Nasal Septal Deviation

What Is Nasal Septal Deviation?

The nasal septum is the partition running down the inside of the nose that separates the right side of the nose from the left side. It is made up of cartilage in the front and bone as you move in closer to the skull’s skeletal structure. Ideally, the septum should sit in the center of the nose so there are equal air passages on the right and left side of the septum. However, trauma to the nose or anatomical deformities caused by genetics can cause the septum to skew to one side or the other. This is the deviation of the septum. If this deviation is significant enough, it can cause a myriad of issues, including: nasal obstruction in breathing, headaches, nose bleeds, sinus infections and ear infections. Some cases of septal deviation can be treated with medicines that decrease the swelling in sinus tissues, opening the nasal passage. Other, more severe cases can require surgery to achieve optimal, healthy results. After a check-up appointment, one of our ENT doctors or nasal specialists will be able to determine the proper course of treatment.

Medical Treatment Options For Nasal Septal Deviation

We treat nasal septal deviation primarily by focusing on decreasing the swelling of the lining in the nose. This consequently increases the size of the nasal airway and allows for better airflow through the nose. We can accomplish this by using saline flushes, decongestants, antihistamines or nasal steroid sprays. Further, other potential causes of nasal inflammation to be evaluated to successfully treat the nasal cavity. This could reveal that we also need to be treating for sinusitis or allergies.

Surgical Treatment For Nasal Septal Deviation

If it is determined that we need to use surgery to treat your septal deviation, you will undergo a procedure called septoplasty. This is what you can expect during that procedure:

  • First, a septoplasty is an outpatient procedure, so plan on having a person with you the day of your surgery appointment.
  • General anesthesia is required.
  • The surgery takes approximately 25-45 minutes.
  • The surgery is all done through the nose. There will be no external scars, external bruising or change in the external appearance of your nose.
  • Plastic nasal splints are placed in the nose, which will stay in place for one week after the surgery. These splints hold the newly straightened septum in place while it heals.
  • No packing is placed in the nose. You may have heard about nasal surgeries requiring packing, which is placed in the nose after the surgery and painfully obstructs the nasal passages. I DO NOT use packing.
  • You will need to be off work for five to seven days for healing to complete. I ask that you take this time off work to totally let your body heal. This will produce the best results.
  • You will have a post-operative visit at our office one week after the procedure to have the splints removed.
  • Some common complications after a septoplasty are a hole in the septum, infection or bleeding.
  • Taking post-operative antibiotics and cleaning the nostrils beginning one day after surgery decrease infection risks.
  • Refraining from aspirin, Motrin, Aleve, herbal supplements and multivitamins one week prior to surgery and two weeks after surgery decreases bleeding risks tremendously.
  • The risk of septal perforation, which is the risk of a hole in the septum, is about 1% - 5% nationwide. My complication rate is much lower.

Inferior Turbinate Hypertrophy – Another Possible Cause Of Sinus Problems

You may not have a septal deviation responsible for any problems you are experiencing with your sinuses. It could be caused by inferior turbinate hypertrophy. You have two inferior turbinates, one in each side of your nose. These inferior turbinates contain a large amount of spongy mucosa (the pink lining inside your nose). The turbinates are very susceptible to allergy and dust irritation. If they are irritated, they can swell, causing difficulty of breathing through the nose. Again, there are both medical and surgical courses of treatment for our patients.

Medical Treatment of Inferior Turbinate Hypertrophy

The main goal of medical treatment for inferior turbinate hypertrophy is to decrease the swelling of the lining in the nose. By decreasing the swelling, we increase the nasal airway and allow for better airflow through the nose. Again, similar to septal deviation, nasal saline flushes, decongestants, antihistamines or nasal steroid sprays can reduce swelling. Using medical treatments, we report significant improvements in most patients. If these medical treatments don’t help to alleviate the problem, surgery is the only other option.

Surgical Treatment Of Inferior Turbinate Hypertrophy

There are many ways to treat inferior turbinate hypertrophy. I prefer, and most often use, Coblation, which is a procedure where a very fine radiofrequency wand is inserted into the turbinate. The radiofrequency energy creates a channel down the center of the turbinate. As this channel heals during the next two to three weeks, it contracts and shrinks the overall size of the turbinate. This improves the nasal airway, allowing the patient to breathe easier naturally. This surgery is occasionally performed by itself, but it is often combined with another operation, such as septoplasty or sinus surgery, to further address the patient’s upper airway obstruction.

Contact Your San Antonio, TX ENT Doctor With Any Questions Today

If you are experiencing any difficulty in breathing, sleeping or suffer from unexplainable headaches, nosebleeds or nasal sensitivity, contact us at Everyone’s ENT today. Dr. Christine Gilliam and her expert specialized staff are always here to help you with questions or schedule an appointment to be evaluated for any Ear, Nose or Throat issues, including asthma, allergies and sleep apnea. We look forward to hearing from you!