Introduction
The nasal septum, a crucial structure dividing the nasal cavity into two chambers, can sometimes deviate from its usual position. This deviation, a deviated septum, can lead to complications such as nasal congestion, breathing difficulties, and recurring sinus infections. Submucous resection, a surgical technique designed to correct these deviations, has emerged as an effective solution for patients experiencing persistent nasal obstruction.
What Are the Causes of Deviated Septum?
Several factors contribute to the development of a deviated septum, including congenital abnormalities, traumatic injuries to the nose, and improper nasal growth during childhood.
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Congenital Abnormalities: Some individuals are born with a deviated septum due to congenital abnormalities in nasal development. These abnormalities may occur during fetal development and result in an asymmetrical growth of the nasal septum. The septum may be misaligned from birth, leading to breathing difficulties and other symptoms later in life.
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Traumatic Injuries to the Nose: Trauma to the nose, such as a blow to the face or a sports injury, can cause displacement or fracture of the nasal septum. The impact of the injury may shift the septum from its central position, leading to deviation. Common scenarios include vehicular accidents, falls, or physical altercations. Nasal trauma is a significant cause of deviated septums, particularly in adolescents and adults.
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Improper Nasal Growth During Childhood: Nasal septum deviations can also arise from improper growth during childhood. Chronic nasal congestion, allergic rhinitis, or frequent sinus infections during childhood may disrupt normal nasal development. As a result, the septum may grow asymmetrically or develop deviations, contributing to nasal obstruction and related symptoms.
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Genetic Syndromes: Certain genetic syndromes, such as Ehlers-Danlos syndrome and Marfan syndrome, are associated with connective tissue disorders that can affect the structure of the nasal septum. These syndromes may predispose individuals to septal deviations and other craniofacial abnormalities. The underlying genetic mutations lead to weakened or abnormal connective tissue, increasing the likelihood of nasal deformities.
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Environmental Factors: Environmental factors can also influence the development of deviated septums. Chronic exposure to irritants or pollutants, such as cigarette smoke, industrial chemicals, or airborne allergens, may irritate the nasal passages and contribute to inflammation and nasal congestion. Prolonged exposure to these environmental factors can exacerbate nasal deformities and worsen existing septal deviations.
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Nasal Surgery: In some cases, previous nasal surgeries, such as septoplasty or rhinoplasty, can result in postoperative septal deviations. Improper surgical technique, inadequate healing, or complications during the healing process may change the nasal septum's structure and alignment. Revision surgery may be necessary to address these complications and correct the deviated septum.
What Are the Symptoms of Deviated Septum?
The symptoms of a deviated septum can vary in severity from mild to debilitating.
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Nasal Congestion: One of the hallmark symptoms of a deviated septum is nasal congestion. This congestion often feels like a stuffy or blocked nose and can worsen during certain times, such as when lying down or during allergy seasons.
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Difficulty Breathing Through the Nose: The deviated septum can cause obstruction in the nose, which can make breathing through the nose difficult.
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Recurrent Sinus Infections: A deviated septum can cause altered airflow and impaired drainage, which can predispose individuals to recurrent sinus infections.
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Facial Pain: Some individuals with a deviated septum may experience facial pain or pressure, particularly around the nasal area. This discomfort may be exacerbated by sinus infections or inflammation resulting from compromised nasal airflow.
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Snoring: The obstruction caused by a deviated septum can contribute to snoring during sleep. As air struggles to pass through the narrowed nasal passages, turbulent airflow may result, causing vibrations of the soft tissues in the throat and nose, leading to snoring sounds.
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Sleep Disturbances: Snoring and difficulty breathing through the nose can disrupt sleep patterns, leading to sleep disturbances such as frequent awakenings, poor sleep quality, and daytime fatigue. Over time, chronic sleep disturbances can impact overall health and well-being.
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Chronic Sinusitis: In severe cases, untreated or inadequately managed deviated septums can contribute to chronic sinusitis. A deviated septum can exacerbate sinusitis symptoms and make treatment more challenging.
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Reduced Sense of Smell: A deviated septum can affect the airflow to the olfactory receptors in the nasal cavity, leading to a reduced sense of smell (hyposmia) or even anosmia (complete loss of smell) in some cases. This reduction in olfactory function can impact a person's ability to detect and enjoy aromas, affecting their quality of life.
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Sleep Apnea: In severe cases of septal deviation, particularly when combined with other factors such as obesity or enlarged tonsils, obstructive sleep apnea (OSA) may develop. A deviated septum can contribute to airway narrowing and increase the risk of OSA, which can have serious health consequences if left untreated.
How to Treat Deviated Septum?
Treatment options for a deviated septum encompass both conservative measures and surgical intervention. In cases of mild septal deviation, initial management often involves using medications such as nasal decongestants or corticosteroids to alleviate symptoms like nasal congestion and inflammation. Nasal decongestants shrink swollen nasal tissues, providing temporary relief, while corticosteroid sprays help reduce the swelling for longer-term management. However, for individuals with more pronounced septal deviations causing significant nasal obstruction and associated symptoms, surgical intervention may be necessary. Nasal septoplasty, or submucous resection, is the gold standard for correcting severe septal deformities.
During septoplasty, the surgeon accesses the nasal septum through the nostrils and carefully excises or repositions the deviated portions of cartilage and bone to restore proper alignment. This surgical approach improves nasal airflow and alleviates symptoms such as difficulty breathing, snoring, and sleep disturbances, ultimately enhancing the patient's overall quality of life. In select cases, concurrent procedures such as turbinate reduction or rhinoplasty may be performed alongside septoplasty to optimize nasal function and aesthetics.
Continuous monitoring and follow-up appointments with healthcare providers are essential for long-term management, ensuring optimal postoperative healing and ongoing nasal health. By combining conservative measures and surgical intervention, individuals with a deviated septum can significantly improve nasal function and overall well-being.
Conclusion
Submucous resection of the nasal septum is a vital intervention for individuals suffering from deviated septum and resulting nasal obstruction. This surgical procedure offers long-term relief from symptoms such as nasal congestion, breathing difficulties, and recurrent sinus infections by addressing the underlying structural abnormalities.
Timely identification and treatment of a deviated septum are crucial in preventing the progression of associated complications and improving patients' quality of life. Otolaryngologists play a pivotal role in diagnosing septal deviations and recommending appropriate treatment options, including submucous resection when warranted, enabling patients to breathe easier and enjoy enhanced well-being.
