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A Singaporean ENT Surgeon Explains The Treatment Options For A Deviated Septum

The face is a fragile part of the human anatomy. It accounts for many of our senses and is made up of a structure of soft tissues as well as meticulous alignments.

It should come as no surprise then that when people suffer from symmetrical deficiencies, these can compromise functionality in seeing, hearing, tasting or even breathing.

One such issue is a deviated septum. It results in symptoms like difficulty breathing and one side of the nose being more congested than the other. 

Generally, most patients are able to manage this condition successfully by using nasal steroids, oral or topical decongestants. [1]

nasal steroids

Nose drops, nasal spray, oral spray, pills, tablets and capsules

However, these medications will not be able to completely fix a deviated septum. It's a structural problem that can only be corrected with surgery. Thus, in more severe cases, patients have to get it repaired with Septoplasty. 

Dr Valerie Tay, a consultant with the Otolaryngology department in Tan Tock Seng Hospital (TTSH), leads the Facial Plastic Surgery service and has considerable experience in the Ear, Nose, Throat (ENT) department.

She answered some common questions DxD readers had regarding deviated septum symptoms and solutions. Here's what you should know.

So, what is a deviated septum?

deviated septum

The nasal septum is the cartilage and bone that divides the nostrils. When we say that someone has a deviated septum, it means that the wall inside the nostrils is not aligned properly. 

Most people have some form of imbalance in the size of their breathing passages. However, only the more severe cases are considered a problem.

Symptoms include difficulty breathing

Primarily, symptoms of a deviated septum involve difficulty breathing, since the severe misalignment of the wall that divides the left and the right side of the nose can cause poorer airflow on the side that's experiencing deviation.  [2]

It's diagnosed through the use of a video nasoendoscopy

ENT office singapore - endoscope close up

ENT office; a close up of an endoscope

ENT surgeons use a video nasoendoscopy (nose scope) to assess underlying structures of a deviated septum.

nasoendoscopy singapore

Sometimes, the deviation can be obvious but there are cases where it can only be visibly identified by ENT specialists with video nasoendoscopy in their clinics.

Septoplasty and Rhinoplasty can be performed to treat the condition

septoplasty

A septoplasty is carried out to fix the deviated nasal septum without altering the appearance of the nose. It simply aims to improve breathing functionality or any nasal obstructions. 

rhinoplasty singapore

On the other hand, rhinoplasty is performed to change the external appearance and shape of the nose.

Your doctor will decide if you need one or both procedures 

In the cases where the deviated septum is mainly "internal", there is no need to perform rhinoplasty at the same time to correct the shape of the nose. 

However, if the external nose has deviated as well, then the combined Septorhinoplasty procedure would be medically necessary.

Septorhinoplasty can be functional or cosmetic, this will depend on the assessment by your surgeon at the time of consultation.

A septoplasty is in direct response to frequent nasal obstruction

deviated septum symptoms

If a patient is experiencing frequent nasal obstruction and the condition can't be managed via medication, then a septoplasty will be suggested by the specialist.

If left untreated, symptoms can persist and possibly worsen

Obstructive sleep apnea singapore

If a deviated nasal septum isn't treated soon enough, symptoms can persist and possibly lead to more detrimental conditions.

In the situation where it's part of obstructive sleep apnoea (OSA), long term complications like high blood pressure, heart problems and an increased risk of stroke may develop.

Septoplasty surgery can lead to better breathing and other benefits

Since a septoplasty works to open up space in the nasal passages, the operation lets patients breathe better and retain more oxygen, which in turn leads to better sleep and an overall boost in energy. [3]

Rhinoplasty revisions are performed 6-12 months after surgery

nose surgery

Sometimes, patients aren't happy with the initial rhinoplasty results and want to undergo corrective measures. In such cases, most revisions should take place at least 6-12 months after the initial surgery in order to allow time for the swelling to subside.

However, earlier revisions are possible

Earlier revisions are possible for slippage/migration grafts or implants as well as nasal bones that are asymmetrical but it's best to go for a formal medical consultation first.

Conclusion

A deviated septum can be a problematic condition to manage, however, with proper treatment and consultation it isn't impossible.

Consider septoplasty and rhinoplasty surgery if you are seeking out effective corrective measures.

Reach out to your specialist for advice in order to get help resolving the issue once and for all. Don’t wait until things get worse!

Article medically reviewed by Dr Valerie Tay


References: 

 1. Nasal obstruction is a common complaint of many patients in the primary care sector. Tan Tock Seng Hospital. 

 2. Shiva Regmi. Analysis of Symptoms and Types of Deviated Nasal Septum- A Clinical Study. International Journal of Research in Health and Allied Sciences. February 2018. 

 3. C. Parrilla. et al. The role of septal surgery in cosmetic rhinoplasty. Acta Otorhinolaryngol Ital. June 2013.

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