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A deviated septum is an irregular arrangement of the cartilage that separates the two sides of the nasal cavity. The septum is the wall that divides the nasal cavities. It is made of cartilage and divides the nose into two separate cavities.
Having a deviated septum may cause problems such as nasal discharges or breathing difficulties. Many people may have a mildly deviated septum without being aware of it. The more deviated the septum is, the more serious the problem will be. There are many reasons a person can have a deviated septum. It may be a birth defect or caused by an injury, or the result of previous medical treatments.
There is a reconstructive plastic surgery procedure that can correct a deviated septum. This is known as septoplasty. This procedure can also be performed to correct other medical problems such as cleft defects, which also affect the nose and nasal cavities.
The septoplasty operation consists of peeling away the mucus membranes from the cartilage and bone. No incisions are made through the nose, as the operation is performed through the nostrils. Once the septum is exposed, parts of it can be removed or pushed back towards the middle. The linings are then stitched back to cover the septum.
There is usually little pain or bleeding involved in the correction of a deviated septum. Anesthesia will be given by injection either into the nose or into the mouth. The surgery is performed in an operating theatre and should last approximately 45 minutes. Most people are able to leave the hospital one to two hours after surgery.
After the deviated septum has been corrected, there may be a slight swelling to the nose. There should be no blackening around the eyes. There should also be no pain, but if there is, medicine can be taken. A bandage will be placed under the nose to catch any mucus or blood. This can be removed 12 to 24 hours after the operation.
There is a chance of short-term side effects after an operation to correct a deviated septum. These are rare, but can include a dull headache, swelling and bruising around the eyes. Your face may feel puffy, and small burst blood vessels may appear as red spots on the skin's surface. Healing is always a gradual process, and in some cases it can take up to a year before the results of the surgery are fully apparent.
The most common symptom of a deviated septum is nasal congestion, with one side of the nose being more congested than the other, along with difficulty breathing. Recurrent or repeated sinus infections can also be a sign of a deviated septum. Other symptoms include frequent:
nosebleeds
facial pain
headache
postnasal drip
loud breathing and snoring during sleep
A deviated septum may also cause sleep apnea, a serious condition in which a person stops breathing during sleep.
During septoplasty, a surgeon, working through the inside of the nose, makes a small incision in the septum and then removes the excess bone or cartilage required to even out the breathing space of the nostrils.
Sometimes a rhinoplasty, or "nose job," is combined with septoplasty to improve the appearance of the nose. This procedure is called septorhinoplasty. Septoplasty may also be combined with sinus surgery.
Surgery to repair a deviated septum is usually performed in an outpatient setting under local or general anesthesia and takes about one to one and a half hours, depending on the amount of work being done. You should be able to go home three to four hours after surgery.
Internal splints or soft packing material may be put in the nose to stabilize the septum as it heals. If a septoplasty is the only procedure performed, there should be little to no swelling or bruising after surgery. However, if a septorhinoplasty is performed, a week or two of swelling and bruising is normal following the procedure.
If possible, it is best to wait until after the nose has stopped growing, around age 15, to have surgery.
No surgery is completely risk-free and the benefits from undergoing surgery -- in this case, being able to breathe better -- must outweigh the risks. Septoplasty and septorhinoplasty are common and safe procedures and the chance of having a dangerous side effect is rare. Still, talk with your doctor about the possible risks of surgery before you make a treatment decision.
Although rare, risks of septoplasty and/or rhinoplasty may include:
infection
bleeding
hole (perforation) of the septum
loss of the ability to smell
If you are having nasal symptoms and think you may have a deviated septum, make an appointment to see an ear, nose, and throat doctor, or ENT. There are a number of reasons why you may be experiencing these symptoms, including chronic sinusitis or nasal allergies. Make sure you get the right diagnosis so that you can get the treatment you need.