When to operate on a deviated septum

Deformation of the nasal septum is one of the most common reasons for visiting otorhinolaryngologists and plastic surgeons. Deviation of the nasal septum implies a deviation of the bony or cartilaginous structures of the nasal septum from the median plane, resulting in a violation of the respiratory function of the nose. In addition, the curvature of the nasal septum deforms the external nose and distorts the overall appearance of the face. The curvature of the nasal septum most often occurs as a result of trauma, less often as a pathology of the development of the facial skeleton and the result of neoplasms in the nasal cavity. Deviations of the nasal septum can be completely different in form, localization and degree of nasal breathing disorder.

What methods will help to diagnose a deviated septum of the nose

Diagnosing a deviated septum is not a difficult process. An analysis of the patient's complaints, anamnestic data, as well as objective examination data is often enough to make a correct diagnosis. Rhinoscopy using special otorhinolaryngological instruments allows you to confirm the diagnosis and clarify the degree of deformation of the nasal septum. To clarify the extent of the curvature of the nasal septum, endoscopic examination using endoscopes with different viewing angles is used. To assess the degree of violation of the respiratory function of the nose, rhinomanometry is used, in especially difficult diagnostic cases, computed tomography is used.

Indications for surgical treatment of deviated septum

There are three types of deformity of the nasal septum: deviated, crested and spiked. There may also be various combinations of them. Deformation of the nasal septum, depending on the severity, causes a characteristic clinical picture. Patients may complain of deterioration in the respiratory function of the nose in the form of shortness of breath, a feeling of nasal congestion, the presence of mucous or mucopurulent discharge from the nose.

If the deformation of the nasal septum is so pronounced that it comes into contact with the mucous membrane of the opposite wall of the nose, headache, congestion and tinnitus, and impaired olfactory function of the nose may occur. But it also happens that the curvature of the nasal septum is mild and does not provoke the occurrence of any symptoms. Thus, the indication for surgical treatment of deviated septum is the presence of symptoms that impair the patient's quality of life.

Conditions for performing surgical interventions for deviated nasal septum

In order to improve the respiratory function of the nose and eliminate other symptoms caused by deformity of the nasal septum, performs surgery – septoplasty. To date, two main types of such operations are most often used: the classic submucosal resection of the nasal septum and the more sparing circular resection according to Wojaczek.

Septoplasty is one of the most difficult surgical interventions in plastic surgery, since its improper performance can lead to the formation of adhesive processes, perforations, synechia in the nasal cavity and even more pronounced violations of the respiratory function of the nose. Thus,  surgical treatment of nasal septal curvature should be performed strictly according to the indications, taking into account the individual characteristics of the structure of the patient's nose and subject to sufficient qualifications of the operating surgeon.

If all these conditions are met, the deformity of the nasal septum can be completely eliminated, the respiratory function of the nose will be restored and the quality of life of the patient will be significantly improved.