Deviated Nasal Septum

DEVIATED NASAL SEPTUM
 Nasal septum deviation or deviated nasal septum

(DNS) is a physical disorder of the nose involving a
displacement or deflection of the nasal septum
 Some degree of displacement is common.
Affecting 80% of people unknowingly
CAUSES
 Trauma – blow to the face
 Congenital disorder – compression of nose
during child birth
 Genetic connective tissue disorders – marfan
syndrome
 Pressure from massess
PATHOPHYSIOLOGY
 Nasal septum in the nose separates the nasal

cavity into two nostrils
 Normally septum lies centrally and thus the nasal

passages are symmetrical
 A deviated septum is an abnormal condition in

which the top of the cartilaginous ridge leans to
the left or the right causing obstruction of the
affected nasal passage
SIGNS AND SYMPTOMS
 Only more severe cases of deviated septum

will cause symptoms
 Difficulty breathing
 Infections of the sinus
 Sleep apnea
 Snoring
 Repetitive sneezing
 Facial pain
 Nose bleeds
 Mild to severe loss of the ability to smell

DIAGNOSTIC MEASURES
 History collection
 Physical examination – nose examination with
a pen torch
 X ray
MANAGEMENT
 In mild cases – symptomatic
treatment
 Medications – decongestants,
antihistamines and nasal spray
 Medications will relieves only the
symptoms but does not correct
the underlying condition
 Nasal strip - A nasal
strip, external nasal dilator
strip or nasal dilator strip is a
type of adhesive bandage with
embedded plastic ribs or splints
that is applied across the bridge
of the nose and sides of
the nostrils, to assist in keeping
the airway open.
NASAL
INHALATION
 Remove cap form the nasal inhaler
 Shake the container well
 Hold the inhaler between the thumb and forefinger
 Tilt the head back, slightly and insert the end of the inhaler
in to the nostril, mean while close the other nostril.
 Press down the container to release one dose and at the
same time inhale gently
 Ask the patient to hold the breath for a few seconds then
breath out slowly through mouth
 Withdraw the inhaler from the nostril and repeat with other
nostril
 Replace the cap after usage
Surgical management –septoplasty (1-2
hours) – complete healing occur within 2 days to 4
weeks
 The surgeon makes a incision through the mucosa at the
caudal end of the septal cartilage, elevates the septal
mucous membranes, and separates the septal cartilage
from its bony attachments and straightens it .
 After that nasal septal splints made of plastic is inserted
 Nose may be packed for several days to prevent

hematoma formation
Complications of septoplasty –
 Infection
 Bleeding
 Hole (perforation) of the septum
 Loss of the ability to smell

Rhinoplasty – cosmetic surgery
 A plastic surgery procedure for correcting and
reconstructing the form, restoring the functions
 Open and closed rhinoplasty is there
 Rhinoseptoplasty – combined cosmetic and septal

corrective surgery
NURSING MANAGEMENT
 Assess the signs of hemorrhage – excessive blood

on nasal dressing, bright red vomitus, repeated
swallowing(check back of throat with a pen light for
blood running down throat), rapid pulse,
restlessness
 Assess for signs of infection- fever, elevated white

blood cell count.
TAKEMEASURES TO RELIEVE DISCOMFORT AND
PROMOTE EFFECTIVE BREATHING
 Place patient in mid – fowler’s position to decrease

local edema
 Provide cool mist via face tent
 Apply ice compresses over nose for 24 hours
 Provide psychological support and sedation if

needed
 Use flashlight or penlight to examine back of
throat to check packing has not slipped to back
 Provide frequent oral care
 Change dressing under nose as needed

 Promote good nutrition – provide increased
amount of fluid
Instruct the patient to :
 Avoid blowing nose for 48 hours after packing
has been removed
 Avoid constipation and straining
 Expect stools to be tarry
 Expect face to be discolored around eyes and

nose for several days

Deviated Nasal Septum

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DEVIATED NASAL SEPTUM

 Nasal septum deviation or deviated nasal septum

 Nasal septum in the nose separates the nasal

 Normally septum lies centrally and thus the nasal

 A deviated septum is an abnormal condition in

 Only more severe cases of deviated septum

 Infections of the sinus

 Mild to severe loss of the ability to smell

 Nose may be packed for several days to prevent

 Hole (perforation) of the septum

 Loss of the ability to smell

 Rhinoseptoplasty – combined cosmetic and septal

 Assess the signs of hemorrhage – excessive blood

 Assess for signs of infection- fever, elevated white

 Place patient in mid – fowler’s position to decrease

 Apply ice compresses over nose for 24 hours

 Provide psychological support and sedation if

 Change dressing under nose as needed

 Expect stools to be tarry

 Expect face to be discolored around eyes and

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