Deviated septum: types, causes, symptoms in children and adults. Deviated septum - symptoms, signs, diagnosis, causes

There is an ongoing discussion about rhino/septoplasty in children and adolescents, as it has long been believed that surgery of the bone and cartilage of the skeleton of the nose and nasal septum can only be justified after reaching the age of at least 16 years.

Often deformities of the nasal septum and external nose occur as a result of fractures of the facial skull and nose in children under 5 years of age. The incidence of nasal trauma increases with age, peaking between 16 and 20 years of age. Numerous observations of nasal growth retardation after submucosal resection of the septum caused restrictions on surgery in childhood. However, if a deviated septum is the cause of significant nasal obstruction in children, then there is a clinical dilemma.

Aspects of the development of the nose in a child

The anatomy of the nasal skeleton in a child is specific and different from that of an adult, and the possibilities of healing of the nasal cartilages are weak. The limited ability to heal the wound of the cartilaginous skeleton of the nasal septum is a key factor limiting the effectiveness of surgery, so this should be taken into account when planning and performing the operation. Traumatic or surgical injury to the nose may have immediate or long-term effects for further growth of the middle part of the face

A child's nose is smaller than that of an adult, it has a short back, a less pronounced tip and style (columel), rounded nostrils and a large nasolabial angle. A flatter nasal tip with a short style is also characteristic. The tissues of the nose are very soft and have a thick subcutaneous layer.

The nasal septum is the main support of the nasal skeleton, and in the newborn it is cartilaginous. The septum forms a T-shaped structure with superior lateral cartilages. In a child, the upper lateral cartilages extend to the anterior skull base, in contrast to adults, in which the upper lateral cartilages extend upward (in the cephalic or cranial direction), "going" under the nasal bones.

The growth of the nose continues after puberty. The growth process ends at the age of 18-20 years (men) and at 16-18 years (women).

The lateral cartilage consists of a cartilaginous septum that lies on the anterior nasal spine and divides the inner nose into two cavities, as well as two upper lateral cartilages that form most of the back of the nose and the lateral walls of the cartilaginous framework. This cartilage is important in the development of the bones of the midface and the cartilaginous skeleton of the nose, since cartilage and bone are closely related during growth.

Intervention, manipulation, cartilage incisions of the septum, fractures, defects affect the normal development of the premaxilla (remnant of the premaxillary bone, which in adults merges with the vomer and forms a complex complex in the anterior-lower part of the nasal septum, and ends above the edge of the pyriform opening of the anterior nasal spine) and can significantly affect the development of all supporting structures of the nose. These specific areas have specific functions in the postnatal development of the midface. The lateral cartilage interacts with the growth of the midface skeletal sutures.

There are two periods of sharp growth of the nose. The first is within a year after birth, when the process of endochondral ossification begins (in the region of the anterior cranial fossa), the second is the period of puberty, when the nose grows faster than other periods of life.

Later, the perpendicular plate increases due to progressive ossification of the cartilage of the nasal septum. The vomer as an independent formation is a consequence of ossification.

There are two very important growth zones responsible for the growth and development of the nose and its elements. These two dense areas with different mitotic activity and histological maturation are located in the cartilaginous part of the nasal septum. These "growth zones" originate from the sphenoid bone.

The first, "sphenoid-dorsal" zone, located between the sphenoid bone and the bridge of the nose. This zone is primarily responsible for the normal increase in the length and height of the bridge of the nose.

The second, "sphenoid-spinal" zone, located between the sphenoid bone and the anterior nasal spine, is the main driving force for the growth of the premaxillary region in the anterior direction.

Rice. Schematic representation of parts of the septum of the newborn. 1 - ventral-central zone of thin cartilage, 2 - sphenoid-spinal zone of thick cartilage, 3 - sphenoid-dorsal zone of thick cartilage, 4 - sphenoid bone, 5 - anterior nasal spine, 6 - rudimentary part that will form the vomer. The dotted line indicates the highest part of the nasal septum and cartilaginous Crista Galli; (2) and (3) are growth zones that affect the length of the bridge of the nose and the size premailla / maxilla .

Common causes of growth plate destruction are septal hematoma, septal abscess, surgery, or trauma. This affects the growth of the midface and can result in nasal deformity (eg, saddle nose, overcurved nasal tip) or retroposition of the midface.

The prevalence of deviated septum

The prevalence of deformities of the nasal septum in children is 34% (range 28% to 40% in different age categories), the prevalence is higher in men (37%) than in girls (27%). The greatest prevalence in the age group of 14-17 years, when there is an intensive growth of the naso-maxillary complex. The second frequency peak is preschool age.

Clinical manifestations

A deviated septum may be asymptomatic. However, patients may complain of nasal congestion, nasal discharge, and headache, which occurs in 74%, 41%, and 20%, respectively. Other complaints may include sneezing, throat discomfort, nasopharyngeal drainage, nosebleeds, snoring, and anosmia.

Indications for surgery

Nasal septal deformities that lead to significant narrowing of the nasal cavity are a relative indication for septoplasty. The patient's symptoms are the most important factor in deciding whether to operate.

There are other situations where septal surgery is indicated, such as a hematoma/abscess of the septum, significant deformities of the septum due to a nasal fracture, a dermoid cyst, or a deviated septum due to cleft palate. Also, septoplasty should be considered in the presence of chronic/recurrent sinusitis.

Indications for septoplasty in children

For each indication, the expected beneficial effects of the intervention should outweigh the possible negative effects on nasal and midface growth. These include:

• pronounced tumors of the nasal septum,
• violation of nasal breathing caused by deformation of the nasal septum,
• deviated septum in patients with cleft palate.

Children with less severe pathology need to monitor the progression of the disease by the time a final decision is made on the operation. With a progressive increase in the curvature during the growth of the child, a decision can be made to perform a septoplasty.

There is a growing trend in the world to increase the number of septoplasty in children.

Preoperative examinations

After an injury and before surgery on a child's nose, rhinological, orthodontic and cephalometric examinations should be performed. The patient (older child) and parents should be advised of the potential benefit of surgery and the need for ongoing postoperative monitoring of facial growth until the end of the nose growth period.

Before surgery on a child's nose, it is very important to identify defects (ancient and recent), fractures of the nasal septum, their relationship to specific growth zones.

In all other cases, the surgeon must fix the twisted or superimposed cartilage fragments, adapt them in shape and size, reconstruct the nasal septum and place it in the midline. Incisions through growing and supporting areas (spheno-ethmoid-dorsal zone) should always be avoided.

Nasal septal surgery in a child should be as cost-saving as possible and as large as necessary.

8 principles of septoplasty in children

• Deviated septum is a very common problem in childhood. Mostly such distortions do not manifest themselves in any way. In difficult cases, surgery is required.
• Surgery of the nasal septum in a child should be as economical as possible.
• By following the principles of septoplasty in children, it is possible to achieve the maximum functional effect while maintaining the aesthetic appearance of the external nose and face of the child during the growth period.

List of sources

1. Bae JS, Kim ES, Jang YJ. Treatment outcomes of pediatric rhinoplasty: the Asan Medical Center experience. Int J Pediatr Otorhinolaryngol. 2013; 77(10):1701-10.

2. Fattahi T, Steinberg B, Fernandes R, Mohan M, Reitter E.J. Repair of nasal complex fractures and the need for secondary septo-rhinoplasty. Oral Maxillofac Surg. 2006; 64(12):1785-9.

3 GraberTM. Postnatal development of cranial, facial and oral structures: the dynamics of facial growth. In: Orthodontics: Principles and Practice. Philadelphia: WB Saunders, 1966:69-78.

4. Killian G. Beitragezur sub submukosenfensterresektion der nasenscheidewand. Passow U. Schaefer Teits. 1908:183-192.

5. Kopacheva-Barsova G., Nikolovski N. Justification for Rhinoseptoplasty in Children - Our 10 Years Overview. Open Access Maced J Med Sci., pp 1-7, August 01, 2016 as http://dx.doi.org/10.3889/oamjms.2016.080.

6. Lawrence R. Septoplasty: A review of the literature. International Journal of Pediatric Otorhinolaryngology 76 (2012) 1078–1081.

7. Menger DJ, Tabink I, NolstTrenite GJ. Nasal septal abscess in children, reconstruction with autologous cartilage grafts on Polydioxanone Plate. Arch Otolaryngol Head Neck Surg 2008;134(8):1-6.

8. Menger DJ, Tabink I, NolstTrenite GJ. Treatment of septal hematomas and abscesses in children. Facial Plastic Surgery. 2007;23:239-243. http://dx.doi.org/10.1055/s-2007-995816 PMid:18085498 .

9. NolstTrenite GJ, Verwoerd CDA, Verwoerd-Verhoef HL. Reimplantation of autologous septal cartilage in the growing nasal septum I. The influence of resection and reimplantation of septal cartilage upon nasal growth: an experimental study in growing rabbits. Rhinology 1987;25:225-236 New York: Thieme medical publishers, 1997:168-180.

10. Pirsig W. Morphological aspects of the injured septum in children. Rhinology. 1979;17:65-76. PMid:493821.

11. Pirsig W. The influence of trauma on the growing nose. In: Mladina R, passali D, eds. Pediatric Rhinology. Siena Tipografia Sense, 2000:145-159.

12 Potsic WP, Cotton RT, Handler SD, Zur KB, eds. Surgical Pediatric Otolaryngology. 2nd ed. Thieme, 2016:pp 900.

13. Poublon RML, Verwoerd CDA, Verwoerd-Verhoef HL. Anatomy of the upper lateral cartilages in the human newborn. Rhinology. 1990;28:41-46. PMid:2336524.

14. Rao JJ, Kumar ECV, Babu KR, Chowdary VS, Singh J, Rangamani SV. Classification of nasal septal deviations- relation to sinonasal pathology. Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 57, no. 3, July-September 2005: 199-201.

15. Shandilya Munish, Den Herder Cindy, Dennis Simon C.R, Nolst Trenité Gilbert. Pediatric rhinoplasty in an academic setting. Facial Plast Surg. 2007;23(4):245-57.

16. Stenner M, Rudack C. Diseases of the nose and paranasal sinuses in child. GMS Curr Top Otorhinolaryngol Head Neck Surg 2014;13:Doc10.

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The cartilage structure is made of flexible tissue coated with skin. Focused on her a large number of vessels that feed this part. In perfect condition, the septum is exactly in the middle of the nasal cavity.

According to statistics, today, almost eighty percent of people have a deviated nasal septum. In most cases, it shifts slightly from the center and does not bring discomfort. Most often, this pathology occurs in children. With a strong violation of the structure of the septum, it can provoke respiratory disorders and become the root cause of chronic rhinitis. Therefore, if you notice discrepancies, it is important to know the symptoms and treatment of a deviated septum in children.

Why is the nasal septum deviated?

The wrong structure of the nasal septum is most often diagnosed in adolescents and children. Such a pathology causes the formation of prolonged rhinitis, breathing problems, as well as abundant secretions of a mucous appearance. In addition, with a curved septum, inflammatory problems arise, as well as a tendency to allergic reactions.

jaw extension

Deviations in the structure of the septum occur at the beginning of the growth of the child.

Usually this process occurs at the age of six, when the patient's molars erupt.

In connection with the expansion of the jaw, the nasal cavity changes. This process becomes the main cause of the curvature of the nasal septum in children.

Congenital etiology

Among the most common causes, a congenital predisposition is manifested, when, being in the mother's stomach, the formation of the child's nose does not occur correctly. The same reason includes various injuries during birth.

Traumatization

The most common cause is considered traumatization of the nose. Violating the structure inside the nose can be a strong blow to one part of the cavity, as well as active games or a serious passion for various martial arts.

Other reasons

Other common causes include the following:

1. The nasal septum may change with a mismatch in the growth of the bones of the skull and a rapid increase in cartilage in the nasal cavity.
2. Due to the pressure inside the nasal cavity due to the penetration of a foreign object or the formation of a tumor or polyp, the septum is primarily affected.
3. With infectious inflammation, a thickening occurs in the nasal part, which leads to a modification of the cartilage.

During the anatomical change, the patient notices that one cavity becomes much wider than the other. This modification leads to many symptoms. If the curvature of the septum is not serious, then the process is not considered a serious pathology.

Symptoms

With the correct structure of the nasal cavity, air enters evenly and penetrates through both parts. When you inhale, oxygen is moistened, warmed and filtered, and then penetrates into the paranasal sinuses.

When the septum is deviated, the inhaled air leads to irritation of the mucous membrane, which leads to various processes in the paranasal sinuses and the Eustachian tube.

Among the main signs of a curvature of the septum is a loss of smell. With the slow development of the deviation, this dysfunction manifests itself slowly, so the patient does not always notice such a symptom immediately.

In addition, there is a violation of breathing and constant nasal congestion is manifested.

In some cases, a deviated septum causes prolonged rhinitis or acute sinusitis. As a result, the patient has pain in the head, stuffy ears, pain in the throat, bleeding.

Pathology in the structure of the nose always causes swelling in the mucous membrane and other inflammations associated with the functions of the respiratory organ. Often a violation in the structure of the septum causes seasonal allergic rhinitis.

Other symptoms include:

• blockage of the right or left nostril;
• nasal congestion, but only from one cavity;
• frequent and unexpected nosebleeds;
• dryness of the mucous membrane;
• pain in the front;
• noisy breathing;
• headache;
• snore;
• sleep on one side;
• frequent viral or infectious inflammations;
• swelling of tissues in the nasal cavity;
• airflow obstruction.

However, at the initial stage of the curvature, the patient may not notice the symptoms. Therefore, with a curvature of the septum, the patient may not be aware of his pathology. People with a noticeable curve are at risk for acute sinusitis, frequent bleeding, and other problems. They can only be removed through surgery.

Treatment Methods

When wondering what to do if a child has a deviated septum, the first step is to undergo a diagnosis. You can determine the obvious symptoms without the help of a doctor, but to conduct a comprehensive examination, contact the ENT.

In some cases, a deviated septum can be treated with medication. Drops and nasal sprays will help eliminate tissue swelling and restore air permeability. To restore the functions of the nose completely, it is necessary to wash the nose, as well as taking decongestant medications.

It is worth noting that drug treatment can be justified and effective only in the case of a non-serious pathology. If the patient has a noticeable curvature, doctors prescribe surgery.

During the operation, the patient straightens the cartilage and bones in the nasal cavity. Such therapy is carried out under local anesthesia and only after taking certain medications.

Nasal septum plasty

To restore the septum, the patient may choose plastic surgery. In this case, the surgical effect is carried out through the patient's nostrils. The advantage of plastics is the absence of scars and adhesions on the outer part of the nose, as well as absolute painlessness.

The whole procedure takes about one hour. After the operation nasal breathing recovered within eight weeks.

During the rehabilitation period, the patient must use antiseptics and antibacterial drugs, and also adhere to the medication course prescribed by the doctor.

During the recovery, the patient needs to visit a doctor twice a month. This is necessary to prevent the formation of adhesions and disruption of tissue fusion.

If the curvature manifested itself in the baby, you should wait for eighteen years. Until this age, the child continues to grow and the operation may disrupt the natural growth of the nose.

Septoplasty

In certain cases, the patient may choose a reconstructive plastic surgery. When choosing septoplasty, the incorrect structure of the nasal septum is corrected.

The procedure passes through the nostrils, but in extremely difficult moments, doctors can perform the operation with an open method.

When choosing septoplasty, it is necessary to be aware of the formation of scars, scars and adhesions. However, the main goal of the operation is the rapid restoration of breathing.

The rehabilitation period lasts up to seven days. After the operation, there is swelling of the face, bleeding, negative reactions to medications and pain in the nasal cavity. They usually pass on the fifth day.

In the first month after surgery, the patient has pain in the head, swelling, bleeding, often bursting vessels in the nasal cavity. Complete recovery occurs within two months.

Prevention

Unfortunately, there is no way to prevent a deviated septum. But you can protect yourself by avoiding any damage. To do this, when playing actively or participating in contact sports, wear a protective helmet and be extremely careful.

Directory of major ENT diseases and their treatment

All information on the site is for informational purposes only and does not claim to be absolutely accurate. medical point vision. Treatment must be carried out by a qualified doctor. By self-medicating, you can harm yourself!

Deviated septum: types, causes, symptoms in children and adults

Deviated septum is a common and even more often underestimated pathology that affects the cartilage and bones of the face and can lead to a significant deterioration in the quality of life.

Experts recommend correcting the nasal septum in early age to reduce the burden on the body and prevent the development of complications due to disruption of the respiratory system. The situation is complicated due to the fact that the deformity can be of a different nature, affect different passages of the nose and, accordingly, require individual approach to the patient from the otolaryngologist.

Why You Shouldn't Underestimate Nasal Septal Defects

The curvature of the nasal septum leads not only to a narrowing of the external respiratory tract with one or both sides, but also changes the direction of movement and creates additional turbulence in the air currents. Curvature causes the appearance of places with low pressure, which leads to periodic collapse of the lumen.

Because of the discomfort associated with excessive cooling and pressure changes, sensitive nerve cells The nose sends signals to the brain and spinal cord. As a result, the brain centers affect the tone of the vessels of the nose, which can turn into a rhinitis-like condition, which is called vasomotor rhinitis. In this case, the displacement violates such important functions of the nasal cavity as:

• Heating of passing air.
• Increasing the humidity of air streams.
• Sensation of smells.
• Protection against mechanical irritants: dust, particles of burned fuel, pollen, etc.
• Counteracting infectious agents.
• Pressure regulation in ear canal and the middle ear chamber.

The curved nasal septum brings changes in the blood circulation in the adjacent area, which can lead to malnutrition of the mucous membrane or due to the body's attempt to compensate for the pathological process - its hypertrophy. In the latter case, there is an increase in the nasal conch and a change in the shape of the ethmoid bone.

Therefore, in patients with a curved part of the septum, only to the right or to the left, respiratory failure can be observed on both sides. If the changes lead to mucosal degeneration, then the cilia of the nose degrade along with it, which are normally responsible for holding and facilitating the removal of mechanical particles entering the nostril lumen.

When the partition is curved, the air movement pattern is disrupted. Normally, when inhaling, it does not go by itself shortcut, and first rises, and then descends along an arc to the choana, mixing with the remnants of the heated masses. Exhalation follows a path close to a straight line - along the lower nasal passage.

Therefore, affecting at least one of the levels leads to a violation of the entire system. Along with the redirection of flows and a decrease in the quality of heating, the risk of developing infectious diseases in the nasopharynx increases: tonsillitis, rhinitis, frontal sinusitis, sinusitis and other unpleasant diseases that can give complications in the form of otitis media or meningitis.

In most cases, a young body is able to compensate for respiratory disorders, however, with age and a gradual deterioration in the effectiveness of the immune, cardiovascular, nervous and respiratory systems, the pathology will increasingly remind of itself with discomfort.

An additional aggravating factor in the displacement may be a pathological reaction nervous system, gradually turning into neuroses. At risk are people who have deeply formed "combs" cut deeply into the nasal shells.

On the part of the autonomic nervous system and distant organs, this can result in spastic syndromes of the larynx, sleep disturbance, increased likelihood of developing bronchial asthma and epileptic foci. In addition to physiological disorders, the crooked nasal septum leads to purely aesthetic unpleasant sensations, as it breaks the symmetry of the face and can make the nose visually wider.

Structural features

The septum is a plate of complex structure that divides the nasal cavity into 2 approximately identical parts. It has a bony structure at its base (vomer and vertical plate of the ethmoid bone) that continues anteriorly in the form of cartilage.

It is lined with a mucous membrane that contains blood vessels, mucus-secreting glands, and sensory nerve cells. Deviated septum in children can look like spikes and ridges. At the same time, minor deviations that are present in everyone and do not interfere with breathing are not perceived by otolaryngologists as a pathology.

Types of deformation

The structure can be deformed in several ways, acquiring:

• C-curve.
• S-like anterior-posterior or affecting only one department.
• Change in shape along with the crest of the upper jaw.

With improper fusion of bones and cartilage after traumatization, "ridges" that go deep into the body often form. Their typical direction is from front to back or from bottom to top, often obliquely. In the anterior sections of the plate, relief disturbances occur at the bottom of the nose. These structures may end in a spike that cuts into the wall of the pathways and cuts off breathing. At the same time, the mucous layer on the convex side is thinner and easily torn.

What is the disease associated with?

The causes of a deviated septum can be divided into 3 main areas:

• Associated with the uneven increase in the facial and cerebral parts of the skeleton of the head (they consist of many elements that increase in size during maturation, acquire a denser structure, and some fuse into a single solid structure). In this case, individual elements can grow at different rates, which leads to bending of the cartilage.
• Caused by uneven activity of growth points. Since the bone, like the skull, does not grow as a whole, then with an increase or slowdown in the growth rate at one of the points (for genetic and infectious reasons or due to a lack of calcium, phosphorus and vitamins in the diet), a significant curvature of the nose can occur.
• In rare cases, the deformation begins due to excessive growth of the Jacobson's organ (vomeronasal), which is not expressed in 75% of people (usually leads to deformation of the anterior-lower part of the plate).

Injury related These causes include fractures and displacements of the bones that support the cartilage or adjacent to them. Displacing bones in children under 12 years of age can even be a small blow or hit by a tightly stuck snowball, so the curvature of the nasal septum in a male child is a more frequent occurrence (in the CIS, it occurs 3 times more often in boys). The most severe consequences are improper fusion of bones after an imperceptible fracture from the outside. Compensatory

• Due to an excessive increase in 1 of the turbinates, which presses on the plate and causes it to shift.
• In connection with chronic obstruction of one of the nostrils due to differences in pressure.
• In response to the formation and expansion of nasal polyps, benign and malignant tumors.

Congenital curvature Meets less than others and can sometimes be confused with acquired during childbirth.

Symptoms of pathology

An accurate diagnosis of a deviated septum can only be made by a qualified otolaryngologist after examining the nasopharynx, however, due to a violation of the breathing pattern and the main functions of the nose, it manifests itself in several forms:

• Difficulties in breathing. The intensity of the symptom depends on the angle of curvature and the degree of occlusion of the upper, lower, or middle airway. Most noticeably, it is expressed with periodic collapse of one half of the nose. In young people, due to the good adaptability of the body, this manifestation can be expressed very weakly and not be noticed by the patient himself. However, with inflammation of the mucous membrane, drying of snot, injuries, SARS and serious physical activity it makes itself felt even in hardy patients.
• Increasing the rate of drying of mucous secretions.
• increases colds and sinusitis.
• Decreased concentration due to constant irritation in the nose and reduced oxygen supply.
• Swelling of the mucous membrane.
• Noisy ragged breathing.
• In the event of a breach affecting lacrimal canal, there may be difficulty in draining fluid and an increase in the incidence of inflammation in the lacrimal sac.
• Due to the deterioration in the supply of oxygen to the brain and skeletal muscles, performance deteriorates and accelerated fatigue appears.
• Due to the location of parts of the cartilage or individual elements at an angle to each other, the external vessels are in a vulnerable position when itching, hitting or intense blowing along with the drying of the mucus. In this case, patients suffer from the occurrence of non-intensive, but frequent bleeding. If at the same time there is a tendency to sclerotization of the vessels, then the prognosis worsens significantly.
• Due to the redirection of air flows and stimulation of mucosal receptors, sleepers often snore.

Features of manifestation in childhood

The curvature of the nasal septum in children is especially dangerous in the first years of life, because due to a decrease in the concentration of air in the blood, it can lead to a slowdown in brain growth and, accordingly, to mental retardation. During the period of upbringing kindergarten and at school, it will contribute to attention deficit disorder and learning delay due to constant visits to the therapist due to frequent colds.

At the same time, the probability of the transition of diseases to chronic form and manifestations of asthma in those prone to it from birth. In addition, it will be more difficult for a child to keep up with peers in physical education and labor classes, during choreographic preparation for holidays, during trips on excursions or after signing up for sports clubs. Therefore, it is recommended to correct the crooked nose in a timely manner.

Treatment options and their features

When diagnosing a deviated septum, the causes can play a significant role in choosing an effective tactic for treating the pathology. If polyps contributed to the shifts or a tumor led to them, then first of all it is important to determine their genesis, and then remove them surgically.

If at the same time the patient has an increase in temperature, it is recommended to first eliminate the prerequisites for the inflammatory process and kill the infectious agents in order to prevent their spread during surgery.

Its main goal should be to facilitate breathing, but in addition it is possible to improve the aesthetic side through plastic surgery.

Nasal septum, the curvature of which is complemented by inflammation paranasal sinuses, requires preliminary examination using X-ray equipment. In simple cases, it is usually enough for a doctor to conduct a rhinoscopy examination. In the presence of clinical symptoms The conservative treatment is surgery.

Septoplasty can correct the vertical plate and give it a vertically even shape. Indications for its implementation can be considered:

• Frequent sinusitis.
• chronic inflammation mucous membranes.
• Increasing incidence of SARS.
• Frequent headaches.
• Strong snoring.

Depending on the location of the bend, it can take place under local (if the damage is in the anterior part of the cartilage) or general anesthesia. It is prohibited or highly discouraged for:

• Hemophilia and other disorders of blood coagulation systems.
• Any type of diabetes.
• Oncology.
• Acute course of an infectious disease.
• Multiple organ failure.

Standard septoplasty consists in arcuate cutting of the mucous membrane, access to the curved area of ​​the 4-coal cartilage and its excision, and in case of impaired bone development, removal of its part. However, this approach is considered outdated and most clinics perform endoscopic procedures to reduce the degree of intervention.

In this case, not a chisel is used, but a special endoscope with instruments for microsurgery. After a day of observation in the hospital, the cured patient can go home and come to the hospital only for bandaging and control over the restoration of health.

If, due to the pathological process, chronic vasomotor rhinitis has developed and / or the vessels have grown excessively, then the choroid is additionally excised.

The child has a deviated septum

I have a curvature. The doctor said this: if there is no effect on breathing, then we will not correct it. But if it does, then problems of a secondary nature may appear, it is necessary to correct it. I managed. Be sure to consult, find out the cause of bad breath. Perhaps it's just dry air or an allergy, and if the cause is a curvature, then it needs to be corrected. Good luck!

where did you get it from?

I don’t know what to do directly. We already bought a humidifier, it seems better. But the opinion of Laura (they were already at 2) diverge.

The 1st prescribed washing + drops on silver (they prepare 16.00 UAH in the pharmacy)

2nd drink Job-baby + drip at night renizolin + buy at the health center drops on silver for 160 UAH

And don't know what to do

Tried the 1st option seems to be better

later moved to 2. but it got worse

What don't I know now?

And they told me, oddly enough, Yes, I do not insist on this option.

By the way, my nose starts to breathe noticeably better when I physically "turn" it. Therefore, I know that I have a slight deterioration in breathing, but not so much that it interferes with life. Salt solutions improve the situation a little.

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Deviated septum in children

Curvature of the nasal septum - its deviation to the right or left with a deformation of the shape.

The reasons

The septum may suffer due to some kind of facial injury. Children, especially those of school age, are prone to random situations: the ball hit the face, a fight with a peer, a fall from a bicycle and other accidents can become the basis for this pathological phenomenon. Another reason may be anomalies in the process of growth of the nasal skeleton. If the bones grow unevenly for some reason, the septum may suffer.

Symptoms

• A small patient may experience a feeling of nasal congestion. This state may not pass. long time or happen periodically. The nose can be blocked on one side or alternately.
• Mucous secretion comes out of the nose.
• Mucus from the nose flows into the larynx.
• Ears are often blocked. When swallowing, it gives into the ears.
• A feeling of dryness develops in the oral cavity.
• Poor sleep, snoring.
• Frequent migraine pains.
• The baby is prone to frequent colds.
• The nose is bleeding.

Diagnostics of the curvature of the nasal septum in a child

• First of all, the doctor examines the child, clarifying with him and his parents the details of the course of the disease. The specialist needs to know exactly what symptoms are present in this case, whether there have been cases of injury, whether nasal congestion is present, whether the patient uses nasal drops.
• After a general examination, the doctor performs a rhinoscopy. The study is carried out using a special mirror. The doctor during the examination specifies the degree of curvature, the condition of the nasal passages.
• Endoscopic examination. Using a device called an endoscope, a specialist assesses the condition of the mucosa. Before such an examination, the doctor instills a vasoconstrictor medication into the patient's nose.
• Rhinomanometric inspection - is a method of measuring the strength of the air flow in the nose. The technique is applicable not only for diagnosis, but also as an assessment of the result after therapy.

Complications

• by the most dangerous complication this disease is the development of hypoxia. Oxygen through the nose cannot freely pass and circulate, as a result, oxygen starvation occurs, which negatively affects all body systems.
• Along with the progression of the disease, a number of inflammatory processes develop. Ears, paranasal sinuses, sinusitis and other diseases may develop.
• Every runny nose that starts turns into a serious one inflammatory process and is characterized by a long and difficult course.
• A deformed septum leads to severe rhinitis. A pathological process develops in the turbinates, the vessels lose their functions. This condition can turn into an allergic rhinitis or hypertrophic rhinitis, as a result of which the turbinates become excessively deep.
• The general malaise that the child constantly experiences negatively affects his psychological state. The kid is forced to constantly blow his nose, often breathes through his mouth, regularly uses nasal drops. As a result social adaptation can be compromised, as can self-confidence. Neuroses and unstable mental states may occur.
• The patient develops snoring during sleep. Prolonged snoring can lead to respiratory arrest and pathologies of the cardiac system. Usually such children feel lethargic and fatigued during the day. It is difficult for them to concentrate, they do not study well at school.
• Since a small patient is forced to frequently breathe through his mouth, this can lead to frequent entry of viruses and infections resulting from airborne infection. Children suffer from constant inflammation of the tonsils, the development of laryngitis, tracheitis and problems of pathological processes in the lower respiratory tract.
• The formation of facial bones can also undergo changes. As a result of pathology, a pathological bite may develop. varying degrees.

Treatment

What can you do

Parents of a sick baby should not be delayed in seeking help. It is better to fix a septal defect as soon as possible so that the symptoms of the pathology do not lead to even bigger problems.

What does a doctor do

• A small patient may be scheduled for spetoplasty. This manipulation is a surgical correction of the nasal septum in terms of indicators and observed symptoms.
• Surgical intervention is performed under general anesthesia inside the nose, no incisions are made from the outside. The shape of the patient's nose after surgery will not change. No hematoma remains after the manipulation.
• During the operation, the doctor removes the curved sections of the septum. If they can be straightened, the doctor does this with special tools, armed with an endoscope and a microscope.

Prevention

Parents need to remember how sometimes minor injuries can create big health problems. So you should protect the child from injury, teach the baby the basics of safety in outdoor games and sports. With bruises on the face of the baby, you need to urgently show the doctor. It is better to be safe than to miss the occurrence of pathology.

Arm yourself with knowledge and read a useful informative article about the disease deviated septum in children. After all, being parents means studying everything that will help maintain the degree of health in the family at the level of “36.6”.

Find out what can cause the disease, how to recognize it in a timely manner. Find information about what are the signs by which you can determine the malaise. And what tests will help to identify the disease and make the correct diagnosis.

In the article, you will read everything about the methods of treating such a disease as a curvature of the nasal septum in children. Specify what effective first aid should be. What to treat: choose medications Or folk methods?

You will also learn how untimely treatment of the disease can be dangerous deviated septum in children, and why it is so important to avoid the consequences. All about how to prevent the curvature of the nasal septum in children and prevent complications.

And caring parents will find on the pages of the service full information about the symptoms of the disease deviated septum in children. How do the signs of the disease in children at 1.2 and 3 years old differ from the manifestations of the disease in children at 4, 5, 6 and 7 years old? What is the best way to treat deviated septum disease in children?

Take care of the health of your loved ones and be in good shape!

Deviated septum in children: diagnosis and treatment methods

The nasal septum is a plate that performs a separating function, dividing the nasal cavity into passages: right and left. It consists of bone and cartilage tissue, covered with a mucous membrane. Quite often there is such a problem as the curvature of the nasal septum. In the article, we will consider how to identify and treat this pathology in children. The opinions of doctors on the advisability of surgery for deviated septum of the nose will be of interest to parents of children with a similar problem.

What causes a deviated septum in children?

Causes of deviated septum in children:

• Physiological. These causes of septal curvature are associated with deviations in the growth of the bones of the skull or congenital anomalies.
• Compensatory. The presence of pathological formations in the nasal cavity, such as hypertrophy of the nasal concha or tumors and mucosal polyps, lead to a violation of the respiratory function, which compensates for the nasal septum due to deformation and displacement.
• Traumatic. Various injuries, especially fractures, are the most common cause along which the nasal septum deviates. It can be both birth trauma and intravital.

Specialists distinguish 3 types of pathology of the nasal septum: ridge, spike, curvature. According to the type of deformation, the curvature of the nasal septum can be:

If the curvature of the nasal septum is insignificant, then otolaryngologists do not consider this phenomenon as a pathology. It is somewhat difficult to identify the curvature of the nasal septum in a child at an early age, since the facial bones are still being formed. Most often, the diagnosis of "deviation of the nasal septum" is made at the age of over 12 years, when the facial bones of the skull are almost fully formed.

How to detect a deviated septum in a child?

A deviated septum can cause a child to:

Diagnosis of this pathology includes:

• An examination by an ENT doctor who will conduct a visual examination and rhinoscopy.
• Additional surveys. Sometimes a doctor to clarify the diagnosis may refer the child to an x-ray examination of the skull, magnetic resonance and computed tomography heads. These studies are conducted for children strictly according to indications.

What methods are used to treat a deviated septum in children?

1. Surgical intervention. The procedure for straightening the septum is called septoplasty and is performed after the complete formation of the bones of the skull, that is, at the age of 16 years and older. In exceptional cases, this operation can be performed in children older than 6 years. Modern methods of nasal septum correction include laser procedure, during which the laser reduces the volume of cartilaginous tissues and straightens the septum. This method has established itself as the least traumatic method with a quick postoperative recovery period and minimal undesirable consequences.
2. Drug therapy. In childhood, this pathology is corrected with the help of the following medicines aimed at improving respiratory function:

• glucocorticosteroids are used to eliminate allergic rhinitis;
• antibiotics are used to prevent bacterial infections;
• mucolytics are used to facilitate the removal of excess mucus;
• moisturizing sprays;
• vasoconstrictor drugs are used to reduce mucosal edema with a runny nose.

In order to facilitate breathing and the general condition of the child, it is necessary to monitor the climatic conditions in the room. The air should be moist and cool. It is also undesirable for the child to catch a cold, as this will aggravate the respiratory function, which is already difficult.

Opinions of specialists on the methods of treatment of a deviated nasal septum

ENT surgeon of the International Clinic MEDEM I.A. Tikhomirov:

I must say that there are a lot of myths around the topic of the curvature of the nasal septum. To begin with, there are no direct partitions. Everyone has this or that curvature, there is one or another crest of the septum. They operate only in the case when the function of nasal breathing is impaired. For example, a huge ridge on the septum, but it does not interfere with nasal breathing - nothing needs to be done. Or vice versa, a small but significant ridge (or curvature) that covers a narrow opening leading to maxillary sinus. Such a person suffers from sinusitis all the time - of course, this needs to be corrected. Another thing to consider is that the nasal septum grows throughout life. It consists of several parts, and different parts grow at different rates, so with age, the problems associated with its curvature may be more pronounced.

And finally, often difficult nasal breathing is not due to the fact that the nasal septum is curved. The fact is that a large contribution to the difficulty of nasal breathing is made by hypertrophy of the nasal conchas, when the tissues of the lower nasal conchas grow, the breathing lumen narrows and poor nasal breathing occurs. The man goes to the ENT, and he says that it's a crooked nasal septum. It is corrected, but the nose still does not begin to breathe. There are many such situations. And in this case, the excess part of the tissue can be removed with a laser. This can also be done under local anesthesia outpatient. The correction of the nasal septum must be approached very strictly: from the point of view of preserving the function (breathing or not breathing the nose), weighing the benefit-risk ratio and taking into account the age of the patient.

With regard to surgical intervention for an uneven septum (septoplasty), there are some limitations. So, up to 18 (and according to some authors - flight) they try not to perform septoplasty. This is due to the ongoing growth of bone and cartilage tissue, and sometimes it is impossible to predict how the operated septum will behave. However, with gross deformities of the septum, septoplasty can be recommended at any age. To what extent this intervention is indicated for your child, only the doctor can answer after a direct examination.

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One comment:

I think that the issue of treating a deviated septum is very important, since in Soviet times the military medical commission paid attention to this in young men of military age.

Two of my classmates with such a defect were sent for surgery before serving in the army - one was engaged in boxing, and the other had sinusitis.

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A deviated nasal septum in a child, as a rule, is not noticeable to anyone except his parents. Visually, this small cosmetic defect practically does not manifest itself in any way, but the consequences of such a curvature can be extremely dangerous. To correct such a pathology, septoplasty is performed; this operation does not have any specific contraindications.

The nasal septum in both children and adults should be even! A nasal septum deviated in childhood is not necessarily the result of a child falling out of a stroller or hitting his face against a crib, although there are such cases, and children's bones are fragile and may not grow together correctly. Quite often, the causes of the curvature of the nasal septum in a child are genetic.

Complications of congenital curvature of the nasal septum in a child

A predisposition to a deviated septum in a child may be hereditary. Therefore, if the parents have it twisted, then you should not be too lazy and show the baby to the ENT doctor.

Deviated nasal septum in a child It's not just a minor cosmetic defect. Such a deformation provokes the formation of many disorders in the body and has an extremely negative impact on the development of the child.

With the curvature of the nasal septum, there is a distortion in the blood supply to the nasal cavities and sinuses. Suppose, on the left, the air passes well, and on the right, stagnation occurs. This creates fertile ground for the development of inflammation of the nose and nasopharynx. A deformed septum may well be responsible for adenoiditis (inflammation of the adenoids) and increased adenoid vegetations. And then everything goes along the chain: proliferation of adenoid tissue - large adenoids cover the opening of the auditory tube in the nasopharynx - the child begins to hear poorly. But we can’t lose our hearing at least partially during the formation of voice and speech, it’s for life!

Unfortunately, the ratio “uneven septum equals hearing loss” is sometimes not at all obvious to parents, but it exists, and this bunch of conditions is very stable! In addition, when the septum is deviated, the maxillary and frontal sinuses are poorly ventilated, as a result, stagnation occurs: chronic sinusitis, sinusitis.

There is another vicious circle: when the nasal septum is deviated, it is difficult for the child to breathe through the nose, which means that he will begin to breathe through the mouth. As we have already found out, the mucus and cilia of the epithelium in the nose filter the air from dust and microbes, and then transport the caught “catch” to the outside. A healthy mucous membrane retains and separates 40-60% of dust, viruses and microorganisms from the incoming air.

Why is mouth breathing worse? It is not as deep and supplies the body with oxygen worse. Negative pressure from the chest, which should encourage the lungs to be well cleared of "exhaust" air, is reduced if the child breathes through the mouth instead of the nose. The lack of oxygen for a growing organism is not at all beneficial: the nervous, vascular, and hematopoietic systems suffer. When breathing through the mouth, the back wall of the pharynx dries up, and this makes the child prone to diseases such as pharyngitis and tonsillitis.

If the growth of bone and cartilage tissue is not synchronized and one overtakes the other, then traces of growth jerks - spikes and ridges may form on the nasal septum, which also disrupts free nasal breathing.

The third link: even a small congenital curvature of the nasal septum in a child affects the growth of the inferior turbinates, the large size of which is called one of the main causes of vasomotor neurovegetative rhinitis, or, more simply, chronic unexplained rhinitis.

There is a dependence of the frequent occurrence of headache with a deformed nasal septum: the curved part presses on the lateral, opposite wall, and the headache occurs reflexively.

A deviated septum often increases the susceptibility to nosebleeds.

“But there’s nothing that can be done about a deviated nasal septum, so why should we worry?” - such an opinion among parents is very popular. It comes from the fact that fixing a septum is stressful (yes, surgery, healing period), and it is possible to operate only after reaching a certain age. Prior to this, septoplasty (alignment of the septum) is performed according to strict indications (if the curvature interferes with nasal breathing so much that the brain experiences uncompensated hypoxia - serious oxygen starvation).

Although the formation and ossification of the nasal septum ends by the age of ten, it is necessary to perform septoplasty no earlier than sixteen or seventeen years, when the entire skull has formed, all areas of growth have ossified and taken shape.

Quite rightly, parents may have a question: “So why do you still need to find out about the curvature of the septum, say, in a year, if fifteen or sixteen years pass before you can operate?” Because this feature of the structure of the nose is the root cause of many consequences that spoil the life of a child for many years from an early age! Chronic inflammation of the mucous membrane of the nose and paranasal sinuses, mucus stagnation, poor oxygen supply to the brain affect everything - from appetite to attentiveness, perseverance, and the ability to learn. Undisturbed nasal breathing is very important when playing sports. Indeed, when swimming, running, jumping, acrobatics and dancing, rapid breathing in a certain rhythm is required.

It is very important for parents of children who have problems with the nose to know everything about the structure of this organ and the processes taking place in it. Information is needed to understand the scale of the problem: perhaps this is a slight curvature and it will be enough to regularly do breathing exercises, teach the child to blow his nose correctly, observe the level of humidity in the room, often walk in nature and provide oxygen to vital organs and systems, or maybe , you will have to periodically undergo a course of procedures and think about the operation.

Surgery for deviated septum (septoplasty)

It is important for parents to know that septoplasty- one-time operation. In the literal sense of the word. During the operation, peeling (or, as doctors say, separation) of the mucous membranes on both sides occurs. Also, the periosteum and perichondrium exfoliate from both sides - formations less than a sheet of paper thick, almost invisible, but having extremely great importance. Therefore, the excellent qualification of the surgeon is very important: if they are not peeled off correctly, then the nasal septum will receive less nutrition in the future, it will dry out, which is fraught with inflammatory or atrophic processes in the nose.

Then, during the operation, the bone and cartilage of the septum are isolated, after which the curved part is removed, straightened, and put in place. Further, all separated layers and the straightened nasal septum are fused.

So, if you repeat all this, there is a serious risk that the mucosa will tear, and the septum (already operated) will be perforated - it will lose its integrity, there will be a hole in it. That is why I urge parents not to rush with a septoplasty on a child until he reaches the right age. Of course, if there are no indications for its early implementation - for example, severe hypoxia.

Contraindications for surgical treatment of deviated nasal septum in children are approximately the same as for surgical interventions in general:

• disorders in the blood coagulation system, systemic blood diseases (hemophilia);
• diabetes;
• infectious diseases;
• tumors.

Let's talk about how to prepare for a septoplasty.

First of all, you need to get tested. It includes:

• consultation and examination of ENT organs by an otorhinolaryngologist;
• computed tomography (CT) of the paranasal sinuses;
• general and biochemical analysis blood;
• blood test for hepatitis B and C, HIV, syphilis;
• blood test for group and Rh factor;
• general urine analysis.

An important part of the examination program is a visit to the dentist. Before the operation, the doctor must check the condition of the gums and teeth and treat any problems, if any. The ENT doctor must provide a certificate from the dentist that there are no inflammatory processes in the oral cavity.

In the event that the operation will be performed under general anesthesia, it is necessary to take an x-ray of the nose.

Before the operation, all acute infectious diseases should be completely cured, and chronic ones should be put into remission.

Surgery should not be performed during the hot season: fever environment increases the risk of bleeding. Girls should be scheduled for surgery in the middle of the menstrual cycle.

What happens after the operation? Previously, many were afraid of septoplasty, because doctors used tampons in the form of long bandages. Such bandage tampons had to be worn for two or three days, and the patient could only breathe through his mouth. Now completely different means are used: tampons are made of a material similar in properties to polyurethane foam. It fills the entire nasal cavity, tamponing it well, but at the same time not exerting excessive pressure: the patient does not feel a strong swelling in the nose. And most importantly - through these tampons you can breathe through your nose! And you can take them out the next day after the operation.

An important point: the patient after the operation must stay in the hospital for two days. Do not go to clinics where they promise you that you can go home immediately after the operation. There is always a risk of bleeding, sometimes they are so strong that they begin to threaten not only health, but also life! That is why two days the patient should be under increased control.

What to do if bleeding occurs after discharge from the hospital? Before the operation, you should purchase a hemostatic sponge and hydrogen peroxide at the pharmacy. With the development of bleeding, it is necessary to cut a cone or triangle out of the sponge, moisten it in peroxide and insert it into the bleeding nostril, after which you need to urgently contact an ENT doctor!

Crusts also accumulate in the nasal cavity, which must be removed, but not on their own! Visit the otorhinolaryngologist as much as required, do not ignore this problem. The accumulation of crusts can provoke the appearance of synechia - fusion of the nasal septum with surrounding tissues. This defect in the future will require a new operation.

After surgery, the doctor may prescribe antihistamines to relieve swelling and oil drops to moisturize and nourish the nasal mucosa.

It is very important to say “no” to vasoconstrictor drops immediately after the operation. The nose must learn to breathe on its own. Of course, any surgical intervention reduces local immunity, which makes the nose vulnerable to infection. Sometimes bacterial complications develop, nasal congestion appears. In this case, you can not self-medicate, drip vasoconstrictor drops. Contact an ENT doctor. He will sanitize the nasal cavity and eliminate infectious inflammation.

It is good to place a humidifier and air purifier in the patient's room after the operation. Also, often ventilate the room, carry out wet cleaning in it daily.

For a month after surgery to eliminate the curvature of the nasal septum, the following restrictions are imposed on the child:

• Thermal procedures should be avoided: warming up the nose, visiting baths and saunas, taking hot baths.
• Swimming pools and water parks are not allowed.
• Weight lifting, sports are excluded.
• It is important to protect the child from coughing, sneezing or fever relatives. It is also better to skip school if there are several sick people in the class. During the period of epidemics of influenza and SARS, it is impossible to visit places of mass congestion of people.

If there are no complications, the otorhinolaryngologist should appear one month after the operation, and then visit him annually for preventive examination ENT organs.

If, with a curvature of the nasal septum, a child has a violation of nasal breathing, as well as chronic infection in the nasal cavity, the situation must be corrected surgically. Such an operation is less dangerous for the child than the consequences of a curvature.

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Alexandra asks:

Good afternoon! My child had a nose injury at the age of 2, as a result of which, from that age, he has very poor nasal breathing. Initially, the doctors did not make a diagnosis - a curvature, referring to teething, etc. Now my son is already 4 years old, nasal breathing is absent by 80 percent, we do not sleep at all at night. Doctors say that no one will undertake the operation before the age of 11-14. Tell me how to be in such a situation, surely there are ways to solve the problem? After all, a child cannot not breathe normally until 11 years old?

Responsible Bozhko Natalya Viktorovna:

Alexandra, how you can help your child can only be determined after an examination. In addition, an alternative opinion is never superfluous. Try to contact the ENT institute in Kyiv.

Tatyana asks:

Hello! The child has a deviated nasal septum, adenoids of the third degree and enlarged tonsils. The child has hearing loss against this background, frequent nasal congestion, snoring .. etc. adenoids. The child also has connective tissue dysplasia!! I would like to know if dysplasia can somehow influence the further development of the nasal septum.

Responsible Bozhko Natalya Viktorovna:

Good afternoon, Tatyana! Adenotomy (removal of adenoids) is performed at any age, if there are objective indications for this. As far as I can judge in the format of correspondence communication, in this case there really are such indications (persistent nasal breathing disorder, sleep disorder, hearing loss). With regard to surgical intervention for an uneven septum (septoplasty), there are some limitations. So, up to 18 (and according to some authors - up to 20-25 years), they try not to perform septoplasty. This is due to the ongoing growth of bone and cartilage tissue, and sometimes it is impossible to predict how the operated septum will behave. However, with gross deformities of the septum, septoplasty can be recommended at any age. To what extent this intervention is indicated for your child, only the doctor can answer after a direct examination. Connective tissue dysplasia implies mass pathological conditions varying degrees of severity, different morphological picture, different course and prognosis. So the question of flow postoperative period in the presence of this concomitant disease, it is better to decide with the doctor on an individual basis. All the best!

Natalia asks:

Hello. a 3.5-year-old child has a deviated nasal septum / difficult nasal breathing, the ENT said that the edema is due to the septum. They did a smear; no staphylococcus aureus was detected. how to remove swelling? Thanks.

Answers:

Good afternoon, Natalia! In order to fight edema, you need to know its nature. So, if it has an allergic genesis, then antiallergic treatment is appropriate here (consultation of an allergist is needed). If the mucosal edema is caused by vasomotor rhinitis (violation of the vascular innervation), then a completely different set of therapeutic measures will help. In addition, the inflammatory-infectious nature of the problem cannot be ruled out (the fact that staphylococcus was not detected is good, but there may be other pathogenic pathogens). It would also be worthwhile to clarify the degree of curvature of the nasal septum - it can also indirectly provoke swelling of the nose and dysfunction external respiration. And lastly, some common diseases organisms can contribute to the appearance of problems with the nose. This is, first of all, the presence of helminths, dysbacteriosis, diseases of the gastrointestinal tract, endocrine system, reduced immunity, etc.. Summarizing the above, I must say that you need to undergo a comprehensive and comprehensive examination of the body. And on the part of the ENT organs, it would be appropriate to conduct an endoscopic examination, a microbiological study and a nasocytogram. All the best!

Catherine asks:

Good afternoon. The child has a deviated nasal septum to the left side, from the age of 1.5, frequent runny noses, green discharge, breathes through the mouth, the ENT said that there are signs of adenoiditis, she said to be observed once a year. The son often suffers from bronchitis, laryngitis, and does not speak well words, in a dream he sniffles and snores. With all this, he also has allergic rhinitis. Every day we wash the nose with saline. Protargol was dripped.

Responsible Medical consultant of the health-ua.org portal:

Good afternoon, Catherine! It is possible to determine the need for surgical correction of the nasal septum only after a direct examination of the child. I must say that at the age of at least 16-18 years, such surgery is performed very rarely and only in exceptional cases. This is due to the fact that intensive growth of cartilage and bone tissue continues in children, which can further aggravate the septal defect. But if the curvature is pronounced and makes it impossible to carry out the natural act of breathing through the nose (which in turn leads to a number of complications: otitis media, sinusitis, apnea syndrome, etc.), then as an exception, septoplasty can be performed at an earlier age. Such a gross deformation of the septum is actually not so common. In your situation, first of all, I would rule out adenoiditis and / or adenoid hypertrophy. In addition, it is necessary to consult with an allergist and receive appropriate anti-allergic therapy. The question of the connection of an uneven septum with an existing pathology can only be determined by a specialist. All the best!

Karina asks:

Tell me, please, my son is 2 years 6 months old, he has a deviated nasal septum. Constantly purulent angina. At what age can it be corrected and where? We are from Irkutsk.

Responsible Medical consultant of the health-ua.org portal:

Good afternoon Karina! Operations to correct a defect in the structure of the nasal septum in the vast majority of cases are carried out after 16-18 years. Such age limit due to the cessation of the main growth of bone and cartilage tissue (and according to some studies, such surgical interventions should be performed only after 25 years). But this postulate is not an axiom at all - in cases where the curvature is significant and sharply disrupts nasal breathing, then septoplasty is performed at any age (and at two years too). To determine whether the child in this particular case needs an operation right now, only a specialist after a direct examination can. Therefore, make an appointment with an otolaryngologist and go through a thorough examination - so you will determine whether it is advisable to carry out surgery on the baby now. And finally, this type of operation is performed in almost every ENT department, equipped with an operating room and the necessary anesthetic equipment. Contact your local hospital first. All the best!

Olesya asks:

My son, six years old, had a deviated septum damaged in the maternity hospital, while cleaning his nose, he didn’t notice right away, now he has difficulty breathing, snoring during sleep and breathes through his mouth all the time, he often gets sick with ENT diseases, can this be corrected at an early age? We were told that we had to wait 16 years and now the operation costs 40 thousand rubles! Is it possible to find a less expensive clinic in our region? We live in the Chelyabinsk region, Satka.

Responsible Medical consultant of the health-ua.org portal:

Good afternoon! Indeed, the gold standard for nasal septum alignment surgery (septoplasty) is 16 or even 18 years of age. This is due to the fact that it is by this period of life that the tissues that form the skeleton of the nose (bone and cartilage) stop growing. If the operation is performed before the age of 16, then with the continued growth of bone and cartilage, it is quite difficult to predict the consequences. But it must be said that there are exceptions to the rule. So, septoplasty is performed at an earlier age if: the curvature is quite pronounced and greatly interferes with nasal breathing, contributes to the appearance of other diseases (otitis media, etc.), leads to deformation, as well as in case of acute traumatic injuries. Only a specialist can make a conclusion about the need to perform the operation at your age after examination and a series of additional methods studies (rhinopneumomanometry, tympanometry, etc.). Seek qualified assistance in the regional center. All the best!

Anna asks:

After a year, we noticed that the tip of the nose was shifted to the right side of the child, as a result of which, he often has a runny nose. Tell me, please, what to do in our case? Where can I apply in Uzhgorod or in the nearest cities of Ukraine? Thank you in advance.

Responsible Medical consultant of the health-ua.org portal:

Good afternoon! Violations of the anatomical structure of the nose can indeed be a provoking factor for many diseases ( chronic rhinitis, ethmoiditis, sinusitis, otitis media, apnea syndrome, oxygen deficiency, etc.). The question here is whether a particular existing defect in a child causes a violation of nasal breathing or not. It is quite possible to determine this. To do this, you must undergo a routine ENT examination and perform rhinoflowmetry. The question of expediency plastic surgery and alignment of the tip of the nose in a child of 2.5 years is very controversial. As a rule, such interventions are carried out after the end of growth and formation of the facial skeleton (at least after 16 years). If the operation is performed earlier, the continued growth of tissue can lead to even more deformity of the nose. In any case, the question of treatment tactics in this case should be decided strictly on an individual basis. Seek advice from a specialist in the regional medical center. All the best!

Asks Vlolodya:

Good afternoon, my name is Vladimir. I am 16 years old, at the age of 8 I fell off a swing, as a result of which I got a deviated nasal septum. what kind of anesthesia does the operation take? How long does it take? What is the cost? The rehabilitation period?

Responsible Medical consultant of the health-ua.org portal:

Hello Vladimir! A deviated septum with free nasal breathing does not preclude military service. If nasal breathing is impaired (which is confirmed by special studies), upon initial military registration, the conscript is sent to the ENT hospital for examination and treatment (including for surgical treatment deviated nasal septum). The operation to correct the nasal septum is performed under general anesthesia, the duration of the operation is not limited, it depends on many factors - the more complex the pathology, the longer the operation takes. The duration of rehabilitation depends on how difficult the operation will be, the presence or absence of complications. A face-to-face consultation with an ENT doctor will help determine the degree of complexity of the situation, the presence of concomitant diseases of the ENT organs and give answers to all your questions. Take care of your health!

Elena asks:

Hello, my son is 3 years and 7 months old. , he constantly grunts his nose and snores in his sleep, and sometimes it seems to me that he even hears badly, respectively, he speaks badly, at the ENT appointment he diagnoses congenital nose bridge, swelling of the entire nasopharynx. He prescribes nasal drops Nasonek Sinus and strongly recommends surgical intervention. Is it possible to do this for children at this age?? or can we get by with treatment? Please advise what we should do. Thank you!

Responsible Medical consultant of the health-ua.org portal:

Good afternoon! The curvature of the nasal septum can indeed lead to a pronounced violation of nasal breathing, the development of otitis media and hearing loss. The ideal age criterion for septum alignment surgery is after 16-18 years of age, since it is during this period that the facial skeleton completes its formation. Otherwise, it is quite difficult to predict the shape of the nasal septum after surgery with continued growth of bone and cartilage. But there are situations when an uneven nasal septum causes the development of various complications (otitis media, hearing loss, lack of nasal breathing, sinusitis, etc.), in which case septoplasty is performed at any age. Seek a full-time consultation with a specialist - he will be able to correctly determine the "guilt" of the curved septum in the genesis of the development of otitis media and other pathologies. And if the causal relationship is proven, but do not waste time - agree to the operation. All the best!

Dmitry asks:

Hello! I am 12 years old. I have a deviated nasal septum. I want to enter the Suvorov Lyceum. The doctor said that I need to do an operation if I want to enroll. I'm a little scared. How long does the operation take and how long will I stay in the hospital? I want to have an operation in Dnepropetrovsk. Where is the clinic located and if possible a phone number?

Responsible Yavorsky Lubomir Antonovich:

Hello, Dmitry It is not entirely clear what clinic you are asking about and who you need the phone number of. Operations on the nasal septum are performed in all state ENT hospitals and in private clinics. If you take the city of Dnepropetrovsk, then there are dozens of clinics. To begin with, you need Dmitry and his parents to visit one of the clinics where there is an ENT doctor. As for the duration of the operation, everything here depends on the volume of the curvature of the septum and the method of the operation itself. To date, there are two main methods of how such an operation is performed 1. Classical submucosal resection of the nasal septum (with the removal of a curved section of the septum) 2. Endoscopic correction of the septum with a laser is the most modern method with many advantages and a minimum of disadvantages (in more detail this technique is presented on the website www.doctorlor.com section "Curvature of the nasal septum.)

Julia asks:

Good afternoon, please tell me a month ago, a child had an operation to remove adenoids (a child of 5 years old), at first the nose was clogged, over time one nostril began to breathe, and the second one was clogged and snot from it, were today at the doctor, he said that after the operation everything normal, but one nostril does not breathe because the septum is curved ((and that’s all, I didn’t advise anything else. Please tell me what should we do now? Wait or surgery is necessary again. Thank you.

Responsible Bozhko Natalya Viktorovna:

Good afternoon Julia! The curvature of the nasal septum can indeed cause a violation of nasal breathing. In this case, the only treatment is surgical correction (septoplasty). True, such operations in childhood are performed extremely rarely. The fact is that the final formation of the osteochondral skeleton occurs by the age of 18-20 (and according to some authors - 25 years) and it is simply impossible to predict the growth of an already operated septum. In other words, by correcting the defect now, no one will guarantee that in 1-2-3 years the partition will be even. And only in rare cases (in the absence of nasal breathing, pronounced apnea syndrome, constantly recurrent otitis media and sinusitis), septoplasty is performed at any age. Discuss with the attending doctor how compensated the function of nasal breathing is in this particular case, and whether the child needs surgical treatment right now. All the best!

Gulya asks:

Hello! I am 15 years old. For 5 years now I have been laying my ears. This happens after a runny nose. right ear. And this year I had a runny nose and pain in both ears. I went to many doctors and they said that the deviated septum in the nose and therefore laying the ears, of course, everyone advised the operation, since then it will lead to a weak memory and will interfere with learning lessons. Until now, I don’t know what to do, I’m afraid of the operation, but I also want to have a plastic nose a little long, what would you advise? Many thanks in advance to all

Responsible Medical consultant of the health-ua.org portal:

Hello! An uneven nasal septum can indeed cause many diseases - this primarily concerns pathological changes in the ears, paranasal sinuses, as well as the development of a general hypoxic syndrome. Treatment, as you noticed - one thing - surgery. Judging by your complaints, the appointment of septoplasty (surgery to straighten the nasal septum) is fully justified. However, pay attention to this nuance - this type of operation is performed with rare exceptions at the age of at least 16-18 years. This is due to the end of the processes of growth and formation of bone and cartilage tissue. And lastly, regarding the dissatisfaction with the long nose. This anatomical feature the structure has nothing to do with an uneven partition. If you want to correct the external shape of the nose, then such an operation is called plastic surgery and is also performed at the age of at least 18 years (preferably over 25). All the best!

The nasal septum is a bone-cartilaginous plate that divides the nasal cavity into two halves. Septal curvature is a change in the shape of this plate, in which it deviates from the median position.

Why does the nasal septum deviate

This can happen for two reasons:

1. the result of a nose injury. Any mechanical impact (impact, compression) can cause displacement of the nasal septum;
2. congenital change of the septum; when the bones of the skull ossify, a bony ring is formed (like a hole in the nose of the skull on a pirate flag), and the nasal septum continues to grow.

What is dangerous curved septum

First of all, the curvature disrupts nasal breathing. Thus, the nose ceases to perform its functions:

• warm, humidify the air, that is, prepare it for entry into the lower respiratory tract;
• stand as an outpost on the path of infection, since the nasal mucosa is saturated with substances and cells that fight infection.

With impaired nasal breathing, a person begins to breathe through his mouth, and unprepared, unpurified air enters the throat along with bacteria, causing various respiratory diseases.