Synonyms
Nasal septum, septum nasi
Anatomy
The nasal septum divides the main nasal cavities into a left and a right side. The nasal septum thus forms the central boundary of the nostrils (nares). The nasal septum forms the externally visible shape of the nose with a posterior bony (vomer and lamina perpendicularis ossis ethmoidalis), a middle cartilaginous (cartilago septi nasi = wing cartilage and square cartilage) and an anterior membranous part with the nostrils.
The cartilaginous as well as the bony parts are covered by mucous membrane, like the remaining main nasal cavities (Cavum nasi) and the paranasal sinuses (Sinus paranasales). The olfactory epithelium is localized on the upper edge of the nasal septum and on the upper nasal concha (opposite). A network of blood vessels (Locus Kiesselbachi) ensures blood circulation, especially in the front part of the nasal septum.
Diseases of the nasal septum
Mechanical manipulation, such as nose picking or frequent nose blowing, can irritate or even injure the sensitive mucous membrane and cause small bleedings (nosebleeds). Especially dry heating air can lead to drying of the mucous membrane on the nasal septum in the cold season. Small cracks may occur, which heal within a few days with mucosal care.
Furthermore, typical mucosal infections such as bacterial infections or fungal infections can also affect the area of the nasal septum. The use of cocaine, Wegener’s disease or lues can lead to a hole in the nasal septum (septal perforation). This should be closed surgically.
Deformations of the nasal septum can be genetic and thus congenital. For example, the hump and hooked noses. The saddle nose and the crooked nose are acquired.
Violence against the midface can lead to bleeding between the cartilage and the mucous membrane. This nasal septum hematoma can become infected and lead to a septal abscess. There is a risk of cartilage cell death (cartilage necrosis), which is why surgical drainage of the hematoma within 24 hours is recommended for nasal septum hematoma.
Depending on the cause and type of deformation, a nasal septum correction can be performed. A nasal septum deviation (misalignment of the nasal septum) is often the cause of restricted nasal breathing or snoring. Even if the nose appears straight on the outside, the nasal septum is often crooked, but this is not noticed by people because there are no symptoms.
A tilted position of the nasal septum alone is therefore no reason for treatment. A hole in the nasal septum is called a nasal septum perforation and can be caused by many different factors. In addition to traumatic events such as a blow or a mistake during an operation, chronic inflammation can also cause a hole in the long term.
Risk factors for a hole in the nasal septum are permanent exposure to industrial dusts and regular consumption of drugs. This hole can be noticed by obstructed nasal breathing, bleeding, pain, a whistling sound when breathing and crust formation. These crusts are often infested with bacteria and can produce an unpleasant smell.
If a nasal septum perforation is suspected, a doctor should be consulted, as the disease and thus the symptoms do not improve by themselves. The doctor will examine the nasal septum to confirm the diagnosis. For this purpose, a camera with a light, a so-called rhinoscope, is inserted into the nose.
The therapy consists of the surgical closure of the hole by means of a cartilage transplantation of the body’s own cartilage, usually from the ear. Despite a successful operation, the cause should be combated. For example, if exposure to industrial dusts continues or the chronic inflammation is not treated, a hole in the nasal septum is likely to reoccur.
