professionalism of the doctors, but also on you. It is important to properly prepare for septoplasty and follow all recommendations in the postoperative period. A timely visit to a doctor to solve the problem of curvature of the nasal septum will allow you to avoid many health problems that are formed due to impaired nasal breathing.
