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Deviated septum in a child. deviated septum surgery

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A person who fights endlessly with rhinitis, suffers from colds or flu several times a year, suffers from insomnia and loss of smell, may not realize that the problem is not only in the immune system and nervous system. Deviated septum is a diagnosis that is rarely made, but is present in the majority, although urgent correction is required mainly in severe forms: a spike, a ridge. Is treatment possible without surgery and why is this problem dangerous?

What is a deviated septum

The central even thin plate that divides the air flow into equal parts, due to which it is processed and delivered harmoniously - this nasal septum made up of cartilage and bone tissue. If the air begins to pass unevenly, the doctor may say that there is a displacement of the nasal septum (its cartilaginous sections), or its deformation in the form of a spike or ridge in the bone area. Curvature occurs in 95% of people, but with varying degrees of severity, so you may not know about it until the end of your life.

Symptoms

A deviated nasal septum can make itself felt both externally and through internal changes in the body. If there is a deformation of the cartilaginous tissues close to the front, or at the top of the bridge of the nose (bone section), it will be visible due to the loss of symmetry of the nose. The internal curvature is mainly expressed in:

frequent nosebleeds, provoked by thinning of the mucous membranes in the narrowed nostril;
difficulties with nasal breathing (feeling that air is not coming in at all);
snoring if a person sleeps on their back;
frequent overwork (due to hypoxia due to difficulty in nasal breathing);
a decrease in immunity, which entails acute respiratory infections, influenza, and other diseases that are difficult to tolerate;
chronic diseases of the ENT organs (mostly doctors focus on the appearance of chronic rhinitis in patients with a deviated septum).

Why is a deviated septum dangerous?

If timely and complete air purification does not occur, sufficient oxygen does not enter the blood and brain, immunity and brain activity gradually decrease, and blood vessels suffer. Following the curvature of the septum entails inflammation of the mucosa and chronic hypoxia, which can give rise to constant headaches, and can cause male impotence.

Symptoms of the disease gradually develop into chronic disorders, and the result is:

polyps of the nasal cavity;
problems with olfactory function;
hearing impairment;
occurrence of allergic rhinitis.

Types of curvature

There are 2 classifications of deformation of the nasal septum - according to the prerequisites for its appearance and according to the type that the plate takes. Curvature of the anterior opener is predominantly observed, and even if there is a defect in the posterior opener, its edge remains even. The most commonly used classification of septal curvature by doctors is as follows:

Thorn- the appearance of a process of bone tissue, can be unilateral or bilateral. Depending on the length and direction, it can provoke irritation of the mucous membrane of the opposite wall, injure it.
Crest- local thickening of the nasal septum at the site of the bend, associated with its deformation, can also injure the membrane of the nasal cavity, going into it.
Classical curvature of the nasal plate- C-shaped deformation, in which a slight deflection appears mainly in the central part. Such minor curvatures are very common, but not always a person knows about their existence, since they may not manifest themselves in any way.
Combination of all 3 types- the most difficult variant of the curvature, since it is already guilty not only of breathing difficulties, but often of its complete absence (if the deformity is bilateral, there is a displacement of the anterior and middle sections).

Causes of deviated septum

Doctors subdivide the entire list of prerequisites for deformity of the nasal septum into 3 categories:

traumatic. Due to blows to the facial zone of the skull, this cause is mainly found in males. Even with minor injuries, the curvature of the nose is not excluded if the fusion of broken bones and cartilage tissue did not occur correctly.
Compensatory. They are the result of pathologies of the nasal cavities, including polyps, tumors, and even permanent rhinitis, due to which a person, imperceptibly, due to the obstruction of one of the nasal passages, learns to breathe only free and thereby provokes a curvature of the septum. Separately, compensatory hypertrophy is distinguished, in which one of the turbinates, due to its increased size, presses on the septum and can displace it. In compensatory curvature, cause and effect often change: even a doctor cannot always tell what happened first - plate deformation or breathing problems due to an increase in bone formations that divide the nasal cavity into zones.
Physiological. Associated with the congenital features of the structure of the skull - mainly the uneven development of its bones. In rare cases, there is such a physiological curvature of the septum as the development of a rudiment behind the zone of smell, pressing on the nasal dividing plate. This deviation is rare.

The child has

The nasal septum in children under 10 years of age is predominantly a cartilaginous plate: more flexible than bone, and more vulnerable. Doctors mention cartilage fractures in children more often than in adults, and this often causes septal deformity. If time does not attach importance to the violation of proper breathing after an injury, the plate will stiffen over time (when the child gets older), and the curvature will no longer be as easy to straighten as in childhood.

However, there are several more prerequisites for this problem in babies:

birth trauma;
uneven growth of the bones of the skull (minor curvature, eliminated independently);
cartilage inflammation.

Diagnostics

An attempt to confirm or refute the diagnosis of "septal curvature" begins with an examination of the patient by an otolaryngologist, who first evaluates appearance the front of the nose. With serious deformations of the nasal septum, they will be visible already at this stage. After the breath of each nostril is checked separately, the results are correlated: if there is no curvature of the nasal septum, the force of inhalation and exhalation is the same for the left and right parts. The last one is the smell test.

If suspicions that the nasal septum is curved are getting stronger, the doctor may prescribe:

Rhinoscopy- consists in examining the nasal cavity (left and right) using a special tool that expands the nostrils. Next, a thin probe is inserted into the lumen to probe the mucosa, evaluate neoplasms (if any): these are polyps, tumors, abscesses. Additionally, hypertrophy of the posterior ends of the turbinates can be detected when examining the curvature through the oral cavity.
endoscopy– a more informative examination, which should be carried out with local anesthesia nasal mucosa. The assessment of her condition is carried out through a probe with a "video camera". Thanks to the endoscopic method, the lower shell is clearly visible, where mucus accumulates.
skull x-ray- a picture is needed to tell if there are formations in paranasal sinuses nose, confirm or refute the presence of traumatic deformity, congenital bone anomalies of the skull, which could provoke a curvature.
Computed tomography- helps to examine in detail the back of the nasal cavity, to determine the presence or absence of spikes and ridges on the septum.

Treatment

A crooked nasal septum is an anatomical problem, so it is impossible to align the plate medically. If, during its deformities, respiratory and hearing disorders are noted, a disorder of smell develops, the middle shell is additionally enlarged, or hypertrophy of the lower one is observed, we will definitely talk about surgical interventions, mainly traditional ones - septoplasty or endoscopic surgery. In rare cases, a deviated septum can be corrected with a laser.

Treatment without surgery

Conservative therapy can be aimed at eliminating the chronic inflammatory process, polyps, adenoids (a consequence of the curvature of the septum), helping to alleviate the condition in allergic diseases, restoring breathing and strengthening the immune system. However, correction of the curved septum is impossible, so the effectiveness of such treatment by doctors is questioned. Mostly experts can advise:

removal of adenoids, polyps;
osteopathy (manual therapy);
a long course of drugs to eliminate puffiness.

Operation

The doctor may recommend surgical correction of the curvature in case of serious abnormalities in the development of the cranial bones, which provoke a large number of complications: among them are hypertrophy of the conchas, persistent sinusitis, and the inability to breathe in a narrowed nostril. Surgical intervention is performed only in persons over 16 years of age (exceptions are possible). Resection of the nasal concha can be performed with an endoscope, which is less painful. In case of severe injuries, rhinoplasty is performed simultaneously with the classical surgical intervention.

Laser chondroseptoplasty

Classical septoplasty is performed only in case of severe forms of curvature, and for minor deformities, the doctor may suggest laser treatment. This method is used only if it is necessary to align the cartilage tissue - the laser will not perform resection of the spines and correct the bending of the bone tissue, nor will it help with traumatic curvature. According to reviews, the procedure is painless, but it is not recommended for children and the elderly.

Rehabilitation after surgery

If it was necessary to perform a surgical correction of a deviated nasal plate, after it, tampons are inserted into the patient's nostrils, and silicone retainers are required. The next day they are removed, if there is no heavy bleeding, the patient returns home, but he may stay in the hospital for 4 days. However, completely normal breathing is restored only 3 weeks after the septum is straightened. During rehabilitation you need:

during the first week, clean the nasal passages daily at the ENT doctor to remove crusts, prevent the appearance pathogenic microorganisms;
do breathing exercises, which will not allow spikes to form;
use wound healing agents for external use (they must be prescribed by a doctor).

Possible complications after surgery

Doing septoplasty, according to doctors, is relatively safe (even from an aesthetic point of view - photos of people who have undergone it prove that there are no scars): blood loss is minimal, traumatization too. However, any operation is accompanied by risk, therefore, after septoplasty, they can:

abscesses, hematomas form;
appear prolonged nosebleeds in the rehabilitation period;
observed fusion of cavities, narrowing of the lower course;
develop purulent sinusitis, perichondritis.

Treatment at home

If the nasal septum is not so curved that the doctor insists on an operation (resection of the ridges, removal of spikes, correction of the consequences of a fracture is not required), but causes problems, you can do procedures on your own that make breathing easier, expel mucus, but this will only relieve symptoms. Home therapy may include:

Corticosteroids.
Silver preparations.
Antiseptics.
Compositions for washing the nasal passages (combating a common symptom of a crooked septum - rhinitis).

Prevention

You can protect yourself from deformation of the central nose plate only if it is initially even, or the curvature is slight. For this it is recommended:

avoid activities that are accompanied by fractures of the skull bones (traumatic sports, etc.);
prevent ENT diseases from developing to polyps and adenoids;
strengthen immunity.

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Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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What is dangerous deviated septum of the nose, causes, treatment and rehabilitation

The cartilage structure is made of flexible tissue covered with skin. A large number of vessels that feed this part are concentrated on it. In perfect condition, the septum is exactly in the middle of the nasal cavity.

According to statistics, today, almost eighty percent of people have a deviated nasal septum. In most cases, it shifts slightly from the center and does not bring discomfort. Most often, this pathology occurs in children. With a strong violation of the structure of the septum, it can provoke respiratory disorders and become the root cause of chronic rhinitis. Therefore, if you notice discrepancies, it is important to know the symptoms and treatment of a deviated septum in children.

Why is the nasal septum deviated?

The wrong structure of the nasal septum is most often diagnosed in adolescents and children. This pathology causes the formation of prolonged rhinitis, breathing problems, as well as copious secretions slimy look. In addition, with a curved septum, inflammatory problems arise, as well as a tendency to allergic reactions.

jaw expansion

Deviations in the structure of the septum occur at the beginning of the growth of the child.

Usually this process occurs at the age of six, when the patient's molars erupt.

In connection with the expansion of the jaw, the nasal cavity changes. This process becomes the main cause of the curvature of the nasal septum in children.

Congenital etiology

Among the most common causes, a congenital predisposition is manifested, when, being in the mother's stomach, the formation of the child's nose does not occur correctly. The same reason includes various injuries during birth.

Traumatization

The most common cause is considered traumatization of the nose. Violating the structure inside the nose can be a strong blow to one part of the cavity, as well as active games or a serious passion for various martial arts.

Other reasons

Other common causes include the following:

The nasal septum may change with a mismatch in the growth of the bones of the skull and a rapid increase in cartilage in the nasal cavity.
Due to the pressure inside the nasal cavity due to the penetration of a foreign object or the formation of a tumor or polyp, the septum is primarily affected.
With infectious inflammation, a thickening occurs in the nasal part, which leads to a modification of the cartilage.

During the anatomical change, the patient notices that one cavity becomes much wider than the other. This modification leads to many symptoms. If the curvature of the septum is not serious, then the process is not considered a serious pathology.

Symptoms

With the correct structure of the nasal cavity, air enters evenly and penetrates through both parts. When you inhale, oxygen is moistened, warmed and filtered, and then penetrates into the paranasal sinuses.

When the septum is deviated, the inhaled air leads to irritation of the mucous membrane, which leads to various processes in the paranasal sinuses and the Eustachian tube.

Among the main signs of a curvature of the septum is a loss of smell. With the slow development of the deviation, this dysfunction manifests itself slowly, so the patient does not always notice such a symptom immediately.

In addition, there is a violation of breathing and constant nasal congestion is manifested.

In some cases, a deviated septum causes prolonged rhinitis or acute sinusitis. As a result, the patient has pain in the head, stuffy ears, pain in the throat, bleeding.

Pathology in the structure of the nose always causes swelling in the mucous membrane and other inflammations associated with the functions of the respiratory organ. Often, a violation in the structure of the septum causes seasonal allergic rhinitis.

Other symptoms include:

blockage of the right or left nostril;
nasal congestion, but only from one cavity;
frequent and unexpected nosebleeds;
dryness of the mucous membrane;
pain in the front;
noisy breathing;
headache;
snore;
sleep on one side;
frequent viral or infectious inflammations;
swelling of tissues in the nasal cavity;
airflow obstruction.

However, on initial stage curvature the patient may not notice the symptoms. Therefore, with a curvature of the septum, the patient may not be aware of his pathology. People with a noticeable curve are at risk for acute sinusitis, frequent bleeding, and other problems. They can only be removed through surgery.

Treatment Methods

When wondering what to do if a child has a deviated septum, the first step is to undergo a diagnosis. You can determine the obvious symptoms without the help of a doctor, but to conduct a comprehensive examination, contact the ENT.

In some cases, a deviated septum can be treated with medication. Drops and nasal sprays will help eliminate tissue swelling and restore air permeability. To restore the functions of the nose completely, it is necessary to wash the nose, as well as taking decongestant medications.

It is worth noting that drug treatment can be justified and effective only in the case of a non-serious pathology. If the patient has a noticeable curvature, doctors prescribe surgery.

During the operation, the patient straightens the cartilage and bones in the nasal cavity. Such therapy is carried out under local anesthesia and only after taking certain medications.

Nasal septum plasty

To restore the septum, the patient may choose plastic surgery. In this case, the surgical effect is carried out through the patient's nostrils. The advantage of plastics is the absence of scars and adhesions on the outer part of the nose, as well as absolute painlessness.

The whole procedure takes about one hour. After the operation, nasal breathing is restored within eight weeks.

During the rehabilitation period, the patient must use antiseptics and antibacterial drugs, and also adhere to the medication course prescribed by the doctor.

During the recovery, the patient needs to visit a doctor twice a month. This is necessary to prevent the formation of adhesions and disruption of tissue fusion.

If the curvature manifested itself in the baby, you should wait for eighteen years. Until this age, the child continues to grow and the operation may disrupt the natural growth of the nose.

Septoplasty

In certain cases, the patient may opt for reconstructive plastic surgery. When choosing septoplasty, the incorrect structure of the nasal septum is corrected.

The procedure passes through the nostrils, but in extremely difficult moments, doctors can perform the operation with an open method.

When choosing septoplasty, it is necessary to be aware of the formation of scars, scars and adhesions. However, the main goal of the operation is the rapid restoration of breathing.

The rehabilitation period lasts up to seven days. After the operation, there is swelling of the face, bleeding, negative reactions to medications and pain in the nasal cavity. They usually pass on the fifth day.

In the first month after surgery, the patient has pain in the head, swelling, bleeding, often bursting vessels in the nasal cavity. Complete recovery occurs within two months.

Prevention

Unfortunately, there is no way to prevent a deviated septum. But you can protect yourself by avoiding any damage. To do this, when playing actively or participating in contact sports, wear a protective helmet and be extremely careful.

Directory of major ENT diseases and their treatment

All information on the site is for informational purposes only and does not claim to be absolutely accurate from a medical point of view. Treatment must be carried out by a qualified doctor. By self-medicating, you can harm yourself!

Deviated septum: types, causes, symptoms in children and adults

Deviated septum is a common and even more often underestimated pathology that affects the cartilage and bones of the face and can lead to a significant deterioration in the quality of life.

Experts recommend correcting the nasal septum at an early age in order to reduce the burden on the body and prevent the development of complications due to disruption of the respiratory system. The situation is complicated due to the fact that the deformity can be of a different nature, affect different passages of the nose and, accordingly, require individual approach to the patient from the otolaryngologist.

Why You Shouldn't Underestimate Nasal Septal Defects

The curvature of the nasal septum leads not only to a narrowing of the external airways on one or both sides, but also changes the direction of movement and creates additional turbulence in the air currents. Curvature causes the appearance of places with reduced pressure, which leads to periodic collapse of the lumen.

Due to the discomfort that comes with excessive cooling and pressure changes, sensitive nerve cells in the nose send signals to the brain and spinal cord. As a result, the brain centers affect the tone of the vessels of the nose, which can turn into a rhinitis-like condition, which is called vasomotor rhinitis. In this case, the displacement violates such important functions of the nasal cavity as:

Heating of passing air.
Increasing the humidity of air streams.
Sensation of smells.
Protection against mechanical irritants: dust, particles of burned fuel, pollen, etc.
Counteracting infectious agents.
Pressure regulation in the ear canal and middle ear chamber.

The crooked nasal septum brings changes in the blood circulation in the adjacent area, which can lead to malnutrition of the mucous membrane or due to the body's attempt to compensate for the pathological process - its hypertrophy. In the latter case, there is an increase in the nasal conch and a change in the shape of the ethmoid bone.

Therefore, in patients with a curved part of the septum, only to the right or to the left, respiratory failure can be observed on both sides. If the changes lead to mucosal degeneration, then the cilia of the nose degrade along with it, which are normally responsible for holding and facilitating the removal of mechanical particles entering the nostril lumen.

When the partition is curved, the air movement pattern is disrupted. Normally, when inhaling, it does not go along the shortest path, but first rises and then descends in an arc to the choana, mixing with the remnants of the heated masses. Exhalation follows a path close to a straight line - along the lower nasal passage.

Therefore, affecting at least one of the levels leads to a violation of the entire system. Along with the redirection of flows and a decrease in the quality of heating, the risk of developing infectious diseases in the nasopharynx increases: tonsillitis, rhinitis, frontal sinusitis, sinusitis and other unpleasant diseases that can give complications in the form of otitis media or meningitis.

In most cases, a young organism is able to compensate for respiratory disorders, however, with age and a gradual deterioration in the effectiveness of the immune, cardiovascular, nervous and respiratory systems, the pathology will increasingly remind of itself with discomfort.

An additional aggravating factor in the displacement may be a pathological reaction nervous system, gradually turning into neuroses. At risk are people who have deeply formed "combs" cut deeply into the nasal shells.

On the part of the autonomic nervous system and distant organs, this can result in spastic syndromes of the larynx, sleep disturbance, increased likelihood of developing bronchial asthma and epileptic foci. In addition to physiological disorders, a crooked nasal septum leads to purely aesthetic discomfort, as it violates the symmetry of the face and can make the nose visually wider.

Structural features

The septum is a plate of complex structure that divides the nasal cavity into 2 approximately identical parts. It has a bony structure at its base (vomer and vertical plate of the ethmoid bone) that continues anteriorly in the form of cartilage.

It is lined with a mucous membrane that contains blood vessels, mucus-secreting glands, and sensory nerve cells. Deviated septum in children can look like spikes and ridges. At the same time, minor deviations that are present in everyone and do not interfere with breathing are not perceived by otolaryngologists as a pathology.

Types of deformation

The structure can be deformed in several ways, acquiring:

C-curve.
S-like anterior-posterior or affecting only one department.
Shape change with comb upper jaw.

In case of improper fusion of bones and cartilage after traumatization, “ridges” that go deep into are often formed. Their typical direction is from front to back or from bottom to top, often obliquely. In the anterior sections of the plate, relief disturbances occur at the bottom of the nose. These structures may end in a spike that cuts into the wall of the pathways and cuts off breathing. At the same time, the mucous layer on the convex side is thinner and easily torn.

What is the disease associated with?

The causes of a deviated septum can be divided into 3 main areas:

Associated with the uneven increase in the facial and cerebral parts of the skeleton of the head (they consist of many elements that increase in size during maturation, acquire a denser structure, and some fuse into a single solid structure). In this case, individual elements can grow at different rates, which leads to bending of the cartilage.
Caused by uneven activity of growth points. Since the bone, like the skull, does not grow as a whole, then with an increase or slowdown in the growth rate at one of the points (for genetic and infectious reasons or due to a lack of calcium, phosphorus and vitamins in the diet), a significant curvature of the nose can occur.
In rare cases, the deformation begins due to the excessive growth of the Jacobson's organ (vomeronasal), which is not expressed in 75% of people (usually leads to deformation of the anterior-lower part of the plate).

Injury related These causes include fractures and displacements of the bones that support the cartilage or adjacent to them. Displacing bones in children under 12 years of age can even be a small blow or hit by a tightly stuck snowball, therefore, a curvature of the nasal septum in a male child is a more frequent occurrence (in the CIS, it occurs 3 times more often in boys). The most severe consequences are improper fusion of bones after an imperceptible fracture from the outside. Compensatory

Due to an excessive increase in 1 of the turbinates, which presses on the plate and causes it to shift.
In connection with chronic obstruction of one of the nostrils due to differences in pressure.
In response to the formation and expansion of nasal polyps, benign and malignant tumors.

Congenital curvature Meets less often than others and can sometimes be confused with acquired during childbirth.

Symptoms of pathology

An accurate diagnosis of a deviated septum can only be made by a qualified otolaryngologist after examining the nasopharynx, however, due to a violation of the breathing pattern and the main functions of the nose, it manifests itself in several forms:

Difficulties in breathing. The intensity of the symptom depends on the angle of curvature and the degree of occlusion of the upper, lower, or middle airway. Most noticeably, it is expressed with periodic collapse of one half of the nose. In young people, due to the good adaptability of the body, this manifestation can be expressed very weakly and not be noticed by the patient himself. However, with inflammation of the mucous membrane, drying of snot, injuries, acute respiratory viral infections and with serious physical exertion, it makes itself felt even in hardy patients.
Increasing the rate of drying of mucous secretions.
Increasing colds and sinusitis.
Decreased concentration due to constant irritation in the nose and reduced oxygen supply.
Swelling of the mucous membrane.
Noisy ragged breathing.
With a disorder affecting the lacrimal duct, there may be difficulty in draining fluid and an increase in the incidence of inflammation in the lacrimal sac.
Due to the deterioration in the supply of oxygen to the brain and skeletal muscles, performance deteriorates and accelerated fatigue appears.
Due to the location of parts of the cartilage or individual elements at an angle to each other, the external vessels are in a vulnerable position when itching, hitting or intense blowing along with the drying of the mucus. In this case, patients suffer from the occurrence of non-intensive, but frequent bleeding. If at the same time there is a tendency to sclerotization of the vessels, then the prognosis worsens significantly.
Due to the redirection of air flows and stimulation of mucosal receptors, sleepers often snore.

Features of manifestation in childhood

The curvature of the nasal septum in children is especially dangerous in the first years of life, because due to a decrease in air concentration in the blood, it can lead to a slowdown in brain growth and, accordingly, to a delay in mental development. During the period of upbringing kindergarten and at school, it will contribute to attention deficit disorder and learning delay due to constant visits to the therapist due to frequent colds.

At the same time, the probability of the transition of diseases to chronic form and manifestations of asthma in those prone to it from birth. In addition, it will be more difficult for a child to keep up with peers in physical education and labor classes, during choreographic preparation for holidays, during trips on excursions or after signing up for sports clubs. Therefore, it is recommended to correct the crooked nose in a timely manner.

Treatment options and their features

When diagnosing a deviated septum, the causes can play a significant role in choosing an effective tactic for treating the pathology. If polyps contributed to the shifts or a tumor led to them, then first of all it is important to determine their genesis, and then remove them surgically.

If at the same time the patient has an increase in temperature, it is recommended to first eliminate the prerequisites for the inflammatory process and kill the infectious agents in order to prevent their spread during surgery.

Its main goal should be to facilitate breathing, but in addition it is possible to improve the aesthetic side through plastic surgery.

The nasal septum, the curvature of which is complemented by inflammation of the paranasal sinuses, requires preliminary examination using X-ray equipment. In simple cases, it is usually enough for a doctor to conduct a rhinoscopy examination. In the presence of clinical symptoms in a conservative way treatment is surgery.

Septoplasty can correct the vertical plate and give it a vertically even shape. Indications for its implementation can be considered:

Frequent sinusitis.
Chronic inflammation of the mucous membranes.
Increasing incidence of SARS.
Frequent headaches.
Strong snoring.

Depending on the location of the bend, it can take place under local (if the damage is in the anterior part of the cartilage) or general anesthesia. It is prohibited or highly discouraged for:

Hemophilia and other disorders of blood coagulation systems.
Any type of diabetes.
Oncology.
Acute course of an infectious disease.
Multiple organ failure.

Standard septoplasty consists in arcuate cutting of the mucous membrane, access to the curved area of the 4-coal cartilage and its excision, and in case of violation of bone development, removal of its part. However, this approach is considered outdated and most clinics perform endoscopic procedures to reduce the degree of intervention.

In this case, not a chisel is used, but a special endoscope with instruments for microsurgery. After a day of observation in the hospital, the cured patient can go home and come to the hospital only for bandaging and control over the restoration of health.

If, due to the pathological process, chronic vasomotor rhinitis has developed and / or the vessels have grown excessively, then the choroid is additionally excised.

The child has a deviated septum

I have a curvature. The doctor said this: if there is no effect on breathing, then we will not correct it. But if it does, then problems of a secondary nature may appear, it is necessary to correct it. I managed. Be sure to consult, find out the cause of bad breath. Perhaps it's just dry air or an allergy, and if the cause is a curvature, then it needs to be corrected. Good luck!

where did you get it from?

I don’t know what to do directly. We already bought a humidifier, it seems better. But the opinion of Laura (they were already at 2) diverge.

The 1st prescribed washing + drops on silver (they prepare 16.00 UAH in the pharmacy)

2nd drink Job-baby + drip at night renizolin + buy at the health center drops on silver for 160 UAH

And don't know what to do

Tried the 1st option seems to be better

later moved to 2. but it got worse

What don't I know now?

And they told me, oddly enough, Yes, I do not insist on this option.

By the way, my nose starts to breathe noticeably better when I physically "turn" it. Therefore, I know that I have a slight deterioration in breathing, but not so much that it interferes with life. Salt solutions improve the situation a little.

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Deviated septum in children

Curvature of the nasal septum - its deviation to the right or left with a deformation of the shape.

Causes

The septum may suffer due to some kind of facial injury. Children, especially those of school age, are prone to random situations: the ball hit the face, a fight with a peer, a fall from a bicycle and other accidents can become the basis for this pathological phenomenon. Another reason may be anomalies in the process of growth of the nasal skeleton. If the bones grow unevenly for some reason, the septum may suffer.

Symptoms

A small patient may experience a feeling of nasal congestion. This condition may not go away for a long time or it may happen periodically. The nose can be blocked on one side or alternately.
Mucous secretion comes out of the nose.
Mucus from the nose flows into the larynx.
Ears are often blocked. When swallowing, it gives into the ears.
Feeling of dryness develops oral cavity.
Poor sleep, snoring.
Frequent migraine pains.
The baby is prone to frequent colds.
The nose is bleeding.

Diagnostics of the curvature of the nasal septum in a child

First of all, the doctor examines the child, clarifying with him and his parents the details of the course of the disease. The specialist needs to know exactly what symptoms are present in this case, whether there have been cases of injury, whether nasal congestion is present, whether the patient uses nasal drops.
After a general examination, the doctor performs a rhinoscopy. The study is carried out using a special mirror. The doctor during the examination specifies the degree of curvature, the condition of the nasal passages.
Endoscopic examination. Using a device called an endoscope, a specialist assesses the condition of the mucosa. Before such an examination, the doctor instills a vasoconstrictor medication into the patient's nose.
Rhinomanometric inspection - is a method of measuring the strength of the air flow in the nose. The technique is applicable not only for diagnosis, but also as an assessment of the result after therapy.

Complications

by the most dangerous complication this disease is the development of hypoxia. Oxygen through the nose cannot freely pass and circulate, as a result, oxygen starvation occurs, which negatively affects all body systems.
Along with the progression of the disease, a number of inflammatory processes develop. Ears, paranasal sinuses, sinusitis and other diseases may develop.
Each runny nose that begins turns into a serious inflammatory process and is characterized by a long and difficult course.
A deformed septum leads to severe rhinitis. A pathological process develops in the turbinates, the vessels lose their functions. This condition can turn into an allergic rhinitis or hypertrophic rhinitis, as a result of which the turbinates become excessively deep.
The general malaise that the child constantly experiences negatively affects his psychological state. The kid is forced to constantly blow his nose, often breathes through his mouth, regularly uses nasal drops. As a result social adaptation can be compromised, as can self-confidence. Neuroses and unstable mental states may occur.
The patient develops snoring during sleep. Prolonged snoring can lead to respiratory arrest and pathologies of the cardiac system. Usually such children feel lethargic and fatigued during the day. It is difficult for them to concentrate, they do not study well at school.
Since a small patient is forced to frequently breathe through his mouth, this can lead to frequent entry of viruses and infections resulting from airborne infection. Children suffer from constant inflammation of the tonsils, the development of laryngitis, tracheitis and problems of pathological processes in the lower respiratory tract.
The formation of facial bones can also undergo changes. As a result of the pathology, a pathological bite of varying degrees can develop.

Treatment

What can you do

Parents of a sick baby should not be delayed in seeking help. It is better to fix a septal defect as soon as possible so that the symptoms of the pathology do not lead to even bigger problems.

What does a doctor do

A small patient may be scheduled for spetoplasty. This manipulation is a surgical correction of the nasal septum in terms of indicators and observed symptoms.
Surgical intervention is performed under general anesthesia inside the nose, no incisions are made from the outside. The shape of the patient's nose after surgery will not change. No hematoma remains after the manipulation.
During the operation, the doctor removes the curved sections of the septum. If they can be straightened, the doctor does this with special tools, armed with an endoscope and a microscope.

Prevention

Parents need to remember how sometimes minor injuries can create big health problems. So you should protect the child from injury, teach the baby the basics of safety in outdoor games and sports. With bruises on the face of the baby, you need to urgently show the doctor. It is better to be safe than to miss the occurrence of pathology.

Arm yourself with knowledge and read a useful informative article about the disease deviated septum in children. After all, being parents means studying everything that will help maintain the degree of health in the family at the level of “36.6”.

Find out what can cause the disease, how to recognize it in a timely manner. Find information about what are the signs by which you can determine the malaise. And what tests will help to identify the disease and make the correct diagnosis.

In the article, you will read everything about the methods of treating such a disease as a curvature of the nasal septum in children. Specify what effective first aid should be. What to treat: choose medications Or folk methods?

You will also learn how untimely treatment of the disease can be dangerous deviated septum in children, and why it is so important to avoid the consequences. All about how to prevent the curvature of the nasal septum in children and prevent complications.

And caring parents will find on the pages of the service full information about the symptoms of the disease deviated septum in children. How do the signs of the disease in children at 1.2 and 3 years old differ from the manifestations of the disease in children at 4, 5, 6 and 7 years old? What is the best way to treat deviated septum disease in children?

Take care of the health of your loved ones and be in good shape!

Deviated septum in children: diagnosis and treatment methods

The nasal septum is a plate that performs a separating function, dividing the nasal cavity into passages: right and left. It consists of bone and cartilage tissue, covered with a mucous membrane. Quite often there is such a problem as the curvature of the nasal septum. In the article, we will consider how to identify and treat this pathology in children. The opinions of doctors on the advisability of surgery for deviated septum of the nose will be of interest to parents of children with a similar problem.

What causes a deviated septum in children?

Causes of deviated septum in children:

Physiological. These causes of septal curvature are associated with deviations in the growth of the bones of the skull or congenital anomalies.
Compensatory. The presence of pathological formations in the nasal cavity, such as hypertrophy of the nasal concha or tumors and mucosal polyps, lead to a violation of the respiratory function, which compensates for the nasal septum due to deformation and displacement.
Traumatic. Various injuries, especially fractures, are the most common cause of a deviated septum. It can be both birth trauma and intravital.

Specialists distinguish 3 types of pathology of the nasal septum: ridge, spike, curvature. According to the type of deformation, the curvature of the nasal septum can be:

If the curvature of the nasal septum is insignificant, then otolaryngologists do not consider this phenomenon as a pathology. It is somewhat difficult to identify a deviated septum in a child at an early age, because facial bones are still being formed. Most often, the diagnosis of "deviation of the nasal septum" is made at the age of over 12 years, when the facial bones of the skull are almost fully formed.

How to detect a deviated septum in a child?

A deviated septum can cause a child to:

Diagnosis of this pathology includes:

An examination by an ENT doctor who will conduct a visual examination and rhinoscopy.
Additional surveys. Sometimes a doctor to clarify the diagnosis may refer the child to an x-ray examination of the skull, magnetic resonance and computed tomography heads. These studies are conducted for children strictly according to indications.

What methods are used to treat a deviated septum in children?

Surgical intervention. The procedure for straightening the septum is called septoplasty and is performed after the complete formation of the bones of the skull, that is, at the age of 16 years and older. In exceptional cases, this operation is permissible in children older than 6 years. Modern methods of nasal septum correction include a laser procedure, during which the volume of cartilage tissue is reduced with a laser and the septum is straightened. This method has established itself as the least traumatic method with a quick postoperative recovery period and minimal undesirable consequences.
Drug therapy. In childhood, this pathology is corrected with the help of the following medicines aimed at improving respiratory function:

glucocorticosteroids are used to eliminate allergic rhinitis;
antibiotics are used to prevent bacterial infections;
mucolytics are used to facilitate the removal of excess mucus;
moisturizing sprays;
vasoconstrictor drugs are used to reduce mucosal edema with a runny nose.

For easier breathing and general condition the child needs to monitor the climatic conditions in the room. The air should be moist and cool. It is also undesirable for the child to catch a cold, as this will aggravate respiratory function which is so difficult.

Opinions of specialists on the methods of treatment of a deviated nasal septum

ENT surgeon of the International Clinic MEDEM I.A. Tikhomirov:

I must say that there are a lot of myths around the topic of the curvature of the nasal septum. To begin with, there are no direct partitions. Everyone has this or that curvature, there is one or another crest of the septum. They operate only in the case when the function of nasal breathing is impaired. For example, a huge ridge on the septum, but it does not interfere with nasal breathing - nothing needs to be done. Or vice versa, a small but significant ridge (or curvature) that covers a narrow opening leading to the maxillary sinus. Such a person suffers from sinusitis all the time - of course, this needs to be corrected. Another thing to consider is that the nasal septum grows throughout life. It consists of several parts, and different parts grow at different rates, so with age, the problems associated with its curvature may be more pronounced.

And finally, often difficult nasal breathing is not due to the fact that the nasal septum is curved. The fact is that a large contribution to the difficulty of nasal breathing is made by hypertrophy of the nasal conchas, when the tissues of the lower nasal conchas grow, the breathing lumen narrows and poor nasal breathing occurs. The man goes to the ENT, and he says that it's a crooked nasal septum. It is corrected, but the nose still does not begin to breathe. There are many such situations. And in this case, the excess part of the tissue can be removed with a laser. This can also be done under local anesthesia on an outpatient basis. The correction of the nasal septum must be approached very strictly: from the point of view of preserving the function (breathing or not breathing the nose), weighing the benefit-risk ratio and taking into account the age of the patient.

With regard to surgical intervention for an uneven septum (septoplasty), there are some limitations. So, up to 18 (and according to some authors - flight) they try not to perform septoplasty. This is due to the ongoing growth of bone and cartilage tissue, and sometimes it is impossible to predict how the operated septum will behave. However, with gross deformities of the septum, septoplasty can be recommended at any age. As far as this intervention is shown to your child, only the doctor can answer after a direct examination.

One comment:

I think that the issue of treating a deviated septum is very important, since in Soviet times the military medical commission paid attention to this in young men of military age.

Two of my classmates with such a defect were sent for surgery before serving in the army - one was engaged in boxing, and the other had sinusitis.

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Deviated septum is a common pathology. Different degrees of deviation of the septum from the median position can lead to various complications. Operations to correct the crooked septum of the nose make up a significant part of surgical interventions in ENT hospitals and really help get rid of many problems.

Nasal septum

The nasal septum is a plate of cartilage and bones that divides the nose into two halves. In the anterior part, the septum is represented by a quadrangular cartilage, and in the back by a vomer and a perpendicular plate of the ethmoid bone. The nasal septum is, as it were, inserted into the frame of the frontal bones at the top, the hard palate at the bottom, and the sphenoid and ethmoid bones at the back.

Actually, such a multicomponent structure is most often a prerequisite for its curvature, since there is an uneven growth of various parts of the septum and bones that form the "frame" into which the septum is inserted.

The nasal septum is needed for uniform distribution of air flows. The division of the air flow into two parts is necessary for its fastest warming, humidification and purification.

Causes of deviated septum

A deviated septum is present to a greater or lesser extent in 90% of people. However, for the most part, it goes unnoticed and does not cause any inconvenience.

Causes of the formation of curvature of the nasal septum:

Curvature forms

Deformities of the nasal septum are divided into several types:

Offset to one side or the other from the middle position. The bowing of the nasal plate can be S-shaped or C-shaped, in different planes.

Spikes - pointed protrusions of the bony part of the septum.
Crests are elongated bony growths.
Combination of two or three types of deformations. This type is the most common.

Also, curvature can be one- or two-sided.

How does a deviated septum affect our body?

When the nasal septum is displaced, the lumen of the nasal passage decreases, and air passes through the narrowed nasal passage with difficulty. In addition, the resulting pathological air turbulence dries out the mucous membrane, the ciliated epithelium loses its cilia, thereby losing its protective function. The secretion of mucus is disturbed, the cleansing of the mucous from microbes. Arises.

Our nose has communications with other organs as well. In each nasal passage, the natural fistulas of the four paranasal sinuses, the auditory tube (communication with the tympanic cavity of the middle ear), and the lacrimal canal open. It happens that the nasal septum is curved in such a way that it blocks these natural openings. The outflow of contents is difficult, cleansing and aeration (air exchange) of the paranasal sinuses and the middle ear cavity are disturbed. There are diseases such as (,), dacryocystitis (inflammation of the lacrimal sac).

Chronic sinusitis is a common consequence of a deviated septum.

A long-standing deviated septum can lead to compensatory thickening (hypertrophy) of one or more turbinates on the side opposite to the deviated septum. This leads to aggravation of problems with nasal breathing, not on one, but on both sides.

The nasal septum may be deviated so that it touches the side wall of the nose, causing irritation of sensitive twigs. trigeminal nerve. This causes constant headaches, reflex spasm of the airways, coughing, and frequent sneezing.

The narrowing of the nasal passages leads to the fact that in Airways less air enters, oxygen starvation of the tissues of the whole organism occurs. The corresponding symptoms are chronic fatigue, headache, shortness of breath, poor sleep. In children, this can lead to a lag in physical and mental development.

Because of this, a person is forced to breathe mainly through the mouth. This leads to overdrying of the oral mucosa, development, bad breath. Air that enters the respiratory tract not through the nose is not cleaned and warmed up properly, and this can cause inflammatory diseases not only of the upper, but also of the lower respiratory tract (bronchitis, pneumonia).

Symptoms of a deviated septum

At first glance, man is a symmetrical being. However, there is no ideal symmetry in living organisms; too many factors affect their development. So with nasal septum. 90% of people have nasal plate curvature to one degree or another.

But most do not even suspect that they have such a pathology. Basically, people with a crooked nasal septum either do not have any complaints, or do not relate their complaints to this defect in any way.

The severity of symptoms is not directly related to the degree of curvature. It happens that a person with a strong curvature does not feel absolutely any discomfort. Conversely, even a slight deviation of the septum can cause complications.

There are no specific (pathognomonic) symptoms that are characteristic only for the curvature of the nasal septum.

But it is possible to single out a number of symptoms with which patients most often go to the doctor, during the examination they reveal a curvature of the nasal septum, and after correcting this defect, these complaints disappear.

. This is perhaps the most common complaint of patients with deviated septum. A person for a long time cannot breathe normally through his nose, drips endlessly into his nose, which only aggravates the situation due to the development of vasomotor rhinitis.
Frequent acute sinusitis or the presence of a chronic inflammatory process in one or more sinuses.
Acute or chronic otitis media.
Dacryocystitis. Violation of the outflow of tear fluid through the nose leads to a violation of the natural cleansing of the eye, inflammation of the lacrimal sac.
Smell disturbance. The olfactory zone is located in the region of the upper nasal passage. If the curvature is localized in the upper part of the septum, the patient may not smell.
Frequent headaches.
Hearing loss.

Pain in the nasal septum is not characteristic of an uncomplicated deformity, unless it is a fresh injury. So, if the nasal septum hurts, you need to look for other causes - sinusitis, boils, neuralgia of the nasociliary nerve.

It is always quite difficult even for a doctor to associate these symptoms with the deviated septum, especially in patients with comorbidities (chronic vasomotor rhinitis, allergic rhinitis), turbinate hypertrophy. usually offered after unsuccessful conservative treatment of these diseases.

Treatment of deviated septum

A crooked nasal septum is an anatomical defect and can only be corrected surgically. Surgical treatment of curvature is indicated only in the presence of complaints. In the presence of a curvature without any clinical symptoms, surgery is usually not indicated.

An operation to correct the nasal septum is offered in cases of a combination of this defect with a long-term violation of nasal breathing, frequent sinusitis, otitis media.

Surgery to straighten the nasal septum is called. There are two types of septoplasty:

Plain standard septoplasty(or submucosal resection, the oldest method of surgical intervention on the septum). In the nasal cavity, the mucous membrane is cut in an arcuate manner, a section of the quadrangular cartilage is isolated and cut off, then the curved bone part of the septum is removed (for this, a hammer and a chisel are used). Mucosal flaps, together with the perichondrium and periosteum, are brought closer to each other, fixed with tampons in the middle position.

Sparing endoscopic septoplasty– more modern method performed using endoscopic equipment. During this operation, under the visual control of the endoscope, a thorough revision of the nasal cavity is carried out and only those areas that narrow the nasal passage are removed with special gentle micro-instruments.

There are various modifications of both operations. For example, the resected cartilage may be specifically straightened and placed in its place between the layers of the perichondrium. After healing, such a modulated septum occupies a normal physiological position.

Often, simultaneously with septoplasty, other surgical manipulations in the nasal cavity are performed: conchotomy– trimming of the thickened turbinate, removal of polyps, vasotomy- resection of the choroid in chronic vasomotor rhinitis.

The operation of straightening the nasal septum is performed in a hospital. Before the operation, it is necessary to undergo an examination. General blood tests, urine tests, biochemical analysis blood, ECG, fluorography, the state of the coagulation system is determined, you need to be examined by a therapist.

There are contraindications to such an operation: acute infectious diseases, severe chronic diseases, bleeding disorders, old age, mental illness.

The operation to straighten the septum of the nose can be carried out free of charge under the MHI policy. The cost of septoplasty in paid clinics ranges from 20 to 100 thousand rubles. The price depends on the volume of the operation, the qualifications of the surgeon, the category of the clinic, the type of anesthesia, the length of stay in the hospital after the operation.

After surgery, tampons are inserted into the nose to hold the septum in the correct position. Tampons are removed after 1-2 days. On the 5-6th day the patient is discharged, but a full recovery usually occurs after 2 weeks.
All this time, it is necessary to observe an ENT doctor, daily treatment of the nasal cavity with antiseptics, rinsing with cleansing sterile solutions. After 2 weeks, complete healing and restoration of nasal breathing occurs.

Complications of septoplasty

As with any other operation, complications may occur after septoplasty:

Bleeding. Slight bleeding is acceptable, within 1-2 days after the operation, there is a discharge of ichor - a mucous discharge with blood.
Septal hematoma- accumulation of blood between layers of tissues.
Perforation of the nasal septum. Quite rare, but an unpleasant complication. Occurs when tissues are cut through. Heals, as a rule, badly. Requires a further operation to restore the nasal septum.
Saddle retraction of the back of the nose.
Suppuration.

Other treatments for deviated septum

Removal of curvature by laser is carried out by heating the curved part of the cartilage and giving it desired shape. The cost of laser septum straightening is from 20 to 50 thousand rubles.

However, despite all the advantages over conventional surgery, the widespread use of laser nasal septum correction is limited. The fact is that only the cartilaginous part of the septum can be deformed by the laser, which is very rare. The most common type of curvature is a combination of deformation of both bone and cartilage parts.

Do I need to straighten a deviated nasal septum?

Many patients for a long time can not decide on surgery to remove the curvature of the septum. Many get used to a constantly stuffy nose, chronic sinusitis and other consequences of the curvature. Yes, indeed, the pathology is not fatal, you can live like that. And any operation is a risk.

But there is still such a thing as quality of life. According to the feedback of patients who underwent septal alignment, only after the operation did they realize that this quality can be different. When you breathe like normal person, you begin to feel all the smells, constant headaches, depression disappear, life begins to play with new colors.

A few words about prevention

The only one available to anyone a method for preventing a deviated septum is a timely visit to a doctor for any injury to the nose. This is necessary to exclude or confirm a septal fracture (it is advisable to do a CT scan for this) and, if the septum is broken, to reposition the broken bones in time.

Main conclusions

If you have a stuffy nose all the time, a runny nose after a cold does not go away for months, you cannot live without naphthyzinum, get an examination by an otolaryngologist and check if this is due to a deviated nasal septum.
Frequent headaches, malaise, constant fatigue and the therapist cannot find the cause? Check if both nostrils are breathing equally well.
Do you snore at night? This may also be due to a violation of nasal breathing due to the curvature of the septum.
In itself, the presence of a curvature is not yet a reason for excitement. Treatment is indicated only when it interferes with life.
The main method of treatment is surgery.
You need to decide on the operation, carefully examine and prepare for at least 2 weeks of disability.
Enjoy a new quality of life and praise yourself for being brave.

Video: deviated septum in the program “Live great!”

In case of violation of the structure of the cartilaginous tissue, the patient is diagnosed with a curvature of the nasal septum. This part is the wall between the two sinuses of the nose, which divides the cavity into the left and right parts. The cartilage structure is made of flexible tissue covered with skin. A large number of vessels that feed this part are concentrated on it. In perfect condition, the septum is exactly in the middle of the nasal cavity.

Why is the nasal septum deviated?

The wrong structure of the nasal septum is most often diagnosed in adolescents and children. Such a pathology causes the formation of prolonged rhinitis, breathing problems, as well as abundant secretions of a mucous appearance. In addition, with a curved septum, inflammatory problems arise, as well as a tendency to allergic reactions.

jaw expansion

Deviations in the structure of the partition occur at the start of a child's growth.

Usually this process occurs at the age of six, when the patient's molars erupt.

In connection with the expansion of the jaw, the nasal cavity changes. This process becomes the main cause of the curvature of the nasal septum in children.

Congenital etiology

Among the frequently encountered causes, an innate predisposition is manifested, when, being in the mother's stomach, the formation of the child's nose is wrong. The same reason includes various injuries during birth.

Traumatization

The most common reason is considered nose injury. Violating the structure inside the nose can be a strong blow to one part of the cavity, as well as active games or a serious passion for various martial arts.

Other reasons

Other common reasons include the following signs:

The nasal septum may change with a mismatch in the growth of the bones of the skull and a rapid increase in cartilage in the nasal cavity.
Due to the pressure inside the nasal cavity due to the penetration of a foreign object or the formation of a tumor or polyp, the septum is primarily affected.
With infectious inflammation, a thickening occurs in the nasal part, which leads to a modification of the cartilage.

During the anatomical change, the patient notices that one cavity becomes much wider than the other. This modification leads to many symptoms. If the curvature of the septum is not serious, then the process is not considered a serious pathology.

Symptoms

With the correct structure of the nasal cavity, air enters evenly and penetrates through both parts. When you inhale, oxygen is moistened, warmed and filtered, and then penetrates into the paranasal sinuses.

When the septum is deviated, the inhaled air leads to irritation of the mucous membrane, which leads to various processes in the paranasal sinuses and the Eustachian tube.

Besides, there is a violation of breathing and a constant nasal congestion is manifested.

In some cases, a deviated septum causes prolonged rhinitis or acute sinusitis. As a result, the patient has pain in the head, stuffy ears, pain in the throat, bleeding.

Other symptoms include:

blockage of the right or left nostril;
nasal congestion, but only from one cavity;
frequent and unexpected nosebleeds;
dryness of the mucous membrane;
pain in the front;
noisy breathing;
headache;
snore;
sleep on one side;
frequent viral or infectious inflammations;
swelling of tissues in the nasal cavity;
airflow obstruction.

However, at the initial stage of the curvature, the patient may not notice the symptoms. Therefore, with a curvature of the septum, the patient may not be aware of his pathology. People with a noticeable curve are at risk for acute sinusitis, frequent bleeding, and other problems. They can only be removed through surgery.

Treatment Methods

In some cases, a deviated septum can be treated with medication. Drops and nasal sprays will help eliminate tissue swelling and restore air permeability. To restore the functions of the nose completely, it is necessary to wash the nose, as well as taking decongestant medications.

It is worth noting that drug treatment can be justified and effective only in the case of a non-serious pathology. If the patient has a noticeable curvature, doctors prescribe surgery.

During the operation, the patient straightens the cartilage and bones in the nasal cavity. Such therapy is carried out under local anesthesia and only after taking certain medications.

Nasal septum plasty

To repair the septum, the patient can choose plastic surgery. In this case, the surgical effect is carried out through the patient's nostrils. The advantage of plastics is the absence of scars and adhesions on the outer part of the nose, as well as absolute painlessness.

The whole procedure takes about one hour. After the operation, nasal breathing is restored within eight weeks.

During the rehabilitation period, the patient must use antiseptics and antibacterial drugs, as well as adhere to the medication course prescribed by the doctor.

During recovery, the patient must visit a doctor twice a month. This is necessary to prevent the formation of adhesions and disruption of tissue fusion.

If the curvature manifested itself in the baby, you should wait for eighteen years. Until this age, the child continues to grow and the operation may disrupt the natural growth of the nose.

Septoplasty

IN In certain cases, the patient may opt for reconstructive plastic surgery. When choosing septoplasty, the incorrect structure of the nasal septum is corrected.

The procedure passes through the nostrils, but in extremely difficult moments, doctors can perform the operation with an open method.

When choosing septoplasty, it is necessary to be aware of the formation of scars, scars and adhesions. But, The main goal of the operation is the rapid restoration of breathing.

The rehabilitation period lasts up to seven days. After the operation, there is swelling of the face, bleeding, negative reactions to medications and pain in the nasal cavity. They usually pass on the fifth day.

In the first month after surgery, the patient has pain in the head, swelling, bleeding, often bursting vessels in the nasal cavity. Perfect recovery comes during two months.

Prevention

What is a nasal septum?

The nasal septum is a bone-cartilaginous plate that divides the nasal cavity into approximately equal two halves. At

newborns

the nasal septum is even and straight. It consists entirely of cartilaginous tissue, on which there are foci of ossification. As the child grows, these foci of bone tissue turn into bones and fuse into one bone. This process is completed by the age of 10. In an adult, the anterior part of the nasal septum consists of cartilage, and the posterior part is a thin bone. Both sides are covered with a mucous membrane.

Thanks to the nasal septum, the inhaled air is divided into equal streams. This ensures its linear movement into the respiratory tract and more uniform warming, moisturizing and cleansing. Any violation of the configuration of this part of the respiratory system leads to a violation of the above functions and predisposes to the development of various allergic and inflammatory diseases of the respiratory organs, headaches, disorders of the heart, nervous system and other organs.

Causes of deviated septum

Reasons leading to

deviated nasal septum, are quite varied. Otolaryngologists divide them into:

physiological;
compensatory;
traumatic.

Physiological causes associated with a violation of the growth of the bones of the skull or congenital anomalies. Among them are:

uneven growth of the bones of the brain and facial part of the skull - the active growth of the brain part of the skull leads to a decrease in the size of the nasal cavity and a bend in the nasal septum;
uneven growth of foci of bone and cartilage tissue of the nasal septum - a more active growth of bone tissue leads to deformation of sections of the nasal septum, consisting of cartilage tissue;
excessive growth of the rudimentary organ of Jacobson, located in the olfactory region of the nose and consisting of an accumulation of nervous tissue - the active growth of this rudiment leads to a limitation of space for the normal development of the nasal septum and its curvature.

Compensatory reasons due to the presence in the nasal cavity of various pathological formations:

hypertrophy of one of the nasal conchas - an enlarged nasal concha presses on the nasal septum and causes its deformation and displacement;
tumors and polyps of the nasal mucosa - with their large size, nasal breathing is disturbed, and the nasal septum compensates for this condition and bends.

Traumatic causes caused by various injuries that contribute to the displacement of the nasal bones and the curvature of the nasal septum. The most pronounced deformations are observed with improper fusion of the bones of the nose after a fracture.

The initial cause of the curvature of the nasal septum can not always be identified. Most often, this deformation is detected in children 13-18 years old, and extremely rarely make themselves felt in early childhood.

Types and types of curvature of the nasal septum Otolaryngologists distinguish three types of curvature of the nasal septum:

curvature;
crest.

According to the type of deformation, pathological curvature can be:

S-shaped anterior-posterior;
S-shaped;
C-shaped;
curvature in relation to the bone crest of the upper jaw;
curvature of the bone crest of the upper jaw and nasal septum.

Minor deformities of the nasal septum are not considered by otolaryngologists as a pathology.
Symptoms of a deviated septum

The main and most frequent complaint of a patient with a deviated nasal septum is a violation of nasal breathing, which can manifest itself in shortness of breath, dryness and nasal congestion, and the release of mucous (sometimes, mucopurulent) discharge. Most often this

appears on one side.

Patients with a deviated nasal septum often experience:

chronic inflammation of the sinuses (sinusitis);
increased susceptibility to viral infections respiratory tract;
nosebleeds;
constant discomfort in the nose;
vasomotor rhinitis (due to excessive vascular proliferation);
pain in the nose and face;
noisy nasal breathing during sleep (especially in children);
snore;
swelling of the mucosa on the affected side;
headaches;
fast fatiguability;
tendency to depression;
decreased concentration and memory.

In patients with a deviated septum, respiratory infections last longer and are often accompanied by complications, and inflammation of the nasal mucosa leads to even greater deformation. Persistently disturbed breathing through the nose leads to the progression or development of allergic rhinitis, which can subsequently become a cause

bronchial asthma

With curvature of the nasal septum due to injuries (fractures or dislocations of the cartilage), the nose may shift to the left or right and change the shape of the nose. These signs are the result of improper fusion of the cartilage of the nasal septum.

Deviated septum in a child

Deviations of the nasal septum in a child manifest themselves as constantly disturbed and difficult nasal breathing, chronic

runny nose

and frequent spontaneous nosebleeds. In some cases, there is an absolute absence of nasal breathing. Children with a deviated septum often breathe through their mouths. During sleep, they may experience noisy breathing through the nose and even snoring.

In these children, respiratory infections are often complicated by frontal sinusitis or sinusitis, which can become chronic. Deformation of the nasal septum can provoke inflammatory diseases of the auditory tubes (tubootitis), adenoiditis and vasomotor rhinitis.

Violation of nasal breathing in a child can lead to aggravation or the appearance of allergic rhinitis. At the same time, such children have itching in the nose and a constant separation of mucus from the nose. With the progression of allergic processes, attacks of bronchial asthma can be observed.

Due to the lack of normal functioning of the respiratory system, the brain of a child with a deviated nasal septum experiences constant oxygen starvation. Lack of oxygen leads to:

headaches;
rapid fatigue;
poor memorization of new information;
decreased attention;
frequent whims.

Sequelae of deviated nasal septum

The curvature of the nasal septum leads to the development of a mass of unpleasant consequences, such as:

tendency to frequent colds;
rhinitis (vasomotor, hypertrophic, atrophic, allergic);
frontitis;
sinusitis;
sinusitis;
tubootitis;
otitis media;
spasms of the larynx;
bronchial asthma;
convulsive epileptiform seizures;
astheno-vegetative syndrome;
disorders of the heart, eyes and other organs;
dysmenorrhea;
decrease in immunity.

Correction of the curvature of the nasal septum is carried out only surgically.

Septoplasty

Septoplasty is an operation in which the surgical correction of a deviated nasal septum is performed. The main purpose of this operation is to improve nasal breathing.

Septoplasty is performed after the completion of the formation of the nasal septum. Most often it is prescribed at the age of 18-21, but in some exceptional cases it is performed at an earlier age. This is due to the fact that before the end of the complete formation of the bone septum, there is a chance that it will correct itself. In addition, surgery at an early age may necessitate a second operation, because before the end of the final formation of the nasal first year, it can be curved again.

Septoplasty can be performed using traditional surgical techniques or endoscopic minimally invasive techniques. Indications for this operation may be:

often aggravated chronic sinusitis;
chronic swelling of the nasal mucosa;
frequent colds;
persistent itching or dryness in the nose;
frequent headaches or pain in the face;
snore.

Surgery is performed under local or general anesthesia. As a rule, the operation lasts about 1-2 hours. The surgeon makes an incision and peels off the mucous membrane. Next, the deformed sections of the cartilage are excised. After that, the mucous membrane returns to its place, absorbable sutures are applied to the mucous membrane or skin, and gauze swabs are inserted into the lumen of the nasal passages, which help stop bleeding and protect the wound surface from infection. A special plaster bandage is applied to the nose. As a rule, after the completion of the operation, there are no bruises and swelling on the face.

In recent years, the most popular is endoscopic septoplasty, which is performed using special equipment and surgical instruments. This minimally invasive operation is performed with minimal damage to soft tissues and cartilage, provides a more aesthetic result and reduces the length of the recovery period.

As with any operation, septoplasty has a number of contraindications:

blood clotting disorders;
diabetes;
infectious diseases;
oncological diseases;
severe diseases of the internal organs.

Septoplasty, like any other surgical procedure, can be complicated by infection or bleeding. Specific and rarer complications of this operation include the formation of fibrin clots in the nasal cavity and perforation of the nasal septum.
Laser treatment

Treatment of a deviated nasal septum with a laser (laser septoplasty), despite the presence of some restrictions on the use of this technique, has proven itself in otolaryngological practice. This promising technique is based on the properties of a laser to evaporate deformed areas of cartilage tissue.

Laser septoplasty can only be performed in cases where only its cartilage part has undergone deformation, and the cartilage has not been broken. To perform this operation, special equipment is used that allows the surgeon to control the depth of penetration of the laser beam into the tissues.

The operation is almost bloodless, because the laser, cutting tissue, almost immediately “solders” the damaged blood vessels. The areas of cartilage that need to be removed are heated to a certain temperature. After completion of the operation, the nasal septum is fixed in the required position with gauze swabs and a plaster cast.

Benefits of laser treatment of deviated septum:

bloodlessness;
minimal traumatization of soft tissues and cartilage;
antiseptic effect on the soft tissues of the nose;
stimulation immune system the patient;
extremely rare postoperative complications;
reduction of the rehabilitation period.

Laser septoplasty is performed under local anesthesia and lasts about 15 minutes. This operation can be performed in both inpatient and outpatient settings.

Contraindications for laser treatment are:

pregnancy;
history of seizures;
oncological diseases;
increase in body temperature;
infectious diseases;
some endocrinological diseases.

Rehabilitation after surgery After septoplasty, the patient has to breathe through the mouth, because the nasal cavity is plugged with gauze swabs to fix the nasal septum in the normal position. During this period, it is necessary to exclude various changes in ambient temperature. Immediately after the operation, the patient is prescribed a course antibiotic therapy, which is aimed at the prevention of infectious complications. To relieve pain, various painkillers are prescribed.

Tampons are removed after a few days, and most patients can be discharged from the hospital within 7-10 days after surgery. Despite the fact that the tampons are removed from the nasal cavity, the patient may experience difficulty in breathing through the nose. This is due to the fact that the swelling of the mucous membrane persists for a long period of time.

Recovery after endoscopic or laser septoplasty takes place in a shorter time. Puffiness disappears earlier than after traditional surgery, and soft tissue healing is much faster.

After any type of septoplasty, you can return to your normal lifestyle after 2 weeks. For one month it is recommended to avoid severe physical activity and sudden changes in temperature.

Operation price

The cost of septoplasty depends on many factors:

degree of curvature of the nasal septum;
type of operation;
type of anesthesia (local or general anesthesia);
volume of rehabilitation measures.

For example, the correction of a minor congenital deformity will cost approximately 30-50 thousand rubles, and the restoration of the nasal septum after an injury can cost 2-3 times more.

The final cost of septoplasty must be clarified with the surgeon after all diagnostic measures have been taken.

There is an ongoing discussion about rhino/septoplasty in children and adolescents, as it has long been believed that surgery of the bone and cartilage of the skeleton of the nose and nasal septum can only be justified after reaching the age of at least 16 years.

Often deformities of the nasal septum and external nose occur as a result of fractures of the facial skull and nose in children under 5 years of age. The incidence of nasal trauma increases with age, peaking between 16 and 20 years of age. Numerous observations of nasal growth retardation after submucosal resection of the septum caused restrictions on surgery in childhood. However, if a deviated septum is the cause of significant nasal obstruction in children, then there is a clinical dilemma.

Aspects of the development of the nose in a child

The anatomy of the nasal skeleton in a child is specific and different from that of an adult, and the possibilities of healing of the nasal cartilages are weak. The limited ability to heal a cartilaginous skeleton wound of the nasal septum is a key factor limiting the effectiveness of surgery, so this should be taken into account when planning and performing the operation. Traumatic or surgical injury to the nose may have immediate or long-term effects on further growth of the midface.

A child's nose is smaller than that of an adult, it has a short back, a less pronounced tip and style (columel), rounded nostrils and a large nasolabial angle. A flatter nasal tip with a short style is also characteristic. The tissues of the nose are very soft and have a thick subcutaneous layer.

The nasal septum is the main support of the nasal skeleton, and in the newborn it is cartilaginous. The septum forms a T-shaped structure with superior lateral cartilages. In a child, the upper lateral cartilages extend to the anterior skull base, in contrast to adults, in which the upper lateral cartilages extend upward (in a cephalic or cranial direction), "going" under the nasal bones.

The growth of the nose continues after puberty. The growth process ends at the age of 18-20 years (men) and at 16-18 years (women).

The lateral cartilage consists of a cartilaginous septum that lies on the anterior nasal spine and divides the internal nose into two cavities, as well as two upper lateral cartilages that form most of the back of the nose and the lateral walls of the cartilaginous framework. This cartilage is important in the development of the bones of the midface and the cartilaginous skeleton of the nose, since cartilage and bone are closely related during growth.

Intervention, manipulation, cartilage incisions of the septum, fractures, defects affect the normal development of the premaxilla (remnant of the premaxillary bone, which in adults merges with the vomer and forms a complex complex in the anterior-lower part of the nasal septum, and ends above the edge of the piriform opening of the anterior nasal spine) and can significantly affect the development of all supporting structures of the nose. These specific areas have specific functions in the postnatal development of the midface. The lateral cartilage interacts with the growth of the midface skeletal sutures.

There are two periods of sharp growth of the nose. The first is within a year after birth, when the process of endochondral ossification begins (in the region of the anterior cranial fossa), the second is the period of puberty, when the nose grows faster than other periods of life.

Later, the perpendicular plate increases due to progressive ossification of the cartilage of the nasal septum. The vomer as an independent formation is a consequence of ossification.

There are two very important growth zones responsible for the growth and development of the nose and its elements. These two dense areas with different mitotic activity and histological maturation are located in the cartilaginous part of the nasal septum. These "growth zones" originate from the sphenoid bone.

The first, "sphenoid-dorsal" zone, located between sphenoid bone and back of the nose. This zone is primarily responsible for the normal increase in the length and height of the bridge of the nose.

The second, "sphenoid-spinal" zone, located between the sphenoid bone and the anterior nasal spine, is the main driving force for the growth of the premaxillary region in the anterior direction.

Rice. Schematic representation of parts of the septum of the newborn. 1 - ventral-central zone of thin cartilage, 2 - sphenoid-spinal zone of thick cartilage, 3 - sphenoid-dorsal zone of thick cartilage, 4 - sphenoid bone, 5 - anterior nasal spine, 6 - rudimentary part that will form the vomer. The dotted line indicates the highest part of the nasal septum and cartilaginous Crista Galli; (2) and (3) are growth zones that affect the length of the bridge of the nose and the size premailla / maxilla .

Common causes of growth plate destruction are septal hematoma, septal abscess, surgery, or trauma. This affects the growth of the midface and can result in nasal deformity (eg, saddle nose, overcurved nasal tip) or retroposition of the midface.

The prevalence of deviated septum

The prevalence of nasal septal deformities in children is 34% (range from 28% to 40% in different age categories), the prevalence is higher in men (37%) than in girls (27%). The greatest prevalence in the age group of 14-17 years, when there is an intensive growth of the naso-maxillary complex. The second frequency peak is preschool age.

Clinical manifestations

A deviated septum may be asymptomatic. However, patients may complain of nasal congestion, nasal discharge, and headache, which happens in 74, 41 and 20% respectively. Other complaints may include sneezing, throat discomfort, nasopharyngeal drainage, nosebleeds, snoring, and anosmia.

Indications for surgery

Nasal septal deformities that lead to significant narrowing of the nasal cavity are a relative indication for septoplasty. The patient's symptoms are the most important factor in deciding whether to operate.

There are other situations where surgery on the nasal septum is indicated - hematoma / abscess of the nasal septum, significant deformities of the nasal septum due to a nasal fracture, dermoid cyst or curvature of the nasal septum with cleft palate. Also, septoplasty should be considered in the presence of chronic/recurrent sinusitis.

Indications for septoplasty in children

For each indication, the expected beneficial effects of the intervention should outweigh the possible negative effects on nasal and midface growth. These include:

pronounced tumors of the nasal septum,
violation of nasal breathing caused by deformation of the nasal septum,
deviated septum in patients with cleft palate.

Children with less severe pathology need to monitor the progression of the disease by the time a final decision is made on the operation. With a progressive increase in the curvature during the growth of the child, a decision can be made to perform a septoplasty.

There is a growing trend in the world to increase the number of septoplasty in children.

Preoperative examinations

After an injury and before surgery on a child's nose, rhinological, orthodontic and cephalometric examinations should be performed. The patient (older child) and parents should be advised of the potential benefit of surgery and the need for continued postoperative monitoring of facial growth until the end of the nose growth period.

Before surgery on a child's nose, it is very important to identify defects (ancient and recent), fractures of the nasal septum, their relationship to specific growth zones.

In all other cases, the surgeon must fix the twisted or superimposed cartilage fragments, adapt them in shape and size, reconstruct the nasal septum and place it in the midline. Incisions through growing and supporting areas (spheno-ethmoid-dorsal zone) should always be avoided.

Nasal septal surgery in a child should be as cost-saving as possible and as large as necessary.

8 principles of septoplasty in children

1	Nasal mucosa	The nasal mucosa should not be lifted (peeled off) to prevent injury to the incisal nerve
2	DO NOT cut in growth areas	Incisions in the growth zones and support zones should be avoided, especially in the sphenoid-dorsal/ethmoid-dorsal areas.
3	Without posterior chondrotomy, without separation of cartilage from the perpendicular plate	Posterior chondrotomy or separation of cartilage from the perpendicular plate should be avoided as this may affect the strength and growth of the nasal septum
4	DO NOT cross the link	The septo-spinal ligament (connection of the cartilage of the septum to the premaxilla) should not be crossed as it anchors the septum in the midline
5	Reposition and fixation	Postoperative instability of the septal support frame can be avoided by repositioning and fixation
6	No accumulation of blood	Blood accumulation in the septum should be avoided after surgery
7	Use autocartilage	Alloplastic materials and biomaterials should be avoided as they cannot grow; better to use autocartilage if possible
8	Osteotomy is safe	Osteotomy does not threaten the nose during the growth period, since bone fractures are completely fused

Deviated septum is a very common problem. childhood. Mostly such distortions do not manifest themselves in any way. In difficult cases, surgery is required.
Surgery of the nasal septum in a child should be as economical as possible.
By following the principles of septoplasty in children, it is possible to achieve the maximum functional effect while maintaining the aesthetic appearance of the external nose and face of the child during the growth period.

List of sources

1. Bae JS, Kim ES, Jang YJ. Treatment outcomes of pediatric rhinoplasty: the Asan Medical Center experience. Int J Pediatr Otorhinolaryngol. 2013; 77(10):1701-10.

2. Fattahi T, Steinberg B, Fernandes R, Mohan M, Reitter E.J. Repair of nasal complex fractures and the need for secondary septo-rhinoplasty. Oral Maxillofac Surg. 2006; 64(12):1785-9.

3 GraberTM. Postnatal development of cranial, facial and oral structures: the dynamics of facial growth. In: Orthodontics: Principles and Practice. Philadelphia: WB Saunders, 1966:69-78.

4. Killian G. Beitragezur sub submukosenfensterresektion der nasenscheidewand. Passow U. Schaefer Teits. 1908:183-192.

5. Kopacheva-Barsova G., Nikolovski N. Justification for Rhinoseptoplasty in Children - Our 10 Years Overview. Open Access Maced J Med Sci., pp 1-7, August 01, 2016 as http://dx.doi.org/10.3889/oamjms.2016.080.

6. Lawrence R. Septoplasty: A review of the literature. International Journal of Pediatric Otorhinolaryngology 76 (2012) 1078–1081.

7. Menger DJ, Tabink I, NolstTrenite GJ. Nasal septal abscess in children, reconstruction with autologous cartilage grafts on Polydioxanone Plate. Arch Otolaryngol Head Neck Surg 2008;134(8):1-6.

8. Menger DJ, Tabink I, NolstTrenite GJ. Treatment of septal hematomas and abscesses in children. Facial Plastic Surgery. 2007;23:239-243. http://dx.doi.org/10.1055/s-2007-995816 PMid:18085498 .

9. NolstTrenite GJ, Verwoerd CDA, Verwoerd-Verhoef HL. Reimplantation of autologous septal cartilage in the growing nasal septum I. The influence of resection and reimplantation of septal cartilage upon nasal growth: an experimental study in growing rabbits. Rhinology 1987;25:225-236 New York: Thieme medical publishers, 1997:168-180.

10. Pirsig W. Morphological aspects of the injured septum in children. Rhinology. 1979;17:65-76. PMid:493821.

11. Pirsig W. The influence of trauma on the growing nose. In: Mladina R, passali D, eds. Pediatric Rhinology. Siena Tipografia Sense, 2000:145-159.

12 Potsic WP, Cotton RT, Handler SD, Zur KB, eds. Surgical Pediatric Otolaryngology. 2nd ed. Thieme, 2016:pp 900.

13. Poublon RML, Verwoerd CDA, Verwoerd-Verhoef HL. Anatomy of the upper lateral cartilages in the human newborn. Rhinology. 1990;28:41-46. PMid:2336524.

14. Rao JJ, Kumar ECV, Babu KR, Chowdary VS, Singh J, Rangamani SV. Classification of nasal septal deviations- relation to sinonasal pathology. Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 57, no. 3, July-September 2005: 199-201.

15. Shandilya Munish, Den Herder Cindy, Dennis Simon C.R, Nolst Trenité Gilbert. Pediatric rhinoplasty in an academic setting. Facial Plast Surg. 2007;23(4):245-57.

16. Stenner M, Rudack C. Diseases of the nose and paranasal sinuses in child. GMS Curr Top Otorhinolaryngol Head Neck Surg 2014;13:Doc10.

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Deviated septum in a child. deviated septum surgery

What is a deviated septum

Symptoms

Why is a deviated septum dangerous?

Types of curvature

Causes of deviated septum

The child has

Diagnostics

Treatment

Treatment without surgery

Operation

Laser chondroseptoplasty

Rehabilitation after surgery

Possible complications after surgery

Treatment at home

Prevention

Video

Why is the nasal septum deviated?

jaw expansion

Congenital etiology

Traumatization

Other reasons

Symptoms

Treatment Methods

Nasal septum plasty

Septoplasty

Prevention

Deviated septum: types, causes, symptoms in children and adults

Why You Shouldn't Underestimate Nasal Septal Defects

Structural features

Types of deformation

What is the disease associated with?

Symptoms of pathology

Features of manifestation in childhood

Treatment options and their features

The child has a deviated septum

Who is at the conference now

Deviated septum in children

Causes

Symptoms

Diagnostics of the curvature of the nasal septum in a child

Complications

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What can you do

What does a doctor do

Prevention

Deviated septum in children: diagnosis and treatment methods

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How to detect a deviated septum in a child?

What methods are used to treat a deviated septum in children?

Opinions of specialists on the methods of treatment of a deviated nasal septum

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Nasal septum

Causes of deviated septum

Curvature forms

How does a deviated septum affect our body?

Symptoms of a deviated septum

Treatment of deviated septum

Complications of septoplasty

Other treatments for deviated septum

Do I need to straighten a deviated nasal septum?

A few words about prevention

Main conclusions

Video: deviated septum in the program “Live great!”

Why is the nasal septum deviated?

jaw expansion

Congenital etiology

Traumatization

Other reasons

Symptoms

Treatment Methods

Nasal septum plasty

Septoplasty

Prevention

Aspects of the development of the nose in a child

The prevalence of deviated septum

Clinical manifestations

Indications for surgery