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What is Septum Deviation? How is it treated?
October 28, 2023

Dr. ozbarsut

Nasal functions can be counted as heating, cleaning and moisturizing the air. The nose is important for a quality breath. Heating and humidifying the air taken in and transferring it to the throat with a certain circulation is essential for the protection of the lower respiratory tract, both for protection from diseases and for a quality life.

The nose consists of a structure called the septum, which starts as cartilage from the front and continues with a thin bone structure towards the back. On the opposite wall, there are 3 structures called concha (nasal flesh among the people) and the opening areas of the sinuses.

If the septum does not separate the nose into two equal parts for any reason, the resulting condition is called septum deviation. Congenital traumas, falls that may occur during the playing age, and traumas to the nose can cause shape changes in the cartilage, bone part, and sometimes both.

Pass through the nostril as a result of bending

The volume of the air is reduced and the opposite nasal part has to expand its surface in order to warm and moisturize the air, especially in the nasal flesh area we call the concha, in order to better perform the functions of the opposite nasal part. As a result, the breath taken from the part where the curvature was already reduced, and the surface growth made by the opposite side to undertake the nasal tasks makes breathing even more difficult. Patients usually try to save the day by using nasal sprays to overcome their congestion.The effect of the spray is especially with the shrinkage of the meat we call the concha opposite the blocked nose, so in fact the blocked side does not benefit much again. If the sprays are used over a certain period of time (5 days and over), this time when they do not squeeze, blockages begin and thus a vicious circle is entered into. Patients may encounter recurrent problems such as not only nasal congestion but also disorders in smell due to airway obstruction, frequent sinusitis attacks due to insufficient resistance in their sinuses.

TREATMENT

The operation is performed with a surgical technique called SMR (submucous resection). The procedure can also be performed with endoscopic assistance.

CLINICAL OPINION

Patients benefit a lot from the surgery to be performed with the right surgery to the appropriate patient. In Turkey, the average septum deviation is seen as 70% and the otolaryngologist should not have a mission to correct the nasal bone of the society. The patient, who applies to the physician with different complaints, is confused with a completely different diagnosis and visits the physician with a completely different diagnosis, and his trust in the physician community is broken due to the different opinions he receives…

If possible, it is ideal to determine the intervention area by performing nasal air measurements called Rhinomanometry and measuring the shares of the nasal bone and nasal flesh in the complaint. Sometimes there will be no complaints in deviated noses, and sometimes breathing complaints may be more than expected even in mild curvatures. Rhinomanometry can be an examination that minimizes the error by coming into play here.

OPERATION

Septumplasty operation can be performed under local or general anesthesia. We generally prefer general anesthesia due to both patient comfort and the ability of the physician to concentrate more on surgery. Although the operation time may vary, it does not exceed 20-30 minutes.In our surgeries, taking into account that the septum is the structural support of the nose, we especially reshape the curved parts of the cartilage part and place it back to its anatomical place. It should not be forgotten that the less parts are removed in the operation and the integrity is preserved, the more successful it is. The discourse “The doctor gave a lot of bone cartilage in the cloth after the operation” is the same discourse as “The doctor gave the structure supporting my nose to my hand”.

At the end of the operation, alternative tampon materials can be preferred according to the condition of the case. I generally prefer materials made of silicone that can provide breathing and do not cause pain when removed, but I also apply new tampons such as self-melting merocele when necessary.

3 days after the operation, the patient is re-evaluated and called to clean and check the inside of the nose, the next check is usually 1 week later.

CONCLUSION

Breathing through the nose is to inhale cleaned, moisturized, heated quality air.It is an indisputable fact that it will contribute to many positive aspects.However, the operations recommended for the future health of the person without any complaints do not make much sense to me, frankly.Especially in allergic and high humidity regions such as Antalya, the share of nasal meat (concha) in breathing difficulties is extremely high compared to dry climates.For this reason, complaints such as “I had surgery and after a while I can’t breathe again” are quite common.The continental climates, which live like summer summer and winter, have an atmospheric structure more suitable for human nature, and naturally, interventions in this region give more successful results.The air conditioning factor should never be ignored.

After listening to the complaints of the person well, as a result of a detailed examination, especially with pediatric optics, the intervention to be made by determining the source of the problem with the help of Rhinomanometry and finally shaping the operation with paranasal sinus tomography will increase the chance of success.