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What are the causes of septum deviation?

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What are the causes of septum deviation?

VI./2.: Complaints and Symptoms

The most common symptom is obstructed nose breathing but it is also the most difficult to assess. A deviation may narrow down mainly one half nose or both of them alike. In the first case the obstruction will be typically unilateral. It may happen, however, that with a lasting hypoventilation of one half nose, a subjective complaint does not occur until the other, better ventilated half gets blocked. With many patients a simultaneous or alternate obstruction of both nose halves is common. Some patients tend to suffer in lying position and especially badly when trying to fall asleep in the evening.

A permanently hyperventilated spacious half nose is less capable of tempering and humidifying the air. The swelling of the erectile tissues of the nasal cavity will compensate for the spaciousness of the cavity, mainly the hypertrophy of the lower scroll-bone. In the course of this process, however, the ability of the fine vegetative regulation of congestion and decongestion is often lost. The narrower half of the nose, if it gets ventilated at all, will be burdened by a quicker rush of air. The mucous membrane will then dry up, crustation and rhinitis sicca develop. A similar process takes place in the very thin mucous membrane which covers the edges of the cristae of the big nasal septum, and which is of decreased value physiologically. These are areas where minor nose bleedings often occur.

Pathological nose breathing caused by septum deviation will predispose to infections of the upper respiratory tracts and can prolong their duration. In case of obstruction or

stagnation of discharge consequential sinusitis and complaints of discharge flow are common. Abnormal nose breathing will unfavourably affect the „micro-climate” of the epypharynx. It will disturb the functioning of the pharyngotympanic tube and can cause chronic diseases of the middle ear.

In certain patients the deviated septum causes headaches which are difficult to localise, especially when the extremely deviated parts reach the lateral nasal wall.

To sum it all up we can say that the functioning of the nasal cavities distorted by septum deviation is disturbed in many ways. We must keep in mind that a number of factors are jointly responsible for the complaints of the patient. They include the geometry of the nasal septum, the consequential secondary alterations and any

superimposed diseases which are independent of the deviation. Due foresight is required to investigate and evaluate the numerous possible secondary alterations before we are convinced that a septum operation is clearly indicated.

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