Deviation of nasal septum means that the nasal septum deviates from the midline and bends to one side or both sides or locally forms a protrusion, which causes nasal dysfunction or symptoms, but the nasal septum is rare. If there is no dysfunction, don't deal with it. Common causes include: trauma, dysplasia, tumor foreign body pressing the nasal cavity, etc. The main symptoms are: alternating or persistent nasal congestion, headache, nosebleeds and runny noses.

abstract

Where the nasal septum deviates from the midline, it bends to one side or both sides, or locally forms a protrusion, causing nasal dysfunction or symptoms, which is called nasal septum deviation. In fact, few people have a complete nasal septum. If there is no dysfunction, diagnosis and treatment may not be possible.

The cause of disease

(1) trauma: trauma is an important cause of this disease, which mostly occurs in childhood, and the history of trauma is often forgotten. At that time, all components of the nasal septum were underdeveloped, so there were no symptoms. Later, with the increase of age, it gradually developed into nasal septum deviation, and adults can also cause nasal septum deviation or nasal septum cartilage dislocation due to trauma.

(2) Abnormal development: The nasal septum was originally composed of several cartilages, and then ossified separately, and then a bony nasal septum appeared. In the development process, due to various reasons, the development of bone and cartilage is unbalanced, resulting in deformity or deviation, or the formation of bone spurs or ridges at the junction of bone and cartilage in the nasal septum. Patients with adenoid hypertrophy, breathing from small mouth and high arch of hard palate have limited development of nasal septum, and nasal septum deviation may also occur.

(3) Compression factor: The compression of tumor or foreign body in the nasal cavity can make the nasal septum deviate to one side.

symptom

(1) Nasal congestion: alternating or persistent. Simple deviation or mutation of "C" shape often leads to ipsilateral or alternate nasal congestion. Accompanied by compensatory hypertrophy and "S" deviation of the contralateral turbinate, it can cause bilateral nasal congestion.

(2) Headache: The deviated part compresses the turbinate, which can cause ipsilateral reflex headache.

(3) Nosebleed: The mucous membrane at the convex surface or crest and talus process of deflection becomes thinner, which is often stimulated by airflow or dust, so dry erosion often occurs, leading to nosebleeds.

(4) Increased nasal secretions: Deviation of nasal septum stimulates glands and increases nasal secretions. If the secondary infection stimulates the nasal mucosa and secretes too much, it is mostly mucinous or purulent secretion. If accompanied by sinus infection, it is suppurative.

(5) Symptoms of adjacent organs If the deviated part of the nasal septum is located at the corresponding place between the middle nasal meatus and the middle turbinate, it will cause the middle turbinate to move outward, or make the middle turbinate bone over-gasified and the mucosa thickened, which will hinder the drainage of the sinus orifice to the middle turbinate. Over time, it can induce sinusitis and produce various symptoms. If the ventilation and drainage of the eustachian tube are affected, tinnitus and hearing loss may occur.

(6) The mucous membrane on the convex surface, ridge or spur of nosebleed is thin and often stimulated by airflow and dust, so the mucous membrane is dry and erosive, which is prone to nosebleed, but sometimes nosebleed can also be seen on the concave surface of nosebleed.

(7) The symptoms of vasomotor rhinitis are aggravated.

Surgical correction is the only way to treat nasal septum deviation. However, if there are nasal polyps or enlarged turbinates at the same time, they should be operated on first. If nasal ventilation is improved and nasal symptoms disappear, nasal septum deviation may not be treated. The surgical methods are generally submucosal resection of nasal septum, rocker operation and submucosal correction or plasty of nasal septum.

cheque

The diagnosis of nasal septal cartilage deviation is easy, and the high or posterior segment deviation is easy to be ignored. This disease must be differentiated from hypertrophy of nasal septum mucosa and touched with a probe. The latter is soft and easy to be crushed into pits. Various types of nasal septum deviation can be seen during examination. According to the deviation form, there are "C" type, "S" type, crest and talus process. According to the deflection position, there are high position, low position, front section and rear section.

treat cordially

Anyone who has one of the above obvious manifestations and believes that it is related to nasal septum deviation can be used as an indication for surgery. The previous surgical method has always been submucosal resection of nasal septum, but because of the small surgical field, it is difficult to achieve the therapeutic goal for patients with complex deformities. Since 1960s, from the perspective of rhinoplasty, nasal septum reconstruction has been advocated with satisfactory results.

Surgery should be performed in one of the following situations:

1, nasal septum deviation causes long-term persistent nasal congestion.

2. High deviation of nasal septum affects sinus drainage and causes chronic sinusitis.

3. Repeated nosebleeds or secretory otitis media caused by deviated nasal septum.

4. Reflex headache caused by deviated nasal septum, conservative treatment is ineffective.

5. Vascular motor rhinitis (structural rhinitis) with obvious deviation of nasal septum.

6. Patients with pollinosis, perennial rhinitis or bronchial asthma have severe nasal septum deviation, which is ineffective after other treatments.