The curvature of the septum of the nose is its displacement away from the midline of this organ. Its ideal form is very rare. Therefore, the condition in question in many cases does not constitute a pathology. However, this does not exclude the presence of the latter in certain situations. Therefore, you need to know the symptoms, causes and treatment of this ailment.
The concept of the nasal septum
This is a natural formation located in the middle of the nasal cavity and dividing it into two equal parts. In turn, it also includes 2 lobes, one of which is located in the front, and the other in the back. The front is cartilage, the elasticity and suppleness of which is easily determined by palpation. It is she who is most often damaged due to various injuries.
Nasal structure
The main departments of this body include the following:
- nostrils - inlet openings designed to ensure the passage of oxygen into the nasal cavity;
- initial section - this is where the vertically located nasal septum is located;
- nasal passages - are located further than the initial section, are divided into lower, middle and upper, limited to similar nasal concha;
- choanas are two openings that provide communication between the nasopharynx and the nasal cavity.
The nasal cavity also includes several walls:
- a septum formed in the front of the cartilage, and in the back by the opener;
- side walls, formed mainly by the ethmoid bone;
- lower - is formed due to the hard palate located in the area of the upper jaw and soft palate;
- anteroposterior wall - is formed due to the process in the above region and the nasal bones.
Inside, the nasal surface is lined with mucous membrane, due to which a secret is secreted. It also provides significant blood supply. The olfactory is the upper part of the nasal passage. Nerve receptors are located here.
The nasal concha are located in the back of the corresponding cavity, which divide it into the nasal passages. The lower of them is an independent small bone, and the middle and upper are processes that extend from the ethmoid bone.
The nasal passages communicate with the sinuses and maxillary sinuses located in the departments.
Many small sinus cavities have an ethmoid bone. The sphenoid bone is located at the base of the skull and is almost not visible from the outside. In her body is an air cavity in the form of a sphenoid sinus.
Nose function
These include:
- the perception of various aromas using the olfactory cavity;
- the retention of nasal mucus of various pathogenic microorganisms with their subsequent removal or destruction due to the bactericidal properties inherent in it;
- protection against mechanical irritants due to mucus and hairs, ensuring their retention and subsequent withdrawal;
- heating of the air flow due to the venous plexus located under the mucosa;
- moisturizing the air entering the nasal cavity due to the secretion of glands located in the mucosa;
- air to the larynx and nasopharynx.
Determining the correct distribution of air flow for the two halves of the cavity is provided by the nasal septum. Curvature is a potential cause of impaired performance of these functions.
The ideal condition of the nasal septum is observed in newborns. Here, almost the entire membrane has the appearance of cartilage, which is subsequently partially converted into bones, which are fused with each other. Due to various disorders in these processes, a curvature of the nasal septum is observed. It is rather difficult to identify the initial causes of this phenomenon.
Basically, the curvature occurs at the age of 13-18 years. In men, this deformation occurs 3 times more often than women.
ICD nasal septum curvature
The International Classification of Diseases (ICD) is a normative document created to take into account the incidence of diseases, the reasons for citizens to go to health facilities and the causes of death. He is one. Currently, the classification is valid in revision 10 of the revision. This year it is planned to launch the ICD-11.
The curvature of the nasal septum in the ICD-10 has the code J34.2. It is indicated on the disability sheets.
Causes of nasal septum deformity
The main one is injuries of this organ. The curvature of the nasal septum in a child is mainly formed during the period of cutting the molars, which causes the expansion of the jaws and a change in the nasal cavity.
Sometimes deformation is caused by an overdeveloped primordium of the Jacobson organ, which is located below the front of the nasal septum.
Their combination, causing curvature, can be combined into three groups:
- traumatic - there is nosebleed and respiratory failure through this organ, as a rule, it is preceded by a nose fracture;
- compensatory - occurs due to prolonged irritation of the nasal septum due to thickening of the nasal concha, polyp, ingestion of a foreign body, etc .;
- physiological - mainly found in children and adolescents, due to the mismatch of bone and cartilage tissue of the septum.
Classification
The main types of curvatures considered are the following:
- Crest.
- Spike.
- Direct curvature.
- The combination of the first two options, called mixed.
The third type has the following varieties:
- deformation with the capture of a certain section of the septum, coulter or vertical plate of the ethmoid bone;
- curvature located in front or in the back of the partition;
- single or double-sided deformation;
- curvature in the horizontal or vertical plane.
Basically, anterior curvature is diagnosed. The ridges and spikes are mainly located on one of the edges of the coulter. Their base is bone tissue.
Symptoms
They appear in most people, without bringing them any discomfort. The following are those that concern patients:
- a change in the shape of the nose due to injuries;
- seizures of epilepsy can contribute to the occurrence of severe forms of curvature of the nasal septum;
- sore, sore, and dry throat;
- cough;
- violation of distraction, thinking and memory due to a lack of oxygen in the blood, which can lead to problems with the functioning of the brain and central nervous system;
- signs corresponding to inflammation in the middle ear;
- infectious diseases;
- as a result of curvature, low resistance to physical exertion, increased fatigue, decreased performance can be developed;
- dry nasal cavity;
- allergic rhinitis, which is a pre-asthma - nasal congestion appears due to contact with a certain substance;
- snore;
- rhinitis, as a result of which there are constant mucous discharge;
- difficulty in nasal breathing is the main sign of curvature, but it may be absent.
Curvature of the nasal septum in children can be congenital or acquired. Snoring, bleeding, rhinitis, and mouth breathing in them may indicate adenoids.
Associated Violations
What are the consequences of the curvature of the nasal septum (treatment will be discussed later)? With difficulties in nasal breathing, the following changes occur:
- the attachment of the nasal wing to the septum - occurs due to the curvature of its front part, which leads to a significant difficulty in the passage of oxygen;
- the development of a reaction from nerve endings in the mucosa - with curvature, air vortices form, which irritates the receptors, as a result of which the vessels of the mucosa expand, mucus appears in large quantities, swelling develops;
- narrowing of the territory of the nasal passage, respiratory failure in the side where concavity formed;
- change in air circulation inside the nasal cavity - during normal breathing, the air rises, then it passes through the middle nasal passage and partially along the upper, when exhaling it goes to the lower of them, but when the curvature is disturbed, the air flow is disturbed, which leads to breathing
- change in air circulation in the area in which the septum is convex - until the nostrils are completely blocked on this side.
Changes in the mucosa during curvature occur as follows:
- the vortex flow begins to hit the mucosa, which leads to its thickening in these places and to the loss of cilia by epithelial cells, which causes a decrease in protective functions;
- when excreted, the mucus dries with the formation of crusts;
- rhinitis appears.
A sufficient supply of oxygen to the lungs and blood depends on the processes of nasal breathing. As a result of curvature, gas exchange in the alveoli is disrupted, which leads to oxygen starvation.
In case of violation of the breathing through the nose, a person is forced to carry out this function through the mouth. This process is characterized by the following negative consequences:
- an adenoid develops, accompanied by inflammation of the pharyngeal tonsils;
- for this method, the protective functions of the nasal cavity are not characteristic, which leads to an increased risk of respiratory diseases;
- the air does not warm up and is not humidified, which does not provide the proper gas exchange efficiency in the alveoli, the blood is not sufficiently saturated with oxygen, which negatively affects the whole body.
Due to the curvature of the nasal septum, nerve disorders may appear:
- visual;
- affecting the work of internal organs;
- dysmenorrhea in women;
- seizures in epileptics;
- bronchial asthma;
- laryngeal cramps;
- reflex sneezing and coughing;
- headache.
In addition, the defects in question cause changes in neighboring organs:
- eyes - with pathological deformation, the nasolacrimal canal can act as a source of infection;
- nose - an inflammatory disease develops called sinusitis, sinusitis and frontal sinusitis also develop;
- ears - disturbances in the Eustachian tube and middle ear are noted.
In chronic inflammations, mucus and infectious agents not removed from the nasal cavity may be in the eardrum or auditory tube.
Diagnostics
The treatment of curvature of the septum of the nose should be preceded by a procedure for diagnosing this pathology. First of all, an external examination is required, in which a displacement of the tip or scoliosis of the nose is detected.
The main research method is rhinoscopy, during which asymmetry is detected during the comparison of nasal cavities. In case of violations, on the one hand the nasal concha are clearly visible, and on the other, they may not be visible at all.
To clarify the features of the configuration of the side walls, according to the results of which they decide on the need for nose surgery with a curved nasal septum, lubricate the shell and septum with 5% cocaine solution and adrenaline.
X-ray examination is uninformative. But it may be needed to determine the condition and location of the sinuses.
Nasal septum curvature treatment
Most conservative treatments bring very short relief. Therefore, the main method of treatment is the operation when the septum of the nose is bent. The main method of its implementation is endoscopic septoplasty.
The impact is carried out through the nostril with dissection of the mucosa and its separation from the septum under consideration, after which plastic is performed with suturing. The operation takes about half an hour. It can be performed under local or general anesthesia.
According to reviews, surgery with a curved septum of the nose is better tolerated in general anesthesia. Finally, splints and gauze swabs are inserted into the nasal cavity, which are removed the next day. After their removal, the patient is prescribed saline in the form of drops in the nose or lubrication with oil solutions of vitamins, which contributes to faster healing of the mucosa. Bloody crusts from the nose can be released within a month, swelling subsides after about two weeks, which will help restore nasal breathing.
Thus, staying in the hospital after surgery is one day. After surgery, the curvature of the nasal septum is eliminated. Within a week after this, a medical office is visited to perform dressings that accelerate healing and act as a means of preventing the formation of adhesions.
Laser is currently used to treat nasal septum curvature. The advantages of this method are as follows:
- rehabilitation measures are minimized;
- laser antiseptic effect;
- minimum level of injuries;
- smallest blood loss.
But it also has a disadvantage - with its help it is possible to eliminate not all types of deformations, especially those associated with damage to the bony part of the septum.
Treatment without nasal septum curvature surgery involves the use of laser chondrosentoplasty. In this case, the cartilage warms up, which makes it elastic. With the help of a special tool, cartilage is given the necessary shape, which is fixed for one day with a swab. After this, the septum occupies a position in the center, and the cartilage straightens.
Transaction price
In public hospitals, it is performed free of charge with a medical policy. But you have to wait your turn. In private clinics, the cost of an operation when the nasal septum is curved starts at 35,000 rubles. It is determined by the level of the institution, the complexity of the intervention, the type of anesthesia, the qualifications of the staff, the length of the patient’s stay in its walls.
Laser septoplasty has a minimum price: when the nasal septum is curved, 30,000 rubles. In Moscow clinics, its average cost reaches 54,000 rubles.
Complications after surgery
The consequences of curving the septum of the nose as a result of the operation may be as follows:
- perforation or perforation of the septum;
- the appearance of scars;
- hematoma;
- purulent sinusitis;
- the formation of an abscess under the mucosa;
- inflammation and infection of the wound that formed during the operation;
- adhesion formation;
- deformation of the nose - there is a sinking of his back due to a resection carried out too high;
- bleeding.
To eliminate them, the following measures must be applied:
- hematoma puncture with a pressure bandage;
- taking antibiotics for infection;
- dissection of adhesions with a scalpel;
- hemostatic agents for bleeding.
The likelihood of their occurrence can be significantly reduced if you follow the instructions of the doctor for care in the postoperative period and observe the necessary regimen.
Finally
Curvature of the nasal septum is observed in most people. Most of them do not cause any discomfort. In case of difficulty breathing through the nose, you need to contact the ENT specialist, who can prescribe an operation or the use of laser therapy. It lasts a short time, and its outcome is favorable. Usually the partition is completely leveled.
The operation can be carried out in public and private clinics, which is determined by the funds available to the client. It can be performed under general or local anesthesia. For most reviews, the first option is preferable.