Deviated nasal septum
Introduction
Introduction to nasal septum deviation Deviationofnasalseptum refers to an intranasal malformation in which the nasal septum deviates from the midline and causes clinical symptoms. In fact, most people have different degrees of deviation in the nasal septum, but whether it causes nasal symptoms often depends on the following factors: 1 degree and form of deflection, if some are obvious local protrusion, the part is in the nasal valve area; 2 gasification of the nasal bone; 3 bones of the outer edge of the pear-shaped hole or the cartilage of the nasal valve area are abnormal. basic knowledge The proportion of illness: 0.34% Susceptible people: no special people Mode of infection: non-infectious Complications: perforation of the nasal septum nasal septum hematoma nasal septum abscess
Cause
Cause of nasal septum deviation
1. Traumatic trauma is the most common cause of nasal septum deviation. When a nasal bone fracture occurs in a trauma, the dislocation of the septal cartilage often occurs, and even the cartilage fracture, if not timely reset, can leave the septum deviation, the birth canal stenosis Or due to improper clamping of the forceps, can also cause septal cartilage deflection, dislocation, Gray in the 2095 cases of normal delivery found that the nasal septum deviation accounted for 4%, but in the final stage of delivery for more than 15 minutes, the nasal septum deviation rate can be Up to 13%, and that one-third of the dislocation of the nasal septum occurred when the fetal head was rotated in the pelvis, Sooknumlun (1986) reported that among 201 neonates, 31 had septal deviation, accounting for 15.4%.
2. Pediatric adenoid swelling affects nasal ventilation, open mouth breathing compensation, long-term can cause maxillofacial bone developmental deformity, hard sacral high arch, the result is the bottom of the nasal cavity, gradually making the septum in a deflected state.
3. The growth of the nasal septum is not uniform or deformed, and the deformity is easy to occur at the junction of each part.
Prevention
Nasal septum deviation prevention
1. The main focus of prevention is to prevent external injuries to the nose:
2. After the orthopedic surgery, the nasal mucus can be removed within 24-48 hours after surgery, and the right side can be pumped first, and the other side can be pumped the next day;
3. If the incision heals well, the stuffing can be removed 5 days after surgery.
Complication
Nasal septal deviation Complications nasal septum perforation nasal septum hematoma nasal septum abscess
1. Nasal septal perforation: more than 1 occurs when the soft tissue is peeled off during surgery, because the action is rough, causing bilateral rupture on the bilateral part; 2 when the nasal mucosa has infectious inflammation, even if the unilateral tear can cause perforation; 3 nasal septum two When the lateral soft tissue is not adequately separated, even if the cartilage or bone is removed, the soft tissue is easily torn. If the bilateral side is torn, the removed cartilage piece can be placed between the two sides of the gap, and a "U" shaped plastic piece is placed on both sides. The surface of the rupture is used for protection, and then the Vaseline oil gauze is filled with uniform pressure on both sides, and finally the plastic piece is carefully taken out.
2. Nasal septum hematoma: caused by hemorrhage between the septal and perforating of the nasal septum. If the nasal septum is found after the nasal cavity is removed, the semi-circular bulge is found on both sides of the nasal septum. The texture is soft, and the patient complains of nasal congestion. Although the ephedrine saline does not improve. Small hematoma can be absorbed by itself, and a large hematoma must be treated.
3. Nasal septum abscess: caused by bacterial infection of the nasal septum hematoma, improper timing of surgery, in the intranasal infection period or when there are more purulent secretions, can cause infection from the incision.
4. Collapse of the bridge of the nose: Most of the nasal bridge is removed due to the removal of the septal cartilage during the operation. If the nasal septum abscess is not properly treated in time, the cartilage is softened and necrotic, and such deformity can also occur.
5. Intracranial complications: rare, nasal septum abscess or sieve plate damage, can increase the chance of intracranial infection.
Symptom
Symptoms of nasal septum deviation Common symptoms Nasal septum to one side or... Nasal nasal congestion Nasal hearing loss Nose bleeding
Generally, it can be diagnosed by nasal examination, but it must be differentiated from the nasal septum nodules. The latter occurs in the middle mesothelial position. It is a protrusion formed by the localized hypertrophy of the septum. It is touched by the probe and has a soft texture. The formation of septal nodules is related to the chronic stimulation of purulent nasal discharge. Another rare case is septal syphilis, which is also hard in texture, but the mucosa is obviously congested.
Depending on the degree and location of the deviation, the following symptoms may be observed:
Nasal congestion
This is the most common symptom of nasal septum deviation, mostly persistent nasal congestion, such as one side of the unilateral nasal congestion, if the septum is "S"-shaped deflection is bilateral nasal congestion.
2. Booger
The mucosa of the deflected protrusion is thin and brittle, stimulated by the inhaled airflow, and may cause irritative inflammation and nosebleeds over a long period of time. This type of bleeding is mostly small, and the position of the deflection is mostly in the anterior part of the septum.
3. Reflex headache
If the deflected part is located in the middle turbinate or the inferior turbinate, and even in contact with the turbinate, it often causes ipsilateral headache, and can also be one of the causes of nasal neuralgia. After intranasal drip with vasoconstrictor or nasal mucosal surface anesthesia, Headaches can be alleviated or disappeared.
4. Near structural involvement symptoms
If the septum is located in the middle nasal passage, the middle turbinate is corresponding to the compression, and the middle turbinate is moved or the middle turbinate is over-vaporized, and the mucosa is hypertrophied, which can hinder the sinus drainage in the middle nasal passage. Induces sinusitis and produces various symptoms.
Late Low (1993) by tympanometry in 40 patients with nasal septum caused by nasal septum pressure, found that the middle ear pressure of the nasal plug side decreased significantly, the middle ear pressure increased after the correction of the septum deviation, in the clinical patients often appear as a single Side ear boring or hearing loss.
5. Vascular motor rhinitis aggravation
If the deviation is corrected, the symptoms of rhinitis are significantly alleviated, and some people have called this type of rhinitis "structural rhinitis."
Examine
Examination of nasal septum deviation
It is easy to diagnose the deviation of the septal cartilage in the nasal septum. The high or posterior segmental deviation is easy to be neglected. The disease must be differentiated from the mucosal hypertrophy of the nasal septum. The probe is touched. The latter is soft and easy to be pressed into a small concave. The nasal septum can be seen during the examination. The various types of deflection are classified according to the form of deviation, and there are "C" type, "S" type, and distance protrusion, etc., according to the classification of the deviation, there are high, low, front and back.
Diagnosis
Diagnosis and differentiation of nasal septum deviation
diagnosis
It can be diagnosed by a nasal examination.
Differential diagnosis
However, it must be differentiated from the nasal septum nodules, which occurs in the middle mesothelial region of the middle mesothelial, which is a protrusion formed by the localized hypertrophy of the septum. It is touched by the probe, soft in texture, formation of septum nodules and purulent nasal discharge. Related to chronic irritation, another rare case is septal syphilis, which is also hard in texture, but the mucosa is obviously congested.
