Deviation of the Nasal Septum
Ear Nose Throat Diseases
The nasal septum, commonly referred to as the septum, is the structure that divides the nasal cavity into two sides and is primarily composed of cartilage in the front and bone in the back, with the vomer bone at the base. The nasal cavity is roughly divided into three compartments: the lower, middle, and upper nasal spaces, each with its own function. The lower space directly affects breathing, the middle space is related to sinuses and partially to breathing, and the upper space is primarily associated with the sense of smell.
Does everyone with a deviated septum need surgery?
Not everyone with a deviated septum requires surgery. While it's common for people to have some degree of septal deviation, surgery is typically recommended when the deviation in the lower compartment (caused by the bone that forms the base of the nose) is obstructive. In cases where there is a moderate to severe deviation in the middle compartment, surgery is also considered.
How is Septal Surgery Performed?
Septal deviation surgery, also known as septoplasty, is typically performed through an incision made inside the nose, approximately 1 cm in size. Sometimes, it can be done directly, while in other cases, an endoscope with a camera may be used for a better view. The procedure involves the removal of the bone and cartilage causing the deviation while preserving the anatomy of the septum. Dissolvable sutures are used to close the incision site, and in many cases, the procedure can be done without the need for nasal packing. If packing is required, it is usually removed one or two days after surgery.
Can Septal Deviation Recur?
One of the most common questions patients ask is whether septal deviation surgery can recur. When septoplasty is performed correctly, recurrence is unlikely. However, other nasal conditions, such as recurrent nasal polyps or tumors, can occur separately.
What is the Postoperative Process and Complications of Septal Surgery?
After the surgery, there will be some initial improvement in breathing once the packing is removed, but the full relief of nasal congestion may take a few weeks. Nasal rinses with saline solutions or seawater-based products are typically used for nasal hygiene. Patients can take a shower the day after surgery, but swimming in pools or the sea should be avoided for two weeks.
Complications of septal surgery can include early bleeding, temporary nasal congestion, and nasal discharge. Late complications may involve the formation of adhesions inside the nose (synechiae), septal perforation (a hole in the septum), loss of the sense of smell, or inadequate surgical correction as some of the primary concerns.