Xiao Wang is a science graduate student, in the past 3 years, always feel the left side of the nasal cavity is not ventilated, sometimes also have a left side of the headache. Once the weather is dry in autumn, the left nose often produces nosebleeds. He visited the hospital several times, and the doctor told him that he had a deviated nasal septum, so he was hospitalized for surgery. But he was nearing his master’s degree and had no time to deal with it. Yesterday, he accidentally bumped his nose and a few dozen milliliters of blood came out, and he was worried whether malignant changes had occurred.
I asked them carefully about the onset of the disease and conducted a physical examination. I found that both of them had deviated nasal septum from the midline to the left, and the left nasal cavity was narrower than the opposite side; Xiao Wang also had a localized sharp protrusion of nasal septum, with surface mucous membrane erosion and blood crust. Although Xiao Li had a deviated nasal septum, he did not have any discomfort.
I said to them: “Any deviation of the nasal septum from the midline to one or two sides or the local formation of protrusions, causing nasal dysfunction or symptoms, are called nasal septal deviation. In reality, there are very few people with a completely straight nasal septum, so if there is no dysfunction, it may not be diagnosed and treated. Xiao Li is in this situation and does not need to be treated. Xiao Wang has symptoms such as nasal congestion, headache and nosebleeds caused by deviated septum, and it is more appropriate to do surgery at this time.”
Xiao Wang asked, “Why do I have a deviated septum?”
“The nasal septum is like a wall separating the left and right nasal cavities, and its common causes are: 1. Trauma: Trauma is an important cause of this disease, often in childhood, and the history of trauma is often long forgotten after adulthood. At that time, because the various components of the nasal septum were not fully developed, it did not show symptoms, and later, with the growth of age, it gradually developed into nasal septal deviation.
2.Developmental abnormality: It is composed of nasal septal cartilage, vertical plate of sieve bone, nasal crest of frontal bone, nasal crest of maxilla and several pieces of cartilage of plough bone. During development, for various reasons, the bone and cartilage develop unevenly and form deformities or deviations, or form talipes or cristae at the joints between each bone of the septum or bone and cartilage. Adenoid hypertrophy, open mouth breathing since childhood, and high arch of hard palate have restricted development of nasal septum, and deviation of nasal septum may also occur.
3, compression factors: tumor or foreign body compression in the nasal cavity can cause the nasal septum to deviate to one side.”
I pointed to the anatomical diagram of the nasal cavity and continued to explain, “The main symptoms of nasal septal deviation are: 1. Nasal congestion: alternating or persistent. Simple “C”-shaped deviation or clipping causes ipsilateral nasal congestion or alternating nasal congestion. With compensatory hypertrophy of the contralateral turbinate and “S” type deviation, it may cause bilateral nasal congestion.
2.Headache: partial compression of the turbinate by the deviation may cause ipsilateral reflex headache.
3, nasal bleeding: the convex surface of the deviation or the mucosa at the crest and talus becomes thin, and is often stimulated by airflow or dust, so dry erosion often occurs, resulting in nasal bleeding.”
Wang also asked, “I’ve had a deviated septum for 3 years, and the doctor told me to be hospitalized for surgery, but I don’t have time. Can you do the surgery after a few months?”
“Deviated septum surgery is an elective surgery, not necessarily done immediately. This type of surgery is a small to medium-sized operation, especially performed under the nasal endoscope, with no incision in the external nose, which is safe, less invasive and more effective. Only 3-5 days of hospitalization are required. But you have many times nasal bleeding, a great impact on learning, it is better to operate early better.”
Wang also asked, “Some people say that if you move your index fingers up and down on both sides of your nose with both hands, you will be fine in a week or so. Can I correct the deviated septum by pressing and rubbing? If I don’t need surgery for now, how should I take care of my nose in my daily life?”
I replied, “The method of pressing and rubbing can improve nasal ventilation and is effective for acute and chronic rhinitis. But it is not possible to correct the deviated septum. If you do not have surgery for the time being, you should pay special attention not to dig your nose in daily life and use some nasal lubricants (such as ephedra oil and peppermint oil nasal drops) every day, and take some vitamins and anti-allergy drugs appropriately under the guidance of your doctor. This can reduce the inflammation and erosion and bleeding of the nasal mucosa.” I prescribed some more medicine for Xiao Wang.
“Thanks! I understand.” Xiao Wang went back to school and arranged his homework. He came to the hospital in a few days to have his septum deviation corrected and never had headaches and nosebleeds again.