What is the Nasal Septum Curvature in Children?
Curvature of the nasal septum is a violation of the structure of the cartilage, which separates the two sides of the nasal cavity. The nasal septum is the wall between the left and right sides of the nose. It is a flexible cartilage covered in skin that has many blood vessels. Ideally, the nasal septum should be exactly in the center, so that the left and right parts of the nose are the same. In about 80% of children, the nasal septum is slightly off center, although most people will never notice.
Curvature of the nasal septum is a common disorder in children. Curvature of the nasal septum can cause breathing problems or nasal discharge. The most common symptom when curving the nasal septum is difficulty breathing through the nose, children are prone to the occurrence of inflammatory and allergic diseases of the respiratory system.
Deviations of the septum develop during the growth of the child. Violation of the nasal septum usually develops starting from the age of 7, at a time when permanent teeth begin to erupt and the jaw expands. The teeth and facial part of the skull reach their final shape at the age of 20-25 years. Partial curvature can be diagnosed in young children, aged 3-4 years old, very rarely in children under 3 years old.
Causes of Curvature of the Nasal Septum in Children
The following reasons can affect the appearance of a curvature of the nasal septum:
- Congenital etiology. The formation of the nose in the prenatal period.
- Damage to the nose during childbirth.
- Injuries: a blow to one side of the nose, often occurs during contact sports, on the playground during the game, during a traffic accident.
Pathogenesis during the Curvature of the Nasal Septum in Children
In children with a curved nasal septum, one side of the nose is wider. This changes the structure of the air flow in the nose, and sometimes blocks the narrowed side. A slight change is not considered a pathology.
As a rule, air flows evenly, i.e. on both sides of the septum, in the nasal cavity. With the correct nasal septum, the air flow is moistened, heated and filtered before entering the maxillary sinuses. Curvature of the nasal septum changes the air flow, which in turn leads to irritation of the mucous membrane of the nasal cavity, maxillary sinuses and nasopharynx. Due to constant irritation, the mucous membrane swells and narrows the openings of the nose, maxillary sinuses and Eustachian tube. This can cause pathological processes in the sinuses and middle ear.
Curvature can occur in any part of the nasal septum (rarely in the bone). The partition can be curved only in one direction, or in both directions, in the form of the letter S.
Often in children with this disorder, the sense of smell is impaired. If the deviation develops slowly and gradually, the patient does not feel that his breathing is difficult, as he gradually gets used to it, and such a violation of the blocking of breathing becomes “natural”.
In some cases, these disorders can cause sinus infections (prolonged or recurrent sinusitis). The consequences of such disorders are headache, sinusitis, ear diseases, pharyngeal problems, nosebleeds, snoring, etc.
This disorder is aggravated in the case of concomitant diseases and disorders, including swelling of the mucous membrane. Symptoms can grow exponentially if the curvature of the septum is combined with other diseases. For example, if there is a blockage due to an allergy in combination with a curvature of the septum, then the feeling of blockage increases, which can lead to the development of sinusitis and the formation of a polyp.
Blocked nasal breathing due to a curved septum has a negative effect on the auditory tubes. Acute or chronic ear problems sometimes appear due to septal disorders.
Symptoms of Curvature of the Nasal Septum in Children
Most septal deformities are asymptomatic, so the parents and the child may not even know that they have a deviated nasal septum. However, we highlight the following typical symptoms:
- Blockage of one or both nostrils. This obstruction can make breathing difficult. The blockage becomes more noticeable when the person has upper respiratory tract problems or allergies that can cause swelling of the nasal passages.
- Nasal congestion, sometimes on one side only.
- Frequent nosebleeds. The surface of the nasal septum becomes dry, increasing the risk of nosebleeds.
- Facial pain. Not all scientists agree with this symptom, but a deviated septum affects the inner walls of the nose, which affect pain.
- Noisy breathing during sleep in infants and young children.
- Sleep on one side only. Some people choose to sleep on a specific side to optimize their breathing through their nose at night. This is due to a deviated nasal septum, which affects the narrowing of one of the nasal passages.
- Frequent upper respiratory tract infections. In these children, a respiratory infection causes swelling of the nasal tissues, which creates problems for air flow.
Sometimes the symptoms of a curvature of the nasal septum appear only in the presence of upper respiratory tract infections. People with severe curvature may develop chronic sinusitis or recurrent nosebleeds that last until the problem is surgically corrected.
Diagnostics of the Curvature of the Nasal Septum in Children
The doctor makes a diagnosis based on symptoms, obvious signs, for example, when the tip of the nasal septum protrudes beyond the nostril, and a number of studies.
In an endoscopy, a doctor examines the inside of each nostril as well as the back of the septum.
In the case when the curvature is imperceptible, the diagnosis uses X-ray, computed tomography (necessary to assess the details and condition of the paranasal sinuses), magnetic resonance imaging.
Treatment of Curvature of the Nasal Septum in Children
Some cases of deviated septum are treated with medication, which reduces the swelling of the nasal tissues by opening the nasal passage. First of all, drug therapy is aimed at reducing swelling of the mucous membrane in the nose. This in turn clears the nasal airway and allows better airflow through the nose. This can be achieved with saline washes, decongestants, antihistamines, or nasal steroid sprays.
More severe cases require surgery. A deviated septum can be corrected using a surgical method, the purpose of which is to straighten the bones and cartilage of the nasal septum. Most surgical corrections of a deviated septum are performed under local anesthesia after careful preparation of the patient.
With a deviated septum, the doctor may wait until the baby’s nose has finished growing before performing surgery. In most cases, operations are performed from 15-16 years of age. Boys usually have to wait a little longer than girls because they finish growing a little later.
Nasal septum plastics can be chosen as the method of treatment. This is an outpatient procedure that lasts 25-45 minutes. The operation is done through the nostrils, so the patient does not have any external scars. Contrary to popular belief, the procedure is painless.
For several weeks after the operation, nasal breathing is not fully restored due to the swollen mucous membrane. The cilia that cover the mucous membrane take time to regenerate. Regular postoperative check-ups are important to rule out tissue fusion disorders and complications.
The day after the operation (rehabilitation period), patients are prescribed antibiotics and cleaning of the nostrils to avoid infection.
Nasal septum plasty is the movement of the septum to its correct starting position. In some cases, doctors resort to rhinoplasty – changing the appearance of the nose.
Septoplasty is a reconstructive plastic surgery performed to correct the irregular shape of the nasal septum. The procedure is performed completely through the nostrils. Its purpose is not to eliminate the curvature, but to improve nasal breathing.
Septoplasty can be performed with an open method (sometimes small scars remain) and with an internal one. The postoperative period lasts from several days to a week.
Each child undergoes operations individually, so it is very difficult to predict the result. The following complications can occur after surgery: infection, nosebleeds, perforation, negative reaction to anesthesia.
Short-term side effects may occur after surgery: facial swelling, nasal soreness, dull headaches, puffiness around the eyes, minor bleeding in the first few days, bursting blood vessels as tiny red spots on the skin’s surface. If they persist, an urgent re-examination is necessary.
In most cases, the operations are successful. However, a small percentage of patients undergo a second surgery for cosmetic reasons or to improve airflow.
Full recovery is a slow and gradual process, for example, swelling can be present for several months, especially on the tip of the nose.
Prevention of Curvature of the Nasal Septum in Children
Curvature of the nasal septum can be prevented by avoiding damage to the nose. To do this, it is necessary to use seat belts when driving a car, wear well protective equipment when cycling, rollerblading, skateboarding and contact sports such as football, karate, etc.