Deviated Nasal Septum (DNS) is a common medical problem and affects children and adults alike.
The septum, a partition separating two chambers, is the midline structure in your nose that divides the nose into the left and right nostrils. DNS can be defined as the sideways displacement of this septum between your nostrils (the two external openings of your nose that allow you to breathe and smell). The nasal septum is either off-center or deviated, making your nasal passages smaller.
A deviated nasal septum is a serious condition. It can block one side of your nose and make it difficult for you to breathe. Nasal congestion or a stuffy nose can result from a deviated septum that can hamper your routine activities. A deviated nasal septum is usually treated with medications or if it is too serious, then surgery might be required.
Causes of DNS
A deviated septum can be caused by:
1. Congenital reasons. Congenital means a condition present at birth. A child may be born with a deviated septum. This could be due to pressure on the malleable (something that can be easily pressed) septum of the fetus (developing baby) while in the mother's womb, or sometimes may be related to birth trauma. Birth trauma is distress experienced by a mother during labour and childbirth.
2. Injury to the nose. If you have experienced frequent minor accidents of the nose as a child, then it could cause your nasal septum to deviate. This may also happen on account of sports injuries in adulthood. Sometimes, road and other house accidents can cause your septum to become crooked.
3. Other reasons. A long-standing tumour/ polyp/ concha bullosa or other swellings inside your nose can cause the septum to deviate to the other side.
Nasal tumours are abnormal growths (cancerous or non-cancerous) that begin in and around your nasal passage.
Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. Sinuses are air-filled sacs (4 in number) present in your facial bones.
Concha bullosa happens when one of the conchae inside your nose is filled with a pocket of air. Conchae are structures made of bone inside of your nose.
Symptoms of a Deviated Nasal Septum
Nasal blockage or a feeling of congestion. Nasal congestion, commonly known as a ‘stuffy nose’, is the uncomfortable, stuffed-up feeling you experience due to excess mucus build-up which can cause difficulty in breathing. Mucus is a normal, slippery, and stringy fluid in the nose, produced by your sinuses.
Sinus infection. Inflammation or swelling of the sinus is called sinusitis (sinus infection). Your sinuses are responsible for draining the mucus into your nose and allowing air into the cavities. A deviated nasal septum can cause your sinuses to have trouble draining properly, resulting in sinus infections.
Increase in snoring. Snoring is the harsh or hoarse sound from the nose or mouth that occurs when your breathing is obstructed while sleeping. A deviated septum can be one of the reasons for your snoring.
Increased nasal bleeds. A nosebleed or nasal bleeding is bleeding from tissues inside your nose caused by a ruptured blood vessel. Nosebleeds are a result of extremely dry conditions. The surface of your nasal septum may become dry due to deviation, increasing your risk of nosebleeds.
Facial pain. If you have a severely deviated septum, you are likely to experience one-sided facial pain due to increased pressure.
Risk Factors of a Deviated Nasal Septum
If you play contact sports such as football, rugby, water polo, or kabaddi, then you are at a higher risk of having a deviated nasal septum due to injuries. Another factor that can increase your risk of septum deviation is not wearing your seatbelt while riding in a car or on a motorbike.
Diagnosis of Deviated Septum
Your doctor will first examine your nostrils with a nasal speculum (a medical tool used by your ENT physician to examine the inside part of the nose). Your doctor will check the size of your nostrils and see if the septum’s placement is impacting it. Your doctor will also collect your medical history regarding sleep, snoring, sinus problems, and difficulty breathing.
Treatment of Deviated Nasal Septum
In most cases, treatment is not necessary. Even if treatment is done, it is mainly symptomatic. Common treatments include:
Decongestants are medicines used to relieve a blocked nose.
Antihistamines are medicines used to stop allergy symptoms such as coughing, blocked nose, fever, etc.
Nasal sprays are medicines delivered locally into your nasal cavities to relieve a blocked nose.
For a septum that is deviated enough to cause nasal obstruction, surgery is the only option. One should understand that no medicine can straighten out a bent bone or cartilage. The surgery is fairly simple and patients can hope to return to active work within 3-5 days of the surgery.
Surgery today is usually performed with an endoscope. An endoscope is a medical device with a light attached. It is used to look inside a body cavity or an organ. The results of endoscopy are usually long-lasting.
If you are having difficulty in breathing or other symptoms pertaining to a DNS, consult your ENT specialist immediately.
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