Septal deviation
| Classification according to ICD-10 | |
|---|---|
| J34.2 | Septal deviation |
| ICD-10 online (WHO version 2019) | |
A septal deviation (also called nasal septum curvature ) is a deformation or lateral displacement of the nasal septum ( septum nasi ), which is usually congenital, but can also be caused by an injury (trauma).
According to the American Academy of Otolaryngology — Head and Neck Surgery , 80 percent of people have a nasal septum that is slightly off the side of the median plane , so the occurrence can be considered physiological . This slight form of septal deviation is usually asymptomatic .
Symptoms
A high degree of nasal septal deviation is almost regularly associated with hyperplasia of the turbinates and leads to an obstruction (usually one-sided) of nasal breathing. It should be noted that the natural turbinate size depends on the main nasal cavity space available to them. Depending on the turbinate size, this can lead to increased difficulty breathing ( dyspnoea ) and chronic infections such as sinusitis ( sinusitis ), throat infections ( pharyngitis ) or inflammation of the tonsils ( tonsillitis ).
More germs automatically accumulate in the less ventilated, narrow and warm nose. These are mostly viruses and bacteria . The nasal mucous membrane reacts to this with increased mucus production. It leads to a cold ( rhinitis ) or a cold. In this humid environment, the bacteria proliferate and drive the mucus production of the nasal mucous membrane more and more, which can also lead to swallowing difficulties.
In addition, frequent middle ear infections and also external inflammation of the ear canal are caused indirectly by an obstruction to nasal breathing. Because if the nasal anatomy prevents free nasal breathing, every act of swallowing - especially at night during sleep - creates a negative pressure via the Eustachian tube in the middle ear, which is often perceived by the patient as itching or a foreign body sensation and often triggers manipulation of the auditory canal, with which the patient can inflame the auditory canal Prepare the way. If the curvature of the nasal septum also prevents adequate ventilation of the olfactory fissures, olfactory disorders are possible. Also, nosebleeds ( epistaxis ) with contact with the nasal turbinates and rarely with pronounced spur formation of the nasal septum headaches occur. The sleep is sleep and snoring disturbed because of disabilities or severe nasal breathing.
Typically, affected patients prefer to fall asleep on the side of the body on which their nasal septal deviation lies. A sleep apnea syndrome can be promoted.
Thus, the quality of life can be severely restricted by a high degree of septal deviation. A major improvement can usually be achieved with an operation (see therapy below). The cost of a rhinoplasty is covered by your health insurance , as this is a medically necessary procedure and not a cosmetic operation.
diagnosis
The diagnosis of septal deviation is made by external inspection of the nose, anterior rhinoscopy , endoscopy, or computed tomography (CT). How much a septal deviation hinders nasal breathing can be measured using rhinomanometry . A smell test should also be carried out.
therapy
If the symptoms described occur, surgical correction ( septoplasty or septal resection ) with straightening the nasal septum and correction of the turbinate can be useful. Depending on the severity, outpatient treatment is possible. However, if bone tissue is involved in the displacement, inpatient treatment may be required.
literature
- Rudolf Probst, Gerhard Grevers, Heinrich Iro: Ear, nose and throat medicine . Georg Thieme Verlag, Stuttgart (2000), 30. ISBN 3-13-119031-0 .
