Examination of the nasal septum
Since the nasal septum is already partially visible from the outside, an external inspection can reveal an oblique position, a hump, piercings or even infections lying far out and thus provide clues to the problem at hand. As a rule, this is followed by an examination using a speculum. Here the physician carefully widens the nostril with a small spreader and can thus, in the best case, assess nasal conchae (conchae nasales), the main nasal cavity (cavum nasi) and, of course, the nasal septum (septum nasi).
Surgery & straightening of the nasal septum
Surgery of the nasal septum is usually only treated when there are symptoms associated with a curvature.The complaints range from shortness of breath to snoring, frequent respiratory tract infections, problems with smelling and headaches or migraines. The underlying cause of all of these is a curvature of the nasal septum, which is straightened during the operation. Both the bony and cartilaginous parts can be affected by the curvature.
This curvature usually occurs as a result of uneven growth of the jaw, palate and nose or nasal septum. In addition, more often after the rupture of the nasal septum as a result of a blow or a fall, a crooked coalescence occurs, which can cause the problems mentioned above. Based on the symptoms and the doctor’s findings, the indication for surgery is determined, whereby the extent of the symptoms is an important criterion for the doctor.
Even in the case of a conspicuous physical examination, no surgery is performed if the patient is completely free of complaints. During the physical examination, which includes a rhinoscopy, a special device is inserted into the nose using a nasal spray to assess the condition of the mucous membrane and both bony and cartilaginous structures. In addition, a curvature of the nasal septum can often be assessed from the outside.
The operation is usually performed under general anesthesia, but in special cases it can be performed under local anesthesia. In order to reach the bony and cartilaginous parts of the nasal septum during the operation, the mucosa is separated from them with a scalpel. These structures are then separated from the surrounding skeleton and the nasal septum is removed.
For straightening, the septum is now divided into small individual parts and reassembled into a straight surface. The newly aligned nasal septum is now inserted into the nose and covered with the mucous membrane, while being fixed to the surrounding tissue. Complications are rather rare in this operation, but damage to the mucous membrane, sensory disturbances, bleeding and a renewed curvature can occur.
In children it is important to note that no growth zones of the bone are destroyed by the operation, as this can cause more serious problems with increasing age. After the operation, the nose should be spared. Plastic plates can be used for this purpose, but they are removed within a week.
The bleeding is relieved by a tamponade. In the following days, the body reacts with increased secretion production, which can block the airways, which is why it should be aspirated if possible. If this is not done, the risk of inflammation in the sinuses increases.
Therefore, antibiotics are often prescribed prophylactically. In order to prevent excessive strain, sport and other physical work should be avoided completely. Furthermore, sneezing, sunbathing or hot showers can lead to heavy bleeding.
Since healing can take up to a few weeks, the course of the disease should be regularly monitored by a physician until six weeks after the operation, so that any problems that may arise can be dealt with quickly. The mucous membrane needs this time to regenerate completely and the straightened nasal septum to grow together completely. Even after the end of the medical check-ups, the mucous membrane can be moistened and thus cared for by various ointments or rinses if necessary, as it still reacts very sensitively.
