Q. My CT says nasal septum deviates towards right. What does it mean?

Answered by
Dr. Sumit Srivastava
and medically reviewed by iCliniq medical review team.
Published on Jun 14, 2017 and last reviewed on: Nov 15, 2019

Hi doctor,

Over six months I have had what was thought to be an epidermoid cyst at the end of the right side of my nose. I have taken antibiotics on a regular basis as there is redness, swelling and tenderness in the area when inflamed. Approximately 2 weeks ago this cyst on my nose became very inflamed or infected. I was experiencing headache, sore neck, painful and uncomfortable nose and facial pressure (swelling), pressure in my ears and dry infected eye that too right side consequently. I visited GP and had CT scan of paranasal sinuses. I hope you could provide me the explanation for the below sentence, which I am unable to understand. The nasal septum deviates towards the right associated with a large right sided bony spur which abuts the right middle turbinate. Pneumatization of the left middle turbinate (concha bullosa) noted. In simple terms what does this mean? What is the likely recommended action for this? Are these comments and findings consistent with the symptoms I have experienced?

Dr. Sumit Srivastava

General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

It means there is obstruction to your sinus drainage because of a deviated nasal septum with spur and concha bullosa, leading to recurrent sinusitis.

Due to retained secretions in the paranasal sinuses there is infection and headache.

Nasal septum deviation to the right means that the central bone of your nose is not straight and is bent towards the right side.

A surgical procedure called septoplasty is done to correct the deviated nasal septum. It is an intranasal operative procedure may be performed under local or general anesthesia.

Turbinates are bony structures that project from the side of the nose that function to humidify and warm the air.

Concha bullosa is presence of an air cell inside the turbinate. The middle turbinates have an inner core of thin, single-layered bone covered with the normal nasal membranes.

Occasionally that bone can get pneumatized and results in a much bulkier structure. This will lead to blockage of breathing passages as well as obstruction of sinus drainage path leading to sinusitis.

A prolonged course of intranasal steroid sprays with short course of oral steroids along with nasal decongestants is usually tried before planning for surgery.

Persistent of symptoms post medical treatment is an indication for endoscopic surgery.


The Probable causes:

1. DNS (deviated nasal septum).
2. Concha bullosa.

Probable diagnosis:

Sinusitis.

Treatment plan:

1. Septoplasty
2. Endoscopic surgery.

Regarding follow up:

For further information consult an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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