Septum Deviation in Istanbul, Turkey

A deviated septum is a condition in which the nasal septum is not centered. It is usually congenital, but sometimes nasal injuries can also lead to septal curvature. A deviated septum can cause breathing difficulties, constant nasal congestion, and headaches. Such symptoms can significantly reduce one’s quality of life. Therefore, individuals with a deviated septum often opt for surgery. During the operation, the septum is corrected and the airways are returned to normal. This procedure improves the person’s quality of life and minimizes health problems.

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What Is the Definition of Septal Deviation?

Septal deviation refers to an improperly aligned nasal septum. This condition is characterized by the nasal cartilage and bone that divide the nasal cavity being off-center. In most individuals, the deviation is very mild, but in some cases, it becomes more noticeable. Severe deviations can make breathing difficult and result in persistent nasal congestion. In addition;

Breathing difficulties,
Frequent headaches,
Discomfort and restlessness during sleep.

Individuals experiencing these issues often feel considerable discomfort in their daily lives. While a large portion of the general population has some degree of septal deviation, not everyone is affected to the same extent. The severity of the deviation and the intensity of related symptoms vary from person to person.

What Are the Symptoms of Septal Deviation?

Septal deviation is marked by the curvature of the nasal septum, leading to various symptoms. First, individuals may notice a significant change in the shape of their nose. Additionally, the anatomical change in the airways may cause difficulty in breathing through one or both nostrils. These breathing difficulties can manifest in various ways during the day and at night:

Noisy breathing
Snoring
Sleep apnea

Another common respiratory-related symptom is nasal congestion. A deviated septum may also cause constant irritation of the nasal mucosa, triggering nosebleeds. Chronic sinusitis is one of the most frequent complications of septal deviation, causing inflammation of the sinuses. These symptoms can substantially impact the quality of life for individuals with septal deviation.

Detecting a Deviated Septum: Self-Checks

There are various methods a person can use to identify a deviated septum. As a first step, you can tilt your head back and observe your nostrils in front of a mirror. If the nostrils are not of equal size, it may indicate a deviated septum. This can also be documented by taking a photograph.

You can test airflow by closing one nostril with a finger.
Pay attention to how easily or difficult it is to breathe in and out.
Then repeat the same process for the other nostril.

If you find it difficult to breathe through either nostril, this could be a sign of septal deviation. Although these self-tests can help you identify a potential deviated septum, a definitive diagnosis should be made by a healthcare professional. These steps can be used as an initial assessment for those who suspect they may have a deviated septum.

What Causes a Deviated Nasal Septum?

A deviated septum, or nasal septum curvature, can arise from several factors. It often begins with congenital causes; difficult childbirth or genetic connective tissue disorders can result in a septum that is crooked from birth. Septal deviation can also occur due to nasal injuries in childhood or adulthood. Examples of such injuries include:

Contact sports,
Car accidents,
Falls,
Fights and physical altercations.

Additionally, septal deviation can occur as part of normal developmental processes. As a person grows, the structure of the nose also grows, and during this process, the septum may bend to one side. This is one of the most common causes of septal deviation and often becomes more evident during or after adolescence. It can happen naturally without any injury.

Which Health Issues Can a Deviated Nasal Septum Cause?

Mild septal deviations rarely cause serious problems. However, a significantly deviated septum can trigger various complications that directly affect breathing and sleep quality. A deviated septum can restrict proper airflow in the nasal passages, especially noticeable during sleep. Health issues that may arise from a crooked septum include:

Chronic sinus problems; persistent blockages and infections.
Sleep apnea; characterized by partial or complete obstruction of the airway.
Snoring or loud breathing during sleep; caused by narrowed airways.
Frequent nasal congestion; making it difficult to breathe.
Frequent nosebleeds; constant pressure and dryness weaken blood vessels.
Dry mouth; increased mouth breathing due to nasal blockage leads to xerostomia.

These complications can diminish the quality of life for individuals with a deviated septum and may require ongoing medical care.

How Is Nasal Septum Deviation Diagnosed?

Healthcare providers diagnose nasal septum deviation through a comprehensive examination. Initially, the doctor uses a handheld nasal speculum to gently open the nostrils, allowing a better view of the inside of the nose. This way, the physician can assess the position of the septum and the width of the nasal passages. The doctor also asks specific questions to understand the patient’s general health status, such as:

What symptoms are being experienced?
How long have these symptoms persisted?
Is there difficulty in breathing?
Have there been changes in sleep patterns?
Is there snoring during sleep?
Have there been previous sinus problems or nasal congestion?

How Do Healthcare Professionals Treat Septal Deviation?

The treatment of septal deviation depends on the severity of the symptoms. In most people, the condition does not produce notable complaints, so treatment is not always necessary. However, medications can be used to manage certain symptoms. If the symptoms are mild, they can often be controlled with various medications, including:

Nasal decongestants: These are particularly useful for short-term relief. However, using them for more than three consecutive days can lead to rebound congestion.
Nasal steroid sprays: Provide long-term relief.
Antihistamines: Help reduce allergy-related symptoms.

If the symptoms are more severe and disrupt daily life, surgery may be required. The most common surgical procedure is septoplasty. In this procedure, the septum is straightened, thereby improving breathing capacity. Septoplasty is usually performed on an outpatient basis and generally takes between 30 and 90 minutes.

What Is Septoplasty and When Is It Performed?

Septoplasty is a frequently utilized procedure in the field of ear, nose, and throat surgery. It is performed to correct airway blockages caused by a crooked or deviated nasal septum. The goal of septoplasty is to restore normal airflow through the nose. Since a deviated septum can make breathing difficult, septoplasty is highly important. Various surgical techniques may be employed:

Endonasal procedures
Endoscopic procedures
Open procedures

Septoplasty can be carried out on its own or in combination with other nasal surgeries. Such combined procedures may include:

Rhinoplasty
Turbinoplasty
Functional endoscopic sinus surgery

When Is Septoplasty Necessary?

Septoplasty is a surgical intervention designed to address complications resulting from a crooked nasal septum. The main goal of this operation is to improve breathing function. A deviated septum can narrow the airways, reducing airflow and causing nasal congestion, especially noticeable during physical activity.

Common reasons for undergoing septoplasty include:

Chronic nasal congestion: Blocked nasal passages make breathing difficult.
Obstructive sleep apnea: Occurs when breathing stops intermittently during sleep.
Sinus infections: A deviated septum can impede sinus drainage, leading to infections.
Facial and headache pain: Pressure on nerve endings by the deviated septum may cause pain.

Additionally, septoplasty may sometimes be combined with other surgical approaches to manage more complex issues. The patient’s suitability for surgery is determined using various evaluation methods. One commonly used tool is the Nasal Obstruction Symptom Evaluation (NOSE) scale, which assesses how much the condition affects daily life. Patients with a low NOSE score may experience limited benefit from surgery.

Before surgery, other contributing factors to nasal obstruction are examined. These may include:

Chronic rhinitis
Allergies
Drug use
Autoimmune diseases
Malignancies
Prolonged use of decongestants.

If such conditions exist, appropriate medical treatments are offered first, either as an alternative to or in preparation for surgery. Before deciding on surgery, treatment options that can improve the patient’s quality of life are considered. Septoplasty is recommended only when necessary and when medical treatments are insufficient to provide relief.

When Is Septoplasty Not Feasible?

Septoplasty is a surgical procedure to correct a deviated nasal septum. However, certain conditions may prevent or contraindicate this operation. Firstly, there are specific contraindications for septoplasty:

Having active sinusitis or vasculitis,
Lack of sufficient conservative treatment attempts.

Even when conservative treatments have failed, some patients may still be unsuitable for surgery. Intranasal drug use, such as cocaine, poses a significant risk prior to septoplasty. Cocaine can damage the nasal mucosa, complicating the healing process and increasing the risk of complications like septal perforation. Patients are generally advised to abstain from such substances for at least six months before surgery.

Although smoking is harmful to overall health, its direct impact on septoplasty outcomes is not definitively established. Nonetheless, smokers may face a more challenging recovery. Additionally, the following situations may render septoplasty inappropriate:

Patients with rhinitis medicamentosa,
Chronic use of vasoconstrictive nasal sprays.

Unrealistic aesthetic expectations can also serve as a contraindication for septoplasty. Particularly in patients considering concurrent rhinoplasty, comprehensive preoperative evaluation is crucial. Unrealistic expectations may lead to low satisfaction after surgery, reducing the overall benefit of the operation.

The patient’s other medical conditions, functional status, and age are also taken into account. Patients with a high ASA classification or those of advanced age may not be good candidates for general anesthesia. These factors affect their ability to tolerate and recover from surgery. Therefore, each patient must be evaluated on an individual basis.

Possible Complications After Septoplasty

Septoplasty is a surgical intervention that corrects nasal septum deviation. Several complications may occur after this procedure:

The most common complication is excessive bleeding. Although mild bleeding is usually normal, severe bleeding may require nasal packing, and in rare cases, cauterization may be needed.
Septal hematomas: These occur when blood collects beneath the mucoperichondrium. They typically require drainage or aspiration. Without timely management, the risk of infection, septal perforation, and saddle nose deformity increases.
Perforations: These can develop during surgery, often due to bilateral mucosal tears. A perforation can cause a saddle nose deformity, potentially requiring revision surgery.

Other potential complications include:

Infections, which are rare and can generally be treated with oral antibiotics.
A prolonged healing process, observed in some patients. Most individuals recover within a few weeks.
Hyposmia, especially in patients undergoing concurrent turbinoplasty. This typically resolves within six months.
Intranasal adhesions, which can be minimized by using silastic splints.
Numbness or sensitivity in the upper teeth or lip, usually due to manipulation of the nasopalatine nerve. This typically resolves within a few months.

The most frequently reported long-term complaint is insufficient improvement in nasal breathing. This may be associated with recurrent trauma, weight gain, gradual cartilage migration, and surgical technique errors. Patients should be informed of these risks before the procedure. Proper management of postoperative complications is vital for preserving patient health and enhancing quality of life.

Frequently Asked Questions

How much does a septal deviation surgery cost?

Click here for information on rhinoplasty prices.

Is surgery for nasal cartilage deviation difficult?

Surgery for nasal cartilage deviation is no longer as complicated or painful as it once was. Instead of long gauze packing, self-dissolving sutures are now used. This method provides a more comfortable and faster recovery process for patients. The procedure typically takes about 45 minutes. Thanks to these advancements, surgery for nasal cartilage deviation is significantly easier compared to previous years.

Does nasal congestion improve after deviation surgery?

Nasal congestion generally improves after deviation surgery. In the early postoperative period, there may be temporary swelling, which usually subsides within approximately 10 days. As a result, nasal congestion tends to diminish during this time. Following your doctor’s recommendations can further enhance recovery. However, the extent of improvement varies from person to person.

Can a deviated septum heal without surgery?

In most cases, a deviated septum cannot be corrected without surgery. Nasal sprays, antihistamines, and decongestants only help alleviate symptoms; they do not physically straighten the septum. Hence, the breathing problems caused by the deviation usually persist. If the deviated septum is severe and significantly impairs breathing, a surgical procedure known as septoplasty is often recommended.

What does “nasal septum deviated to the right or left” mean?

This indicates that the nasal septum is off-center, tilted either to the right or to the left, meaning the cartilage and bone in the nose are not perfectly straight.

Is nasal septum deviation surgery considered cosmetic?

Nasal septum deviation surgery, known as septoplasty, is primarily not an aesthetic operation. However, aesthetic adjustments can be made during the procedure to alter the shape of the nose. Thus, septoplasty can offer functional correction as well as cosmetic improvements. If performed solely to improve breathing, it is not considered a cosmetic procedure.

Is a crooked nasal bone dangerous?

A crooked nasal bone is typically not a serious health concern. However, in some cases, it can make breathing difficult and reduce one’s quality of life. If complications such as sleep apnea or severe sinusitis occur, treatment may be required. Also, persistent headaches and chronic nasal congestion can negatively affect daily functions.