Nosebleed, stuffy nose, shortness of breath? Beware of deviated nasal septum!

Ms. Xu, 37, has had frequent nose bleeding and nocturnal nasal congestion in the past month. The symptoms are aggravated when lying flat, and the mucus flows back into the throat, causing her to wake up repeatedly at night, affecting her sleep. She thought it was just a common cold and did not pay much attention to it. Recently, her symptoms worsened, so she went to the Department of Otolaryngology of Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine) for treatment. Nasal endoscopy showed that she had a deviated nasal septum.

1. What is a deviated nasal septum and why does it cause nosebleeds?

Dr. Zhong Changying from the Department of Otolaryngology at the Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine) introduced that the nasal septum is a thin wall inside the nasal cavity, dividing the human nasal cavity into two left and right channels. Its surface is covered by nasal mucosa. Under normal circumstances, the nasal septum is upright and located in the center of the nasal cavity. When the nasal septum deviates to one or both sides, or bulges partially on one or both sides, causing deformity of the nasal structure, we call it a deviated nasal septum.

When the deviation of the nasal septum occurs near the bony ridge, bony spine or on the convex surface of the deviation, the mucosa here is thinner and the direction of air flow often changes, causing the nasal mucosa to become dry, which can easily lead to blood vessel rupture and cause bleeding in the nasal cavity.

2. Why does the nasal septum deviate? What are the symptoms?

There are two main causes of a deviated nasal septum:

One is developmental abnormality . The nasal septum is composed of hard bones and cartilage. During the development process, when the bones and cartilages in the nasal septum develop unbalancedly, it can lead to nasal septum deviation.

The second is trauma , such as nasal bone fracture, which may cause dislocation and deformation of the nasal septum cartilage, thereby causing nasal septum deviation.

The main symptoms are:

1. Nasal congestion, runny nose, and difficulty breathing: A deviated nasal septum may cause blockage of one or both nostrils, leading to difficulty breathing and causing nasal congestion and runny nose;

2. Dizziness and headache: When the deviated nasal septum presses on the ipsilateral turbinate, it will cause ipsilateral reflex headache;

3. Nosebleed: It is also one of the most common complications;

4. Symptoms of adjacent organs: When the deviated nasal septum hinders sinus drainage, sinusitis will occur; if it affects the ventilation of the Eustachian tube, it is more likely to cause otitis media and tinnitus.

3. Does nasal septum deviation require surgery?

According to Dr. Peng Bo, director of the Department of Otolaryngology at the Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine) , surgical treatment is the most effective way to cure nasal septum deviation, but not all patients with nasal septum deviation require surgical treatment.

In fact, very few people have a completely centered nasal septum. Most people have a slightly deviated nasal septum, but without obvious clinical symptoms. This phenomenon is also called physiological nasal septum deviation and does not require special treatment.

When obvious clinical symptoms appear, patients should seek medical attention immediately. Clinically, appropriate surgical treatment can be performed according to the severity and shape of the deviation. Classic surgical treatments include: submucosal septum resection, septoplasty, local septum correction, three-line septum tension reduction, etc., which can correct the deviated nasal septum and preserve the nasal septum cartilage as much as possible.

4. What should you pay attention to after nasal septum deviation surgery?

1. Generally, you can raise the head of the bed appropriately 6 hours after the operation, open your mouth to breathe appropriately, avoid sneezing, and try to let the air enter and exit from the mouth. A small amount of bleeding in the nasal cavity after the operation is normal and generally does not require special treatment.

2. Avoid eating spicy and irritating foods after surgery, and increase the supplementation of vegetables, fruits and other vitamin-rich foods.

3. Rinse your mouth regularly and encourage patients to drink small amounts of water frequently to maintain oral moisture, avoid dry throat and coughing symptoms, and ensure oral cleanliness.

Dr. Peng Bo, director of the Department of Otolaryngology at the Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine), kindly reminds everyone that the treatment method for patients with deviated nasal septum is mainly minimally invasive surgical correction under nasal endoscopy. This surgical method has the advantages of short operation time, few complications, less pain for patients, and quick recovery.

When obvious symptoms appear, timely surgical treatment is required, and Chinese medicine nasal irrigation can be used as an auxiliary treatment after surgery. Chinese medicine is good, Western medicine is good, and the combination of Chinese and Western medicine is even better. The coordinated treatment of Chinese and Western medicine can prevent the nose from going astray!

Hunan Medical Chat Special Author: Chen Yan and Wang Xiaohong, Department of Otolaryngology, Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine)

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(Edited by ZS)