If the nasal septum bends to one or both sides, or if the nasal septum protrudes partially on one or both sides, causing physiological dysfunction of the nasal cavity and sinuses and producing symptoms (such as nasal congestion, nasal bleeding, headache, etc.), it is called nasal septal deviation. It is more common in people with a history of nasal trauma, adenoid hypertrophy in childhood, family history, nasal polyps and tumors. If there is no nasal dysfunction, nasal septal deviation is called “physiological nasal septal deviation”.
Etiology: 1. Nasal trauma mostly occurs in childhood, and the history of trauma is mostly forgotten.
2.Developmental abnormalities are one of the main causes of this disease.
3.Some slow-growing nasal cavity or sinus tumors, when growing relatively large, squeeze the nasal septum resulting in deviation and deformation.
4.Heredity.
Clinical manifestations: 1, nasal congestion: the most common symptom of nasal septal deviation, mostly persistent nasal congestion. The nasal mucosa is continuously congested and compensatory hypertrophy of the inferior turbinate occurs, also known as structural rhinitis. If the nasal congestion is serious, the sense of smell may also be reduced.
2.Headache: If the deviation site presses the inferior turbinate or middle turbinate, it can cause ipsilateral reflex headache.
3.Rhinorrhea: The site of rhinorrhea is mostly found at the convex side of the deviation or at the spine or crest.
4, adjacent organ involvement symptoms: such as high nasal septal deviation to prevent sinus drainage, can induce purulent sinusitis or fungal infection. If it affects the ventilation and drainage of the eustachian tube, it can cause tinnitus and ear closure. Long-term nasal congestion and open-mouth breathing can easily lead to colds and upper respiratory tract infections, and serious snoring can occur during sleep.
Generally, nasal septal deviation can be diagnosed by anterior rhinoscopy. It can be seen that the septum is curved to one side and the nasal cavity on both sides is not equal in size. The septum convexity can be seen as congestion and erosion in the littoral area, and compensatory hypertrophy of the contralateral inferior turbinate. Further clarification can be made by additional auxiliary examinations: nasal endoscopy and CT scan of the sinuses.
Disease risk: Mild nasal septal deviation usually has nasal congestion as the main clinical manifestation, but also accompanied by nasal bleeding and reflex headache, which has a certain degree of impact on the quality of life and can induce sinusitis. Chronic obstruction of the upper airway due to prolonged nasal congestion can also cause chronic hypoxia, which can lead to growth disorders in infants and adolescents. Nasal septal deviation can also cause sleep apnea and hypoventilation syndrome in adults.
Surgical correction is the only treatment method. Surgery should be performed in the following cases: 1. long-term persistent nasal congestion caused by deviated nasal septum; 2. high deviation of nasal septum affecting sinus drainage; 3. recurrent nasal bleeding caused by deviated nasal septum; 4. reflex headache caused by deviated nasal septum; 5. vasomotor rhinitis (structural rhinitis) with obvious deviation of nasal septum.