The nasal septum is made up of cartilage (in the front) and bone (posteriorly) and is the ”middle wall” inside the nose that divides the left and right nasal passages. Ideally, it should sit in the middle of the nose so that there is an equal-sized air passage on both sides. However, trauma or anatomical deformities can cause the septum to deviate off of the midline, often resulting in nasal obstruction on the side of the deviation.
Other common deviated septum symptoms include:
– Chronic nosebleeds
– Sinus infections
– Congestion
– Blocked breathing
– Trouble breathing at night
– Snoring
Each patient at the Utah Center for Better Nasal Breathing will undergo a thorough history and physical focusing on factors that affect nasal breathing. A combination of 3 modalities are used to accurately diagnose each patient’s cause of restricted nasal airflow.
In cases of more complex septal deviations, a CT scan may be necessary. The CT scanner will create a high quality image of the nose, sinuses and surrounding structures and provides the most complete radiological evaluation of nasal function.
Medical treatments will never actually straighten a nasal septum but for some patients can provide symptomatic relief. There are many medications available and some time just some trials of different medications will be necessary to determine if medical therapy is right for you. Medications can be used to ease symptoms. Some options include: Decongestants (Sudafed, Mucinex-D), Antihistamines (Allegra, Claritin, Clarinex, Zyrtec, Xyzal), Nasal steroids (Nasonex, Nasacort, Veramyst, Omnaris, Flonase), nasal antihistamines (Astepro, Patanase).
Medical treatments can be affective in approximately half of patients. However, many of these medications must be taken more or less for life. And a common side effect of these medications is nasal drying which can lead to other problems such as a dry irritated nose and recurring nose bleeds. Utah is one of the driest states in the nation and as such many patients find the daily use of medications just not a practical long-term solution.
Septoplasty, or nasal- septal reconstruction, is a procedure meant to straighten the deviated cartilage and bone that make up the nasal septum. In short, the mucosal lining covering the septum is temporarily lifted off of the cartilage and bone. The areas of deviation are usually removed and then replaced back in the midline of the nose. While each case is unique Dr. Mobley tends to avoid techniques that involve a technique called “scoring”. Some surgeons will say they simply ‘score’ the septal cartilage and thereby weaken it, instead of actually removing the deviated segment.
Septoplasty is performed as an outpatient procedure and usually takes under one hour. Certain patients, such as those with symptoms of sleep apnea or older patients may be encouraged to spend an overnight stay in the hospital just for extra close postoperative monitoring.
Our medical director, Steven Mobley, MD has gained national and international recognition for taking on some of the most complicated cases of nasal septum reconstruction. This type of operation, referred to as “Extracorporeal Septoplasty” is a technique initially developed in Germany but Dr. Mobley performs it routinely for many of the challenging cases sent to him by other ENTs around Utah and around the nation. You can learn more about the specifics of Dr. Mobley’s Extracorporeal Technique for those that want a more detailed explanation of the procedure.
Recovery Time:
Recovery time can vary based on how much septal reconstruction is performed. For patients with more office type occupations or “telecommuters”, patients can be back at work in as little as 2-3 days. For patients with more physically demanding jobs a period of 7-10 days of recuperation can be more appropriate. One of the many reasons Dr. Mobley continues to get such excellent results is that he follows his patients very closely post operatively. There is flexibility to when you schedule these post op visits, but patients are normally seen the day after surgery, one week after surgery and then a final visit 2 months after surgery. For our many patients from out of town, we can customize the post op visits to fit your overall ability to return to the office.
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