Nasal Blockage and Deviated Septum

Anyone who has suffered from nasal obstruction -- for example, when you catch a cold -- appreciates the importance of normal nasal breathing.

Nasal blockage has many causes. It is convenient to divide them into causes that are treated medically and causes that require surgical treatment. Medical causes include the common cold (viral infection -- a temporary cause), bacterial sinusitis, allergy, sensitivity to dust, smoke, pollution and other irritants.

Surgical causes include anatomic abnormalities such as a deviated septum, nasal polyps, obstructed sinuses that do not improve with medication, over-enlarged turbinates, obstructing adenoids, and other causes. Sometimes, scarring from trauma or prior nasal surgery can cause nasal obstruction.

The nose is a complex organ that gives us a passage for breathing, warms and humidifies air, allows us to smell, and provides a passage for sinus drainage. Any or all of the structural elements of the nose can become blocked and result in various symptoms, including blocked breathing, sinus pressure and headaches, snoring, loss of smell or taste, congestion, and sinus drainage. For this and other reasons, chronic nasal obstruction must be evaluated by a specialist.

One common reason for nasal blockage is a deviated septum. The septum is the wall that divides your nose down the middle, into a right and left side. It is made of cartilage and bone and has a mucous membrane lining on both sides.

When the septum is straight, it simply acts as the divider of your nose and allows for streamlined, aerodynamic airflow and easy nasal breathing. If it is deviated or twisted it can cause nasal obstruction. The septum can twist to the right and block the right side, and then come around further back in the nose and twist to the left to block the left side too!

There is no medicine that can straighten a deviated septum. If your septum is causing nasal obstruction, only surgery can correct it. This surgery is called a septoplasty.

A septoplasty is performed through a small incision made on the inside of the nose (no external incisions!). The lining of the septum (the mucous membranes) are lifted off of the cartilage and bone. The cartilage and bone are sculpted, repositioned, and a portion of it may be removed to achieve the desired straightening of the septum. The mucous membrane lining is then sewn back together with absorbable sutures (no stitch removal necessary!)

The surgeon may place a small nasal packing that is removed the next day. The packing is placed to provide light pressure on the septum to optimize healing, to prevent excessive swelling or bleeding. Our patients do not find this uncomfortable, and they do not find the removal of this packing to be painful. In the past, a kind of packing was used that was uncomfortable. We do not use this packing, but rather we use a state-of-the-art, "slim-line" packing that our patients have given their seal of approval!

The surgery is performed under sedation anesthesia or general anesthesia, and typically takes 30-45 minutes to perform. For more information on surgery for deviated septum, see Dr. Becker's published paper, Septoplasty and Turbinate Surgery (Acrobat .pdf version).

At the Nose and Sinus Center, Dr. Becker can do a complete fiberoptic evaluation of your nose to pinpoint the problem and then discuss a wide range of treatment options with you. Recent technology has made these treatments more effective, safer, and more comfortable than ever before. For more information regarding technology, Click here.

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