I wanted to know if surgery for a deviated septum would solve my nasal and sinus passages. I have difficulty breathing due to mucus blockage. It has gotten so bad it effects the pitch/tone of my voice.
Thank you for your question.
The septum is a wall that extends from the front of the nose to the back and divides the nose into two passageways. It is never completely straight, but sometimes will be twisted from side to side so that it blocks the nasal passages. If is causing enough of a problem in breathing, your ENT doctor or sinus specialist may recommend straightening the “deviated” septum. A deviated septum may cause you to sound clogged and may predispose you to sinus infections. (sinusitis)
This is a surgical procedure, done through the inside of the nose. The surgeon will make a small incision in the lining covering the septum and lift the lining off the cartilage and bone that make up the septum. Some bone or cartilage may need to be removed, and the rest is placed back in the midline- so as to improve the airway. There is NO change in the way you look after septal surgery and you should not get black and blue- That occurs when one gets a rhinoplasty (cosmetic surgery to change the appearance of the nose) at the same time.
I can’t tell for sure that the septum is your problem without an exam. There are many other causes of nasal obstruction, such as allergies, polyps or even temporarily as you know with a bad cold. Additionally, one can have the straightest septum in the world, but yet have the nose blocked from any of those problems. If you don’t have any of the other problems and septum is blocking, it is quite likely that straightening it should improve your breathing and the change in your voice that comes from not breathing well through your nose.
I hope this clears things up.
Robert Pincus MD, FACS
Co-Director NY Sinus Center
Associate Professor Otolaryngology
Question: My three-year-old daughter sustained a childhood nose injury to her by running into my husband’s knee. We did not take her to the ER because after some blood and tears, she seemed fine (she felt pain in the nose only to the touch and felt no pain at all the following day). She had no problems breathing. Three weeks later after the bruising seems to be almost 100 percent gone, I’m noticing a bump on the top (bone) part of her nose. A trip to an ENT today completely devastated me when he told me she probably fractured the bone and the bump may or may not go away. Either way, I was informed, nothing could be done at this point. Do you agree?
Answer: Nasal trauma often can be best addressed within the first few weeks, because the bones are mobile and easier to align. But, we can also address fractures in a delayed fashion, so I would recommend that she be evaluated to see if she would potentially benefit from surgery for the childhood nose injury. We would be very happy to see her in the office.
—Corinne E. Horn, MD
Question: I have deviated nasal septum besides a crooked nose with a minor sinus infection and had septoplasty to correct it. Nothing changed after I had treatment for a crooked nose, and sinus infection got worse from then. Will a septorhinoplasty help solve my problem? Is it safe to perform surgery again?
Thanks for your question.
First of all, while revision surgery is quite common and may solve your problem, one should try to find out why the surgery didn’t help in the first place before having another procedure.
The septum is a dividing wall that separates the nasal airway into to separate passageways. While the septum is never completely straight, the septum can be “deviated” or twisted enough to block the flow of air through one – (if the septum is over to one side)- or through both passages (if the septum has a shape like the letter S). Straightening the septum should be expected to improve breathing through the nose, but sinus infections usually will need to be further treated – either through opening the sinuses wider, or finding out the cause of the infections and treating them medically. Fixing a crooked nose requires breaking the bones of the nose- or rhinoplasty- and is a cosmetic procedure to improve the appearance of the nose. This can be done at the time of septoplasty and/or sinus surgery- or sometimes alone. I am not sure what problems you were having before and are continuing to have.
But, we frequently are called on to treat patients who have had nasal or sinus surgery before that did not fix their problem. Usually, that is because the problem causing the symptoms was not accurately identified, and less common because the surgical results were not as successful as we’d like.
Before I would say to have the procedure repeated, I would suggest having another opinion- certainly something we do a lot of here at the NY Sinus Center.
If revision sinus or rhinoplastic surgery is needed, we have significant experience in helping.
Robert Pincus MD
Co-Director NY Sinus Center
Question: After always having trouble breathing through my nose (with my mouth closed) when sleeping on my right side, I asked my PCP to check, and he informed me that I have a deviated septum which could explain it. Since I can’t ever remember being able to breathe easily through my nose with my mouth closed while sleeping (and not snoring), I’m writing you to see what may be the issue and if I might be a candidate for some sort of deviated septum correction.
Answer: Thanks for your question.
The most likely cause of your breathing problem is a “deviated” septum. The septum is a wall that separates the nasal airway into two separate passages and is never completely straight. Unfortunately, either from birth or from trauma, this wall may be twisted and block either one or both sides of the nose. First, I would suggest an ENT examination to make sure that is the cause of your symptoms. Other problems, such as nasal polyps (benign nasal growths) can block one side or the other- or both, as well.
If a deviated septum is the cause, this can be readily fixed with a minor surgical procedure. Straightening the septum, by the way, does NOT change the appearance of the nose, nor should you get black and blue from this. Frequently, people have coupled cosmetic surgery (rhinoplasty) at the same time, which does both.
I hope this clears things up. We’d be happy to see you here at the Sinus Center and help figure out how to best improve your breathing.
Robert Pincus MD
Co-director NY Sinus Center