Surgical correction is the only treatment. However, if accompanied by nasal polyps or enlarged turbinates, nasal polyps and turbinate surgery should be performed at the same time.

1. Surgical indications

Surgery should be performed in one of the following cases: nasal septum deviation causes long-term persistent nasal congestion; High deviation of nasal septum affects sinus drainage; Repeated epistaxis caused by deviation of nasal septum; Reflex headache caused by deviation of nasal septum; Vascular motor rhinitis (structural rhinitis) with obvious deviation of nasal septum.

The following situations should be contraindicated or stopped: acute nasal infection; Untreated sinusitis; Some systemic diseases such as diabetes, tuberculosis, severe hypertension, cardiac insufficiency, blood diseases, etc. Female patients during menstruation; 65438+ people under the age of 08.

2. Surgical methods

Surgical approaches are divided into intranasal or extranasal gingival sulcus incision, and now the former is mostly used. The surgical method can be performed under anterior nasal endoscope or nasal endoscope. Nasal endoscope is widely used because of its clear field of vision, small surgical trauma and thorough correction.

(1) The main steps are to separate the mucosal cartilage capsule, expose the bone and cartilage, cut off part of the crooked bone and cartilage, restore the cartilage to the mucosal capsule after repair, or move the bone plate fracture to the midline, or restore the cartilage to the midline by scratching and shaking.

(2) The main surgical methods are submucosal resection of nasal septum, septoplasty and septoplasty. Because of the different types and shapes of nasal septum deviation, the surgical methods are not the same. Careful examination should be made before operation to determine the type and location of deviation, and then the surgical plan should be made and applied flexibly according to the findings during operation.

3. Postoperative complications

(1) The perforation of nasal septum is mostly caused by the thin mucosa of nasal septum ridge and spine, high tension and mucosal rupture. In the presence of nasal inflammation, even unilateral tearing may lead to perforation. If bilateral mucosa is torn, the removed cartilage can be placed between bilateral cracks, which may prevent perforation.

(2) Hematoma of nasal septum is cystic hematocele of nasal septum mucosa. If after the nasal packing is removed, it is found that there are semi-circular protrusions on both sides of the nasal septum, even if ephedrine saline is dripped, the patient's nasal congestion will not be improved, and the puncture can extract bloody liquid, and the diagnosis can be made. Small hematoma can be absorbed by itself, and larger hematoma should be cut and drained.

(3) Septal abscess is mostly caused by bacterial infection secondary to nasal septum hematoma, so it should be cut and drained and treated with anti-infection.

(4) Nose collapse Because the nasal septum is an important support of the external nose, there is a risk of nose collapse if the bone and cartilage of the nasal septum are removed or moved. Abscess of nasal septum causes liquefaction and necrosis of cartilage, which can also occur.

(5) Intracranial complications are rare. The vertical plate of ethmoid bone is connected with the cerebral plate, which may rupture in the elderly and osteoporosis, resulting in cerebrospinal fluid leakage. Nasal septal abscess may spread upward to the skull, causing intracranial infection.