It is difficult to breathe through the nose
One half of the nose is constantly blocked, worse when lying on its side.
CONDITION / CARRY
Deviation of the nasal septum.
Curvature of the nasal septum — deviation of the plate between the halves of the nose to the side. A small distortion is present in most people and does not interfere; when it makes breathing difficult, the septum is leveled with an operation called septoplasty.
CONCEPTUAL VISUALIZATION- what is it
- Deviation of the nasal septum — the cartilage-bone plate between the halves of the nose.
- How often
- A small curvature without symptoms is present in most people and is considered a variant of the norm.
- When operating
- If the distortion prevents breathing, and sprays do not help.
- Who treats
- ENT surgeon; septoplasty is usually done through the nostrils, without incisions on the face.
01 / WHAT IS ITWhat is
What is
septal deviation.
The nasal septum divides the nose into two halves. In front, it is cartilaginous, deeper - bony. A completely flat septum is a rarity: most people have a small deviation without complaints.
The curvature becomes a problem when it narrows one or both nasal passages, preventing air from passing and sinus ventilation. Sometimes there are spikes or ridges on the septum that rest on the side wall of the nose.
The curvature is corrected with septoplasty, the most common operation for this condition. Its purpose is to improve breathing and, if necessary, the shape of the nose.
This is general information. The doctor will tell you after the examination whether you need an operation.
02 / SIGNSHow is
How is
distortion manifested.
Complaints depend not so much on what the partition looks like, but on how much it obstructs the air.
Snoring
A narrowed nasal passage increases snoring and disrupts sleep.
Smell
Air reaches the upper parts of the nose more poorly, smells weaken.
Sinusitis
Frequent inflammation of the sinuses: distortion prevents them from ventilating.
Chronic sinusitisHeadache
The spike of the septum touching the sink can cause pain.
Conch shell03 / REASONSWhy is the partition
Why is the partition
curved.
In a study of 681 adults who underwent sinus CT, distortion was found in 80.0% of men and 67.4% of women.
Face growth
Cartilage and bones of the septum grow unevenly - this is how many distortions occur.
Injury
A blow or a broken nose, particularly in childhood, displaces the septum.
Nose after injuryAccompanying changes
Often together with an enlarged shell on the opposite side.
Hypertrophy of shells
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Distortion of the septum does not require emergency care. It is necessary to see a doctor urgently after a fresh injury to the nose: blood may accumulate under the mucous membrane of the septum.
103 immediately if:
- nose bleeding does not stop after 15 minutes of pressing;
- after the injury, the nose suddenly swelled and he could not breathe, pain and fever appeared.
See an ENT doctor in the coming days if:
After a blow to the nose, its shape changed (and if the nose stopped breathing, see a doctor the same day: this is how a hematoma of the septum is manifested). If your nose has been breathing badly for a long time, you snore or often suffer from sinusitis, make an appointment for a scheduled consultation.
05 / DIAGNOSTICSHow to determine
How to determine
whether surgery is needed.
- Review
An examination and endoscopy of the nose are sufficient for the diagnosis.
- Endoscopy
Shows warping in deep sections, spines and shell condition.
- Evaluation of complaints
The NOSE questionnaire - a scale from 0 to 100 - helps to assess how much the nose interferes with life.
- CT scan if necessary
Images are needed for planning — for example, if there is sinusitis.
06 / TREATMENTHow to fix a
How to fix a
partition.
Medicines do not straighten the septum, but sprays can reduce associated swelling. If breathing remains difficult, septoplasty helps.
01
Septoplasty
Usually — through the nostrils, without incisions on the face.
- The result
- In a meta-analysis of 2,577 patients, the NOSE score decreased by an average of 48.8 from 68.1 to approximately 19 out of 100 at 6 months.
- Endoscopic technique
- Compared to the classic operation, it is shorter, less damaging to the mucous membrane, less likely to cause fusion; the functional result is the same.
- Along with the sink
- If the lower concha is enlarged on the opposite side, its reduction together with septoplasty gave better relief of breathing, although there were significantly more complications (12 randomized trials).
02
What to expect
- satisfaction
- In a review of long-term studies, satisfaction rates ranged from 69% and higher, and in one study only half of patients were satisfied; the result is not the same for everyone.
- Complications
- In a series of 647 endoscopic septoplasty, bleeding occurred in 0.3%, adhesions in 5.2%, tears or perforations of the septum in 6.2%.
- Repeat operation
- In the US, repeat septoplasty was performed in 1.1% of 295,236 patients.
07 / AT THE VALIKHNOVSKY CLINIC
How do we
How do we
treat it.
The curvature of the nasal septum is corrected in the "New Nose" direction at Dr. Valikhnovsky's Institute of Surgery - endoscopically, through the nostrils.
DIRECTION TO THE CLINIC
A new nose
Shape, support and breathing of the nose: septum, concha, sinuses, consequences of injuries, failed operations and removal of tumors.
Go to direction
What do we do in this condition
- Endoscopic septoplasty — alignment of the septum under the control of the camera, with preservation of the mucous membrane.
- Post-traumatic septoplasty — if the septum has been displaced by an injury.
- Septoplasty with vasotomy — if the enlarged lower shell also interferes.
- Christotomy — removal of spikes and ridges of the partition.
- Silicone splints with air ducts — instead of tampons, to partially breathe through the nose after surgery.
Rostislav Valikhnovsky
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovsky Institute of Surgery.
How is the treatment in us
- ConsultationTalk about complaints, examination and endoscopy of the nose.
- ExaminationIf necessary — CT, if there is sinusitis or suspicion of other changes.
- PlanWhat needs to be straightened is only the septum or the concha, and if you need to change the shape of the nose, septorhinoplasty.
- OperationThrough the nostrils, under the control of the endoscope.
- RecoveryThe first weeks the nose is blocked due to swelling; physical activity should be avoided for several weeks.
08 / QUESTIONS AND ANSWERSFrequently asked
Frequently asked
questions.
Short answers. What is right for you, the doctor will tell you during the consultation.
Is it necessary to fix a curved partition, if nothing bothers you?
No. A slight distortion without complaints is a variant of the norm that most people have. They operate only when it interferes with breathing.
Which is better: endoscopic or classic septoplasty?
The functional result is the same. Endoscopic surgery is shorter, less traumatic to the mucous membrane and less likely to cause fusion in the nose.
Will the shape of the nose change after septoplasty?
Usually no: a septoplasty corrects a septum inside the nose. If it is necessary to change the shape, septorhinoplasty is performed.
Will septoplasty help with snoring?
Can reduce snoring if the cause is a stuffy nose. But snoring often has other causes, so the result is not the same for everyone.
How much will breathing improve?
In a meta-analysis of 2577 patients, the NOSE complaint score after 6 months decreased by an average of 48.8 out of 100. The proportion of satisfied patients in long-term studies varies from half to most patients.
What are the possible complications?
Bleeding, adhesions in the nose, tears or perforation of the septum, rarely - a change in the shape of the back. In a series of 647 endoscopic operations, bleeding occurred in 0.3%, adhesions in 5.2%, tears or perforations in 6.2%.
Sources
10 sources · reviews, guidelines and studiesShowCollapse
- Clinical Consensus Statement: Septoplasty with or without Inferior Turbinate ReductionOtolaryngology–Head and Neck Surgery, 2015doi:10.1177/0194599815606435 ↗
- Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta-analysisLaryngoscope, 2023doi:10.1002/lary.30684 ↗
- Septoplasty versus septoplasty with turbinate reduction for nasal obstruction due to deviated nasal septum: a systematic review and meta-analysisRhinology, 2022doi:10.4193/Rhin22.157 ↗
- Long-term patient-related outcome measures of septoplasty: a systematic reviewEuropean Archives of Oto-Rhino-Laryngology, 2018doi:10.1007/s00405-018-4874-y ↗
- Endoscopic vs. conventional septoplasty: A review of the literatureEuropean Annals of Otorhinolaryngology, Head and Neck Diseases, 2016doi:10.1016/j.anorl.2015.11.004 ↗
- Nasal Septal Deviation: A Comprehensive Narrative ReviewCureus, 2022doi:10.7759/cureus.31317 ↗
- Nasal septal anatomical variations among Saudi population and their possible coincidence with sinusitis: a computed tomography scan studyAnatomy & Cell Biology, 2022doi:10.5115/acb.22.110 ↗
- Revision Rates of Septoplasty in the United StatesFacial Plastic Surgery & Aesthetic Medicine, 2023doi:10.1089/fpsam.2022.0009 ↗
- Endoscopic septoplasty as a routine approach: Our experience on 647 patientsJournal of Cranio-Maxillofacial Surgery, 2019doi:10.1016/j.jcms.2019.07.018 ↗
- Complications and management of septoplastyOtolaryngologic Clinics of North America, 2010doi:10.1016/j.otc.2010.04.013 ↗
The figures on the page are from these sources.
Does the nose
breathe badly?
Describe how long you have had a blocked nose and what you have already tried. The doctor will tell if the problem is with the septum and if septoplasty is needed.