Can a deviated nasal septum be left untreated without surgery?

Written by Li Mao Cai
Otolaryngology
Updated on September 28, 2024
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Whether or not surgery is needed for a deviated nasal septum ultimately depends on the individual's specific symptoms and the extent of the deviation. This condition, which is a very common congenital developmental abnormality, can also be caused by postnatal trauma. Deviations are very common in the human body, but not everyone requires surgery.

The diagnosis of a deviated nasal septum mainly considers whether the extent of the deviation affects function or appearance, that is, whether it causes pathological changes. If the nasal septum deviation does not cause functional changes or affect appearance, then surgery is not necessary.

If it causes nasal congestion or leads to complications such as rhinitis or sinusitis, or affects appearance, then surgical treatment should be considered. Therefore, whether surgery is needed for a deviated nasal septum should be based on the severity and the presence of related clinical symptoms.

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How to treat enlarged turbinates and a deviated nasal septum?

For the condition of enlarged turbinates and a deviated nasal septum, we need to understand that these are pathological changes in the anatomical structure of the nose. In dealing with anomalies in the anatomical structure, our first step should be to perform a CT scan, then assess the extent of the enlargement of the turbinates and the deviation of the nasal septum. If the condition is severe, and there are relatively prominent symptoms such as nasal congestion, nosebleeds, and even headaches, then we should consider correcting these abnormal structures surgically, by removing these anomalies or correcting the deviated nasal septum or addressing the factors causing the turbinate hypertrophy. If there are no significant symptoms or only minor deviation or enlargement, treatment usually involves medication, primarily nasal sprays such as intranasal corticosteroids. In summary, there are mainly two treatment methods: surgical and medical treatments.

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Can a deviated nasal septum cause nosebleeds?

Deviated nasal septum refers to the fracture of the cartilage of the nasal septum, deviating toward one or both nasal cavities. Patients with a deviated nasal septum are prone to bleeding, and this bleeding tends to recur. This is because after the cartilage of the nasal septum deviates toward one side of the nasal cavity, continuous breathing causes the airflow to rub against the protruding nasal mucosal tissue of the deviated side. Additionally, after the deviation, the nasal mucosal tissue itself becomes thinner. Under these conditions, the thinner mucosal tissue at the deviated part is more likely to rupture and get damaged, making it prone to erosion and bleeding, and the blood vessels are also more likely to rupture, leading to bleeding. In summary, a deviated nasal septum can lead to nosebleeds.

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Can a deviated septum be detected by a CT scan?

A CT scan can detect a deviated nasal septum, which is a common and frequently occurring condition in otolaryngology, typically due to abnormal development of the nasal septum during the embryonic stage or from trauma or pressure from nasal tumors. When the nasal septum is deviated, it can cause persistent nasal congestion on both sides, as well as facial swelling, headaches, and may also lead to sinusitis or nasal polyps. Diagnosis can be confirmed with an endoscopic examination using an electronic nasal endoscope and a sinus CT scan at the hospital. If the deviation of the nasal septum is severe and accompanied by nasal congestion and headaches, surgical correction of the deviated septum may be necessary to completely resolve the symptoms.

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Do deviated nasal septum and enlarged turbinates require surgery?

Whether surgery is needed for a deviated nasal septum and enlarged turbinates should be determined based on the following aspects. First, it depends on whether there are clinical symptoms, such as nasal congestion, and particularly if it is severe and persistent, and whether symptoms like nosebleeds and headaches are present. Symptoms are a necessity before considering surgery; Second, some tests can be conducted, such as a sinus CT scan, to assess the extent of turbinate enlargement and the severity of the nasal septum deviation. If the deviation of the nasal septum is severe, then surgery is absolutely necessary; Third, some tests related to nasal cavity function can be combined to determine the necessity for surgery. The main function of the nasal cavity refers to its ventilation capability, such as the nasopharyngeal reflex and nasal resistance tests. An overall assessment of the impact of enlarged turbinates and the deviated septum on the nasal cavity can then guide the decision on whether to undergo surgical treatment.

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How to correct a deviated nasal septum?

Currently, the correction of a deviated nasal septum is mainly done through surgery. However, for some patients, if the deviation is mild and without symptoms, surgery may not be necessary. Surgery for deviated nasal septum is considered only if the deviation is severe and accompanied by significant clinical symptoms. Presently, minimally invasive surgery under endoscopy, which may involve partial removal of cartilage or septal cartilage reshaping, is a common procedure in otolaryngology. The results are generally reliable and, although there are risks, they are not considered excessively high. Typically, tertiary hospitals with an otolaryngology department can perform this surgery.