The human body is symmetrical, its right and left halves (if not taking the internal structure) can be reflected in the mirror, passing in the sagittal plane.
Therefore, all structures found in the midline experience “increased responsibility”. This is clearly seen in the example of the nasal septum. It may experience deformity during intrauterine development, as well as be affected by injuries and various diseases.
Therefore, a disease such as deformity of the nasal septum, is quite common in people of different races, nationalities and ages.
It, in turn, is capable of causing various problems not only with nasal breathing, but also many other disorders.
Why is the deformation of the nasal septum? What to do if the nose curve, so to speak? Is it possible to recover from this bone defect of the nasal septum without surgery, or is surgical treatment to be always necessary?
What is the nasal septum
At the beginning of a little information from the anatomy. The nasal septum, as it is easy to imagine, divides the nasal cavity in a vertical plane into right and left symmetrical halves. Air enters them, respectively, from the left and right nostrils; therefore, inside the nasal cavity, the inhaled air is divided into two isolated streams and is directed further. What is a nasal septum? – it’s just the inner, median (or medial) wall of the nasal cavity.
It consists of the following durable and elastic formations:
- The upper jaw, which has a crest of the nasal septum on its palatal process;
- Plate of ethmoid bone;
- The opener is an unpaired bone that forms the basis of the septum.
These are bones, but there is also an elastic element in the septum – the nasal cartilage in the form of an irregular quadrilateral, which continues the partition in the anterior sections and participates in the formation of the movable part of the back of the nose, below the nose bridge.
This is the supporting structure of the nasal septum. It must be remembered that outside there is a mucous membrane richly supplied with blood vessels to warm the incoming cold air. On the surface of the mucous membrane are glands that produce a secret. The mucous and deeper layers of the septum are innervated by various sensitive and secretory parasympathetic branches of the cranial nerves.
The main function of the partition is to work with air flow and their proper distribution, cleaning, moistening and warming.
Types of nasal septum deformities
Since the hardness of the nasal septum increases from the surface of the cartilage to the depth of the skull, the curvature is much more common in the front, and in the posterior sections of the septum deformation is almost always absent.
The curvature is different: in the vertical plane, it can be convex, (one-sided), or S-shaped. According to the structure, the curvature can be a significant deformation, like a spike or ridge. Sometimes bone spike in nose or the crest “cuts” into the side wall of the corresponding turbinate.
There are frequent cases of complex curvature, when the wall is not just changed, but “twisted” in several planes. In the case when the deformation captures the anterior sections and the elastic cartilage, then its dislocations are possible, and even its partial detachment from the bones. Of course, this occurs in depth, and outside the mucous membrane “masks” internal disturbances.
The degree and type of curvature give the key to the complications, symptoms and type of treatment tactics.
How to determine type of curvature? It is not enough to collect complaints, we need a rhinoscopy (front and back), which is performed by the ENT doctor at the outpatient admission at the clinic. Magnetic resonance imaging with the construction of a three-dimensional image of the entire nasal cavity can provide exhaustive information.
What are the forms of the nose?
Everyone knows that different people have a different structure of the external nose. But not everyone knows that its internal structure varies significantly, and the shape depends not only on the bones, but also on the configuration of elastic cartilage.
Since the nose is an “integral anatomical structure,” its appearance is made up of the shape of the nose bridge, the wings, the tip of the nose, the incision of the nostrils and the back of the nose. It is these details that make it possible to distinguish the proud Roman profile from the nose with potatoes.
The simplest classification of nose forms includes the following main types:
- straight nose (back is also straight);
- snub-nosed (back concave);
- aquiline nose (crooked).
A separate, rather rare nose is the Greek. A feature of this form is the absence of a notch on the nose, that is, the back of the nose is a continuation of the forehead.
The kids nose is low, and wide, button. Then, by the age of 10, the shape of the nose takes on genetically incorporated shapes with the growth of the skull.
The medial wall of the nasal cavity is also related to the shaping function: removal of the nasal septum, especially in the anterior, cartilaginous part, may affect the overall configuration of the nose.
Why does the nasal septum shift?
All the variety of causes of the curvature of the nasal septum can be divided into several groups:
- physiological causes – that is, associated with the development of the bones of the head, due to heredity;
- injuries of the skull and nasal structures;
Nose deformity due to physiological reasons, it occurs due to the uneven growth of its various departments. This is similar to the curvature of the apple tree trunk, changes occur slowly over many years, and such “surprises” end by mature age.
Injuries are a frequent cause of sudden distortion, especially in the male due to known causes. After the impact, which usually occurs sideways, not only the cartilages are displaced, but with great force, the central structures of the nasal cavity.
In addition, after an injury, hemorrhage may occur, which may not resolve, but organize. Such post-traumatic hematoma of the nasal septum can lead to a significant deformation of the medial wall of the nose for a long distance.
Compensatory causes are a diverse group of various diseases that lead to deformity:
- catarrh of the nasal septum (chronic rhinitis, vasomotor rhinitis);
- sinus polyposis, tumors. In the case of pronounced growth, they can disrupt the flow of air. In order to restore it, a slight curvature of the nasal septum occurs at the beginning, and then a more pronounced one;
- constant congestion on the one hand;
- purulent diseases of the nasal cavity, for example, abscess of the nasal septum.
To understand in time why the nasal septum is displaced – it is very important to choose a treatment. A source:
Symptoms caused by curvature
Signs of septum deformation are different. But the most typical symptoms are:
- difficulty breathing through the nose: more often than one nostril;
- constant runny nose, nasal congestion;
- allergic rhinitis. It is associated with the constant mechanical action of the partition on the adjacent, side wall;
- symptoms associated with dry nasal mucosa: pain, redness, swelling;
- frequent nosebleeds;
- possible night snores and periods of sleep apnea (temporary pauses of breathing);
- more frequent cases of SARS and other respiratory infections;
- signs of chronic inflammation in the middle ear, in the larynx and pharynx (otitis, laryngitis).
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Left-sided curvature of the nasal septum
Does nature have any preference when choosing the side of the nasal cavity? Does the left or right side occur more frequently? According to the existing statistics, there is no definite trend. There is some curious detail that can make it clear why most of the requests on the Internet are concerned specifically with left-side curvature.
Yes, simply because the majority of doctors – otolaryngologists – are right-handed, and with anterior rhinoscopy it is simply more convenient for them to examine the patient’s left nostril, which will be on their right, since the patient is sitting facing them. After all, it is in the right hand that the doctor holds the nasal mirror, while the wings of the nose are on the left and do not block the picture. That is why the doctor may see smaller and minor changes.
Submucous resection of the nasal septum
How to straighten the septum of the nose? Most often with this pathology used surgical treatment method. One of the most common operations is the resection of the nasal septum.
This name is given because this operation is organ-preserving: the mucous membrane is retained, and after the operation it is “put in place,” as a result, the septum simply becomes thinner. Many patients ask when to operate. To understand this, we list the indications for this intervention:
- persistent nasal breathing: full blockage on one side;
- snoring in a dream;
- Silent nasal passage, with no ventilation (even if the patient is used to this, and he has no complaints);
- Deviation of the nose (cosmetic defect);
- In some cases, resection is not the goal, but only the first stage of the operation of accessing more deeply lying structures of the skull, for example, the ethmoid labyrinth. In some cases curved nasal septum complicates access to the nasal sinuses with their purulent inflammation (empyema).
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Curvature of the nasal septum – effects
- The deterioration of gas exchange in the lungs, as in the nasal cavity, the air is moistened, cleaned and warmed. Not completely warmed air can cause a spasm of the small bronchi, and in the presence of concomitant factors, cause bronchial asthma;
- Reduced mucus production leads to a decrease in the number of immunoglobulins in the nasal cavity, causing the body to become susceptible to infections;
- Violation of nasal breathing can cause a reflex cough (if you constantly breathe through your mouth, dry larynx and ligaments develop;);
- Headaches, signs of migraine and other manifestations of insufficient oxygenation may occur. If a patient has had problems with a nasal septum, for example, a lung resection for tuberculosis, or he suffered from emphysema, then due to a deformation of the septum he may have shortness of breath.
In the event that the curvature of the septum prevents the obese person with hypertension and atherosclerosis from sleeping, spontaneous respiration stops in a dream can lead to stroke and sudden death, therefore this disease cannot be underestimated and the consequences can only be local.
Treatment without surgery
Of course, the greatest number of patients with this pathology do not immediately see a doctor, but only with the accumulation of complaints and a far gone process. Then the operation is inevitable.
Only if the deformation occurred in small amounts, and does not cause significant violations of ventilation, you can not go under the knife. In such cases, there is a chance to straighten the nose without surgery.
How to align the nasal septum in conservative ways?
In the event that a curvature of the nose after an injury has occurred, then within a few hours or even days you can “put” the partition into place with special elevators. This is done without any cuts.
The second way to fix the nose curve without surgery is laser septochondrocorrection. It is applicable so far only in the case of anterior deformations, or in the case when a significant part of them falls on cartilage.
This is possible because the laser is capable of evaporating cartilage defects without bloods, but its power is not enough to do the same with bone tissue. In a sense, this type of treatment can be called a “bloodless” and “contactless” operation. For most patients, this is quite acceptable.
The second name of this operation is laser thermoplastic. It is used if the elastic cartilage can be put in a normal position. For example, just pushing it with your finger. If you release your finger, the elastic cartilage will come back again.
To fix it and give it rigidity, it is heated by a laser.
The operation on the nasal septum itself is carried out for a few minutes, and for anesthesia, it is enough to drip lidocaine spray in order to avoid pain. After the operation, the patient is inserted into the nose with a tampon so that he fixes the cartilage and is allowed to go home. The next day, the tampon is pulled out. That’s all.
Therefore, everyone can choose treatment methods. The main thing is that it was carried out, if there are indications for this.