Nasal septum deviation

An MRI image showing a congenitally deviated nasal septum

Nasal septum deviation is a common physical disorder of the nose, involving a displacement of the nasal septum.

Causes

It is most frequently caused by impact trauma, such as by a blow to the face.^[1] It can also be a congenital disorder, caused by compression of the nose during childbirth.^[1] Deviated septum is present in about 11% of patients with Marfan syndrome.^[2]

Presentation

The nasal septum is the bone and cartilage in the nose that separates the nasal cavity into the two nostrils. The cartilage is called the quadrangular cartilage and the bones comprising the septum include the maxillary crest, vomer and the perpendicular plate of the ethmoid. Normally, the septum lies centrally, and thus the nasal passages are symmetrical.^[3] A deviated septum is an abnormal condition in which the top of the cartilaginous ridge leans to the left or the right, causing obstruction of the affected nasal passage. The condition can result in poor drainage of the sinuses. Patients can also complain of difficulty breathing easily, headaches, bloody noses, or of sleeping disorders such as snoring or sleep apnea.^[3]

It is common for nasal septa to depart from the exact centerline; the septum is only considered deviated if the shift is substantial or is adversely affecting the patient.^[1] Many people with a deviation are unaware they have it until some pain is produced. But by itself a deviated septum can go undetected for years and thus be without any need for correction. ^[1]

If the deviation merely entails a mild deflection from the midline in one direction or the other, it should not be considered a medical issue. Some people are concerned about diminished airflow through the effectively smaller nostril resulting from deviation; however, whatever airflow diminishment occurs in one nostril is recaptured by augmentation of airflow in the other (now larger) nostril.

Treatment

In most cases a deviated septum can be corrected with a minor surgical procedure known as a septoplasty, in which the surgeon enters through the nostrils and cuts away the obtruding matter.^[3] The surgery is performed quickly but the patient may take one to three weeks to fully recover.

See also

• Nasal septum perforation

References

External links

• Detailed description with pictures