In order to restore the physiology of the nasal cavity, surgical intervention is often used, the result of which is the correction of the nasal septum. Otorhinolaryngologists refer many of their patients first for an X-ray examination and then for surgery. The problem of curvature of the nasal septum is very common, but not as trivial as many think. People who let such a situation run its course are more likely than others to suffer from sinusitis, sinusitis, resulting in a lack of oxygen and impaired metabolic process in the body.
Causes of curvature
There are only 3 main reasons for this problem - genetic, compensatory or traumatic. Most of the time, doctors are faced with genetic causes of the curvature of the nasal septum - an abnormal structure of the nasal cavity can develop due to a person's improper intrauterine development.
This manifests itself in the displacement or deformation of bone or cartilaginous tissue in this area, in the appearance of ridges in the form of a crest, in the fusion of certain types of tissue and so on.
Traumatic causes are also common in our time, which by their nature can occur in many athletes, military personnel and other categories of people who professionally (or otherwise) have a chance of nasal fracture.
Mechanical actions damage the nose (it is not even necessary to break it in this case), the nasal septum is displaced, reducing the internal cavity on one side. This situation is most dangerous in adolescence, when the bone and cartilage tissue is actively growing. Under the compensatory causes of the nasal septum curvature, specialists understand the growth process of adenoids, the occurrence of polyps in the nose, frequent swelling in rhinitis, as well as the establishment of nose piercings or dumbbells.
What is the operation for?
If rhinoplasty is purely aesthetic and cosmetic in nature and affects only the external factor, then the operation to correct the nasal septum has a long list of medical prescriptions.
This surgical intervention can correct the shape of the nose, but first of all, it is necessary to restore the health of the organ, not its beauty.
If such an operation is not performed in time, serious health complications can occur, including:
- violation of the correction of nasal breathing, which is expressed in the fact that it is difficult for a person to inhale air through the nose;
- disturbance of air dynamics in the nasal cavity; impairment of the protective functions of the mucous membrane;
- the occurrence of a lack of oxygen in the body; sneezing, spasms in the larynx and other reflex disorders;
- frequent migraines;
- the occurrence of somatic cough.
Indications and contraindications for surgery
The operation to correct the curvature of the nasal septum is performed after a comprehensive examination of the patient. To start such an examination, the doctor must analyze the oral complaints that he can hear from the patient.
For example, you can think about such a diagnosis in case of frequent rhinitis or sinusitis, blockage of the function of one of the patient's nostrils, changes in the shape of the nose, occurrence of nosebleeds, frequent allergic reactions and night snoring. With two or more similar complaints, fluoroscopy is prescribed, with the help of which the diagnosis is confirmed or refuted. The X-ray image will visualize the nature of the deformity, as well as its type and shape.
Upon receiving this information, the specialist can determine which operation should be performed in this specific case. Sometimes, the diagnosis is made by rhinoscopy without the use of radiographs.
The main indications for surgical intervention to correct the nasal septum are pronounced deformities, internal cysts, aneurysms in this area or even the patient's complaint of marked worsening of well-being. In addition, an indication for surgery will be impaired metabolism, which arose due to lack of oxygen, often resisted sinusitis, rhinitis, difficulty in nasal breathing and the transition to breathing through the mouth.
All symptoms and diseases of the upper respiratory tract, in the case of a curvature of the nasal septum, are closely related to each other.
The difficulty in breathing is caused by the narrowing of the nasal space, which also increases the likelihood of bacteria entering the nasal passages. For this reason, people who suffer from sinusitis, rhinitis and other diseases in this area, more often than others, suffer from severe sinusitis, which turns into a chronic phase. All of the above diseases cause painful sensations in the head and upper part of the face. These symptoms are the reason for an immediate consultation with a doctor.
With resections of the pituitary tumor, it is also possible to perform operations to restore the nasal septum. This is made possible through transeptal transfenoidal access. A surgical intervention of this nature is also performed in cosmetic rhinoplasty, as in this case there is a need for donor cartilage, the source of which may be the nasal septum.
There are not many contraindications for such a surgical intervention. Such an operation cannot be performed on pregnant women, lactating women with type 1 or 2 diabetes mellitus, with cancer, in old age.
It is also impossible to perform an intervention with very large perforation of the septum, with cocaine dependence, Wegener's granulomatosis, malignant lymphomas and proliferation of T and B cells. In this case, you can consult a doctor about the correction of the nasal septum with laser.
Varieties of surgical interventions
If a severe curvature of the nasal septum is detected, surgery is recommended as soon as possible. This will determine the patient's general well-being and health status in the future. In this case, the operation can be performed in two ways - by resection of the submucosa or by endoscopic septoplasty.
The classic technique for correcting the nasal septum is resection of the submucosa. In this case, the surgeon makes a small arcuate incision in the front of the septal cartilage, dissects the mucous membrane and then the curved cartilage. Then, the cartilage is separated from the perichondrium with a special tool, the parts that need correction are removed, while the upper level of the cartilage is not affected.
The bone septum is removed with special instruments, the upper layer of the mucous membrane, periosteum and perichondrium are fixed and fixed with cotton swabs. During this operation, no stitches will be applied on the face due to the rapid regenerative capacity of the operated tissues.
A deformed nasal septum can be healed in a more gentle way - with the help of endoscopic septoplasty.
This modern technique, using an intranasal endoscope, diagnoses the deformed areas, their nature and helps to remove anything that is unnecessary through microincisions in the mucosa. In conjunction with the endoscope, this technique involves the use of microsurgical instruments, in addition to a computer monitor, which shows the entire course of the operation.
In modern medicine, they prefer to use the second method of surgery, although both are highly effective. Endoscopy helps to prevent further trauma, complications and promotes early restoration of all nasal functions.
As complications and side effects of any type of intervention, hemorrhages can occur inside the nasal mucosa, with bleeding, abscesses, abscesses, purulent sinusitis and deformations.
During the short postoperative period, it is necessary to use clumps for support and recovery, in addition to a gauze fixative dressing in the nasal region. The patient can breathe only through the mouth, until the fourth or fifth day, when the nasal breathing manages to recover.
During the entire postoperative period, the specialist accompanies the patient, removing blood scabs, rinsing the nose. Often, doctors prescribe painkillers to patients, as the nose can hurt. If there is a risk of wound infection, antibiotics are administered. After the patient is discharged from the hospital, he will need to be monitored weekly by an otolaryngologist to monitor the progress of wound healing and restore nose health. At the same time, until the doctor's special order, you cannot do physical activity and eat pepper.
In addition to two surgical techniques for nasal septum restoration, there is also a laser technique for non-surgical intervention. In laser septoplasty, when the mucosa is cut, the vessels are glued, with no need for suturing after treatment. After this therapy, there is no need for hospitalization, the operation itself is performed on an outpatient basis under local anesthesia. One hour after laser correction, the patient can leave the hospital walls.