What is The "Nasal Septum Deviation" and "Septoplasty Operation"?

The structure consisting of cartilage and bone tissue, which divides the nasal cavity vertically, is called nasal septum. If the nasal septum is curved to the right or to the left, the air passageway on the side of the curvature is narrowed and nasal obstruction may occur. This condition is called "nasal septum deviation".

What is the cause of the septum deviation?

Babies can be born structurally with septum deviation, as well as with trauma during the passage of the baby through the birth canal at birth.

Although it does not complain about childhood bumps, falls, injuries at the moment, it may cause deviation as a result of the development of bone and cartilage parts of septum at different speeds during growth.

Genetically, some people have nasal shape differences and deviations that become apparent in adulthood.

What are the symptoms of the septum deviation?

The most common symptom of Septum deviation is difficulty breathing through the nose. It may cause breathing difficulties in one nose or both noses. In some people with mild septum deviations, the symptoms only appear during colds. The swelling caused by the respiratory tract infection in the nasal tissues makes mild obstruction not normally noticeable.

Nasal congestion seriously impairs a person's quality of life.

 The septum deviation can cause the following problems:

• Single or double sided nasal congestion
• Recurrent nosebleeds
• Recurrent sinusitis, pharyngitis, bronchitis
• Pain in the facial area, headache, nasal discharge
• Impaired sound quality, speech from the nose
• Snoring, apnea,
• Eustachian tube obstruction, Fluid accumulation in the ear

Caudal Septal Deviation

The part of the nasal septum that is closest to the ground, that is, when you look at the nostrils in front of the "columella" which is the section between the holes immediately behind the "caudal septum" section is very important especially in the support of the tip of the nose and in The Shape of the tip of the nose. It is the case that the lower part of the nasal septum is dislocated from the midline to one side (also called"Anterior Septal dislocation"). The curves in this section are justified as "caudal septum deviation","caudal septal deviation"or "anterior septal deviation" as illustrated by my patient above, which can cause major 3 problems (source: Caudal septal deviation):

1. nasal congestion
2. trapezoidal nose tip
3. columellar irregularities

Patients with caudal septum deviation usually have a protrusion that can be seen from the front just behind the columella and inside the nostril, and a septum deviation in the opposite nasal cavity further back, as seen in the above photograph.

The nasal tip support is reduced as a result of the shift of the caudal septum to the side, and generally patients may notice that the tip of the nose is softer than normal when they touch the tip of the nose, spreading sideways or dangling while laughing. Sometimes patients can describe a sitting sound rather than a sound due to the movement of the caudal septum region during hand play.

Causes of caudal septum deviation

The causes of nasal septum deviation also apply to kayudal septum deviation and can be summarized as follows::

 the most common cause of caudal septum deviation is trauma to the face region (perhaps especially to the tip of the nose).)

- direct compression and trauma of the nose during childbirth (in this way can also be considered a congenital disease)

- genetic connective tissue disorders such as Marfan syndrome, homocystinuria, and Ehlers-Danlos syndrome, which can cause septum deviation

How is septum deviation diagnosed?

In septal deviation, the diagnosis is made by endoscopic detailed examination of the nose.

Nasal breathing can be determined objectively by rhinomanometric measurements. With acoustic rhinometry, volume stenoses of each nasal canal can be detected.

If there are other problems such as sinusitis swelling and allergy, films, tomography and laboratory examinations can be made.

How is septal deviation treated?

Surgery is the only treatment option for nasal midline bone curvature. The curvature in the nasal bone is corrected with an operation called septoplasty. This surgery can be performed under local or general anesthesia. It is often performed under general anesthesia for patient comfort. The operation time is 30-45 minutes, except for anesthesia. The surgical incision is made through the nose. Bones that block the nasal air passage are removed, cartilage curvatures are corrected if they can be corrected. If there is swelling in the nose, it is corrected in the same operation. The airway opens. Nasal tampon is mostly applied after surgery. Many types of tampons can be used after these surgeries. However, mostly air channel silicone buffers are preferred recently. Since these patients receive air with these tampons, they spend the postoperative period more easily. Since it is silicone, the buffering phase is also more comfortable. As a result of this surgery, there is no skin cut or shape change in the external structure of the nose. Bruising or swelling under the eyes are not observed.

The nose has many positive health-related functions. If the cartilaginous curvature is excessive, the airway may close completely on the side of the curvature. For the purpose of treatment, deviation surgery is performed. Surgery is a very common procedure. It can be used in the sense of curvature of the nose, curvature of the cartilage, or curvature throughout the nose. Septum deviation surgery is the correction of the cartilaginous curve in the nose.

Septoplasty Operation + Radiofrequency Turbinate Reduction  - Septoplasty in İstanbul

It is usually done with Radiofrequency Reduction of Inferior Turbinates. In the above photograph, an intranasal air passage is seen before, after and after the patient in which septoplasty operation + radiofrequency turbinate reduction operations are performed. 

In general, nasal septum deviation is very common and it is among the most common otorhinolaryngologic procedures. As far as possible, the anatomical structures present are planned to be modified by minimally altering and minimally removing cartilage tissue.

Differences of caudal septum deviation surgery compared to normal septum deviation surgery

In patients with caudal septum deviation, it is not sufficient to remove only the curved part as in normal deviation operations. This section is very important for the support of the tip of the nose and for the upright position of the tip of the nose. If the area of curvature is removed, the tip of the nose may fall and the airway section in the nose may decrease as a result of the re-emergence of nasal congestion over time, may cause problems such as deformity in the nose. In patients with caudal septum deviations, an open technique nose tip aesthetic approach, after removing the curve in front of the septum instead of a cartilage graft taken from the back of the support or partial resection with closed technique and instead of sliding into the septum should be planned in the form of treatment. So just simple cartilage removal is not enough

Should every septum deviation be surgically corrected?

80% septum deviation is observed in the society. In most of the ear, nose and throat examinations, which are frequently performed for other reasons, we encounter septum deviation at different rates. The important thing when deciding on the operation is the patient's complaints rather than seeing and detecting the curvature. We should not forget that we will treat the patient, not the image. If the septum deviation presents clinical complaints, it should be corrected. In other words, if our patient has complaints such as nasal congestion, pressure in the ear, headache, snoring, sleep with open mouth and this reduces the quality of life of the person, the operation is planned. As a result of this operation, the quality of life of the person will increase.

You can find details about "Septoplasty in İstanbul, Radiofrequency Turbinate Reduction in Istanbul" at >> Radiofrequency Turbinate Reduction in Istanbul / Septoplasty in Istanbul / Open Techique Septoplasty Operation in İstanbul / Frequently Asked Questions About Septoplasty Operation in İstanbul

You can find details about "Nasal septum deviation definition - Nasal septum deviation causes - Symptoms of deviated septum - Diagnosis of septum deviation with turbinate hypertrophy - Treatment of nasal septum deviation - Septoplasty in Istanbul - Septoplasty in Turkey" at >> Nasal Septum Deviation - Symptoms, Diagnosis and Treatment

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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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