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What is a DNS [Deviated Nasal Septum]?

Discussion in 'Otolaryngology' started by John Jossef, Mar 25, 2011.

  1. John Jossef

    John Jossef Bronze Member

    Mar 21, 2011
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    What is the Nasal Septum?
    The nasal septum is a composite plate like structure made up of membrane,bone and cartilage.The nasal septum divides the two halves of the nose into right and left nasal cavities.

    What is a DNS or Deviated Nasal Septum?
    If the nasal septum which is ideally central, is deviated to one side or the other ,ENT Specialists refer to this as a deviated nasal septum or DNS for short.

    Why does a DNS occur?
    This is a question very commonly asked by my patients.
    A DNS can be developmental in origin - it can bend over timeor the cause may be trauma such as a hit or an accident.

    What are the types of DNS?
    ENT Doctors describe a deviated septum based on the shape of the devaition,parts of the septum deviated and location of the deviation.So you may be having:
    A C shaped deviation-Here the septumis bent in a C shaped manner producing narrowing of the airway onone side
    S shaped deviation- produces airway narrowingin both the nasl cavities and can make the person prone to become symptomatic easily
    A bony, cartilaginous or mixed type deviation
    A high DNS[ upper part of the septumis deviated and this may even be associated with external nose shape deviation which can be noticeable to the patient and others fromt he outside]
    A caudal dislocation[front most part is deviated]- often a smart patient comes to me after noticing the deviationof the septum in the mirror! Many a times such cases of DNS are caudal deviations and can be self diagnosed by lifting up the tip of the nose and looking in the mirror to see if any part of the nasl septum is protruding into the nasal cavity on one side and narrowing the airway on one side!
    The photo shown is a patient with significant caudal dislocation of the nasal septum

    Will my DNS create problems for me?
    Not everyone with a deviated nasal seputm has symptoms due to it.Whether a deviated nasal septum will create problems depends on:-
    Severity of the deviation
    presence of additional Turbinate hypertrophy narrowing the nasal cavities further
    Shape of the deviation
    Allergic tendency- if you have allergic rhinits then the nasl septal deviation can contribute significantly to the problem and correcting the deviation can help the nasal obstruction symptoms to a certain extent depending on the individual case.

    What are the problems caused by a deviated nasal septum?
    A DNS can cause a variety of problems for an individual.The symptoms need not be present all the time and can develop any time in due course.
    Nasal Block
    Nasal discharge
    Nose bleeds
    Post nasal discharge[PND]- secretions dripping into the throat fromt the back of the nose
    Mouth breathing
    Taste and Smell abnormalities
    Sleep Apnoea
    Dry mouth
    Recurrent Throat infections- from abnormal drainage of secretions into the throat and mouth breathing
    Recurrent Sinusitis
    Recurrent Upper Respiratory Infections
    Ear problems- by affecting the eusatchian tube connecting the ears and the back of the nose.

    What is the treatment for a deviated nasal septum?
    Treatment is tailored based on:-
    Severity of the DNS
    Symptoms of the patient
    Age of the patient
    Presence of additional conditions in the nose:
    Turbinate hypertrophy
    Concha bullosa
    Chronic Sinusitis
    Allergic boggy mucosa
    Nasal polyps
    A nasal endoscopy is a prerequisite for any treatment decisiona as it gives a direct visualisation of the nooks and crannies of the nose, the levels of nasal obstruction andthe precise location of the abnormal septal deviation.Your ENT Surgeon will perform a nasl endocopy and discuss the treatment options with you.
    Someimes an additional CT scan is required to further evaluate the sinuses and tailor the managament of an individual patient.
    Treatment options are broadly divided into Conservative medical management and Surgical management

    What is the Surgery for the Nasal Septum Deviation?
    The Surgery for a nasal septal deviation is a Nasal Septal Procedure.There are a variety of nasal procedures done in a patient with nasal septal deviation depending on the individual case.Dr Sonia will discuss which is best suited for you.
    Conventional Septoplasty
    Nasal Spurectomy
    Endoscopic Septoplasty
    Endoscopic Septoplasty + Endoscopic Sinus Surgery
    Endoscopic Septoplasty + Turbinate Procedure
    Endsocopic Septoplasty + FEELS [Functional endocospic endonasal LASER Surgery]
    Septorhinoplasty [ correction of the external shape as well
    Surgery may be performed under local anaesthesia or general anaesthesia.Dr Sonia prefers to use general anaesthesia in majority of the cases as it gives optimum comfort to the patient.The patient is completely asleep during the procedure and there will be no pain during the surgery at all in general anesthesia.

    When can I go home after the procedure?
    Generally speaking you can go home the same day or the next day depending on the individual situation.

    Will there be a scar on my nose after the surgery?
    The surgery is done through the inside of the nose and there will be no scar or stitches on the face or outer part of the nose.

    By : Dr Sonia Suprabha Venugopal

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