Many patients with a deviated septum struggle with the question, “Do I need surgery or not? In fact, about 90% of people have different degrees of deviation of the septum, some of them may be born with it, and some of them may be due to trauma. Deviation of the septum is an abnormality in the morphology and structure of the bone and cartilage, so it can only be corrected surgically because there is no treatment effect with medicine. However, it is not necessary to have surgery whenever a deviated septum is found, but to clarify whether the patient’s symptoms such as nasal congestion, headache and nasal bleeding are caused by the deviated septum or not.
Nasal congestion related to deviated septum: With a deviated septum, the nasal passage on the protruding side will be narrow and the passage on the other side will be too wide. This will result in asymmetry of airflow between the two sides of the nasal cavity and double the work of the turbinate mucosa on the wide side of the nose, which will lead to chronic rhinitis in the long run. Changes in the structure of the nasal septum may also affect the drainage of the sinuses (the mucous membrane of the sinuses has many hair-like cilia, and these cilia can efficiently flow the secretions of the sinus mucosa through the sinus openings into the nasal cavity), thus causing sinusitis. The nasal mucosa is constantly congested and the inferior turbinates are enlarged.
Nasal congestion is often obvious on the narrow side first, and later on the wider side due to secondary chronic rhinitis, sinusitis, and turbinate hypertrophy. Long-term nasal congestion may also trigger snoring, sleep difficulties, mental depression, lack of concentration and memory loss, all of which are symptoms that we often refer to as chronic hypoxic state.
Headache related to nasal septal deviation: You may say, as long as there is nasal congestion and chronic hypoxia, won’t there be dizziness and headache and other symptoms? I know all this. But the headache caused by deviated septum is not so simple. The deviation of the septum may compress and stimulate the turbinates of the lateral wall of the nasal cavity, causing congestion, edema, inflammation and other reactions of the turbinates, stimulating the nerve endings under the mucosa and causing reflex headache. Especially when the septal deviation is located higher, it may compress the middle turbinate and block the sinus opening, then the headache symptoms are the same as sinusitis, often heavier on one side, and sometimes accompanied by loss of smell.
Nasal bleeding associated with deviated septum: Because of the rich distribution of blood vessels at the front of the septum, the deformation and bending of the septum often results in vascular deformation, and the surface tension of the mucous membrane becomes greater, which can easily rupture and bleed after dry weather or nose digging. Generally, the septum of C-shaped deviation is more uniform in shape and the symptoms are not yet serious. If the nasal septum has a crest or spine, forming a sharp deformity, it will be prone to repeated bleeding.
CT examination can clarify the relationship between deviated septum and nasal symptoms You may ask again, how can I be sure that my nasal symptoms are related to deviated septum? The CT scan can show the position of the septum in relation to the surrounding structures and help the doctor to analyze: 1. whether the nasal symptoms are related to this change in position; 2. the relationship between the patient’s deviated septum and sinusitis; 3. the site and extent of the need for surgical correction; 4. the factors that may affect the operation of nasal endoscopy; 5. the impact of surgery on the ventilation and drainage of the nasal sinuses 5. the possibility of surgery affecting nasal sinus ventilation and drainage, and leading to postoperative nasal adhesions.
You can compare these criteria to get a general idea of whether you need surgery. For the surgery can achieve what effect, after surgery is not the same as normal people.