Deviated Septum: Symptoms, Diagnosis, and Treatment Options - Otolaryngology

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Understanding a deviated septum is crucial for addressing symptoms like nasal congestion, headaches, and sleep disturbances. A deviated septum occurs when the thin wall between your nasal passages (the septum) is displaced to one side, which can lead to various complications, including chronic sinusitis and difficulty breathing.


Symptoms of a Deviated Septum
Common symptoms associated with a deviated septum include:
- Nasal congestion or obstruction, often more pronounced on one side.

- Frequent sinus infections.

- Nosebleeds.

- Headaches or facial pain.

- Snoring or sleep apnea.

- Postnasal drip.

- Reduced sense of smell.

In your case, you mentioned experiencing nasal congestion, a heavy head feeling, insomnia, and nasal itching, but no runny nose or sneezing. These symptoms can indeed be linked to a deviated septum, especially when combined with chronic rhinitis or sinus issues.


Diagnosis
To determine the severity of a deviated septum, a healthcare provider typically performs a physical examination, which may include:
- Nasal Endoscopy: A thin, flexible tube with a camera is inserted into the nose to visualize the septum and nasal passages.

- Imaging Tests: In some cases, a CT scan may be ordered to provide a detailed view of the nasal structures.

You mentioned conflicting opinions from different healthcare providers regarding the severity of your septum deviation. It's essential to consult an ENT (Ear, Nose, and Throat) specialist who can provide a thorough evaluation and possibly perform a nasal endoscopy for a definitive diagnosis.


Treatment Options
Treatment for a deviated septum can range from conservative management to surgical intervention:
1. Medications: If you have allergic rhinitis or chronic rhinitis, antihistamines, nasal corticosteroids, or decongestants may help alleviate symptoms. However, overuse of nasal sprays can lead to rebound congestion, worsening your condition.


2. Surgery (Septoplasty): If your symptoms are severe and persistent, surgical correction may be recommended. Septoplasty is typically performed through the nostrils, meaning no external incisions are made. The surgeon straightens the septum and repositions it to improve airflow.
3. Radiofrequency Ablation: This is a less invasive option that uses radio waves to reduce the size of the turbinates (structures in the nose that can become enlarged and contribute to nasal obstruction). Recovery from this procedure can vary, but many patients report gradual improvement over a few weeks.


Age Considerations
Regarding the age for surgery, guidelines can vary by region. In Taiwan, septoplasty can be performed from age 15, while some sources may suggest waiting until 18. This is often due to concerns about facial growth and development. It's best to discuss this with your ENT specialist, who can provide personalized advice based on your specific situation.


Recovery and Expectations
After surgery, most patients experience significant improvement in nasal airflow within a few weeks. However, complete healing may take several months. It's common for swelling to persist initially, which can affect breathing. Your doctor will provide specific post-operative care instructions to help manage recovery.


Conclusion
It's understandable to feel apprehensive about undergoing surgery at a young age. However, if your symptoms significantly impact your quality of life, surgical intervention may be the best option. Be sure to discuss all your concerns with your ENT specialist, who can guide you through the decision-making process and provide reassurance about the procedure and recovery. Remember, the goal of treatment is to improve your overall well-being and alleviate the discomfort caused by your symptoms.