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Anatomic Causes of Nasal Obstruction
The nasal septum is the partition between the right and left sides of the nose. It is composed of both cartilage and bone. The image below shows a normal midline septum compared with a septum that is severely deviated into the right side, as was my case. A deviated septum is usually diagnosed when a physician looks inside the nose. One clue is to breathe in and out through each side of the nose while blocking the other nostril. A consistent difference in airflow between the two sides may indicate a deviated septum. If you have an obvious twist to the outside of your nose, this may also indicate a deviation on the inside.
Often, a deviated septum results from a nasal injury. Some patients who have septal deviations remember the exact incident when they fractured or broke their nose, and recall breathing problems beginning after this. Other people are unable to recall any nasal trauma. No one knows whether these individuals were born with their deviation, or whether they suffered some trauma to their developing nose while sliding down the vaginal canal during birth. If the twist of the septum does not seem to harm your breathing, then there is no reason to correct the problem. However, if the deviation is severe enough to warrant repair, you may need surgery. There may also be instances when the septum needs to be fixed not for breathing but because it blocks the sinus openings, leading to chronic sinus infection. In my case, I don't remember an incident that may have caused damage to my nose (except for that one time Kristin woke me up with a right hook). Dr. Clark and I agree that this has likely been a work in progress over the past 5 or so years.
Surgery for a deviated septum involves working inside the nose to reshape the cartilage and bone, either called a septoplasty or submucous resection. It is performed on an outpatient basis under either general ("all the way under") or local (sedation) anesthesia. The septum sometimes needs to be straightened during sinus surgery so that the surgeon can reach back to the sinuses. Correction of a deviated septum usually does not change the outer appearance of the nose. If someone says they had a deviated septum operation but they look like they have a new nose, they are probably covering up elective cosmetic surgery.
In my case, I went through a septoplasty procedure and was completely knocked out.
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