I am the nasal septum, and many of you may not recognize me. Simply put, I am the wall between the two nostrils that is basically vertical and flat. If we compare the bridge of the nose to the ridge, I am the load-bearing wall under the ridge, and the bottom of the nasal cavity is the ground. From the roof to the ground vertically cut down, the cut surface like the word “individual”, I am the “I” below the word “individual” “person I am the “I” under the word “person”. I am the inner wall of the nasal cavity. The lateral walls are the upper, middle and lower turbinates arranged in a tile-like pattern, which are also important structures of the nasal cavity. My composition: three layers, the middle is a flat plate of cartilage and bone, and the sides are covered with mucosa, the pink-colored “meat” that you see when you open your nostrils and look in the mirror. The average thickness of cartilage and bone is 1mm-2mm, and the part near the nostrils is the anterior part, which is mainly square cartilage, that is, cartilage with a roughly square shape. The posterior part is mainly the vertical plate of the sieve bone, a true hard bone, which is connected to a bone plate called the sieve plate at the base of the skull. Inferiorly and posteriorly there are also bony plates called maxillary nasal crest and plastron. Under the mucosa there is a network of tiny arterioles and veins that are responsible for nourishing me.
I have a great role to play. Besides dividing the nasal cavity in two, I have other important functions. I support the bridge of the nose. The nose is the most important organ of the human face, not only is it the main channel for the body to breathe air from the outside world, but it also determines the beauty of a person’s appearance. If I grow crooked, or injured bent deformation, the nasal cavity is blocked by me and become narrow, which will directly affect the ventilation function of the nasal cavity. As the saying goes, people live a breath of air, trees live a skin. If the nasal cavity is not well ventilated, people can not breathe fresh air smoothly, can not replenish the oxygen in the body’s blood, the brain, heart and lung function will be affected. At this time, some people always feel that the nose is not ventilated, holding air, uncomfortable; some people feel that there is not enough air when running; some people do not sleep well at night, snoring, the next day after waking up dry mouth (because of open mouth breathing), sleepy during the day, dizziness, no energy, and even chest tightness, shortness of breath. Sometimes, I grow crooked or bent deformation not only affects the ventilation, but also affects the appearance. Because of my crooked and bent, the bridge of my nose is also crooked and bent or collapsed, which is not good to look at. Our ancient words and phrases describing beautiful nose are nose like hanging guts, nose like jade onion, nose straight mouth square, straight nose like a peak. The nose is so beautiful all because I am square and straight with the right height.
Another role of my nose is the first line of defense of the human body. My mucous membrane, together with the turbinate mucosa, warms, humidifies, de-bacterizes, and filters impurities from the air inhaled into the nasal cavity. After our treatment, the air that reaches the human throat is warm, moist and clean. Having said that, you may think I am bragging, you are not just a flat plate in the middle of the two nostrils? How can it be so powerful? My mucosal epithelium is composed of columnar ciliated cells and glandular cells. The glandular cells secrete mucus, which is evenly distributed on the surface of the nasal mucosa, forming a mucus blanket. Each ciliated cell has about 200-300 cilia on its head, and the cilia are immersed in the mucus, just like reeds in the lake water. The cilia keep swinging back and forth, pushing the mucus blanket toward the posterior part of the nasal cavity – the nasopharynx. Impurities, foreign bodies, viruses and bacteria that enter the nasal cavity fall on the mucus blanket and are sent to the nasopharynx, where they are finally spit out with phlegm or swallowed into the stomach and digested by stomach acid. There are also immunoglobulins and lysozyme in the mucus, which play a bactericidal and antibacterial role. The rich blood vessels of the nasal mucosa warm the air and the mucus humidifies it. I, the nasal septum, as part of the body’s first line of defense does not deserve the name ah?
Speaking of which, some people have to ask, what if the nasal septum grows crooked or gets injured and becomes crooked? To tell you a secret, many people’s septum is curved, but does not affect the ventilation, no discomfort, and does not affect the appearance, if not told by the rhinologist during the medical examination, he did not know it! In this case, even if the septum is bent or crooked, there is no need to treat it. Only those cases of nasal septum curvature (called deviated nasal septum in terminology) that affect ventilation or even appearance need to be dealt with and need to be surgically corrected by a rhinologist in order to improve ventilation and appearance. The surgical methods are divided into traditional surgery and minimally invasive surgery. Traditional surgery includes: 1. submucosal resection of the nasal septum, which involves peeling away the mucosa covering both sides of the nasal septal cartilage and bone, exposing the deviated part of the cartilage and bone, removing them, and preserving the L-shaped stent with a width of 10 mm at the anterior and superior edges. This method is relatively more traumatic, and only the mucosa on both sides of the postoperative me is left. If the deviation is serious during the operation and the peeling is not smooth where there is a tear, the septum is prone to perforation. 2. Submucosal correction of the nasal septum, the operation method is the same as the previous one, but the cartilage and bone removed are put back between the two layers of mucosa after trimming, so that the me is stronger and the probability of perforation is smaller. Another complication of the traditional procedure is the saddle nose deformity, commonly known as collapsed nose. If the nasal septum is severely deviated, too much cartilage is removed to completely correct the deviation, resulting in its weakened support of the tip and bridge of the nose and the formation of a collapsed nasal bridge. A minimally invasive procedure is the endonasal endoscopic subtraction septoplasty. This procedure is set based on the cause of septal deviation. There are external and internal causes of septal deviation. The external cause is that the bone frame around the square cartilage of the septum is deviated and small, making the square cartilage deviate to one side of the nasal cavity or bend in S rows to both sides during development to accommodate this bone frame. This factor accounts for most of the cases. The internal factor is the distortion of the nasal septum itself, or the local formation of a ridge or spine. During surgery, only one side of the mucosa is separated, all cartilage and bone are exposed, and the square cartilage is loosened from the surrounding bone frame from their natural joints, spread, and the excess cartilage strip at the lower edge is removed so that it can be adjusted to the middle vertical position naturally and smoothly. The posterior septal vertical plate, plow bone and the inferior maxillary nasal crest were fractured and adjusted to the midline position, excess bone was removed and docked with the square cartilage so that the mucosa-cartilage and bone-mucosa sandwich type structure of the nasal septum remained unchanged. In addition, the square cartilage is not separated from the mucosa on the other side and will not move its position, further ensuring its support for the dorsum and tip of the nose. This results in less chance of nasal bridge collapse and septal perforation. For localized distortion of the septum itself, the problem can be solved by making a reduction incision in the distorted area. For localized spines, local separation and removal of the spines is sufficient. If the deviation of the septum affects the shape of the nose, this method can improve both ventilation and shape. The removed cartilage strips and bone strips can be used during the operation as materials to raise the nasal minors (at the front of the septum, between the two nostrils, in relation to the height of the nasal tip) to make the nasal tip taller. In conclusion, endonasal endoscopic reduction rhinoplasty – septoplasty, has the following advantages: it is minimally invasive, saves time, uses autologous tissue, saves money, and has the least probability of complications. Either procedure can be performed under local or general anesthesia, each with its own advantages and disadvantages. Local anesthesia saves surgical time and costs and avoids the risks of general anesthesia. However, the patient will experience some pain during the operation, which is usually tolerable, and people who are timid and afraid of pain cannot insist on cooperating with the surgery. The disadvantage is that it increases the time of general anesthesia and the recovery time after surgery, which increases the cost of anesthesia, and if the trachea is intubated, it increases the risk of intubation. The surgery can be done on an outpatient basis and go home the same day it is done. However, most patients are hospitalized for surgery for about 5-7 days due to reasons such as health insurance reimbursement rates are smaller for outpatient than inpatient.
Although I am in the middle of the nasal cavity, I am also prone to injury. Hard impacts on the nose can cause me to fracture and deform. Improper nasal medication and frequent digging of my nostrils with my fingers can cause my mucous membrane to erode or even perforate. My mucous membrane breaks and I can bleed nasally. Therefore, I need your good protection.
Please remember me, my name is nasal septum, which is an important structure in the human body!