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Twisted nasal septum in children

Twisted nasal septum in children

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The nasal septum curvature (SNP) is a common condition among both children and adults (American statistics say that the nasal septum has a different degree of curvature it occurs even in 78% of adults and 22% of children born by natural means and 4% of children born by caesarean section). Surgical procedure correction of this defect is the second most common ENT procedure (immediately after the tonsils removal). So where does the nasal septum curvature come from, how does it manifest itself, and what are the indications for its treatment in the pediatric population?

Nasal septum curvature - causes

Nasal septum curvature may be innate (result of abnormal positioning of the fetus in the womb or perinatal injury) or a consequence of later injury (the most common cause of SNP in older children and adults). Moreover, in some cases, genetic background (predisposition to uneven development during the growth of cartilaginous parts of the nose and craniofacial) or concomitant malformations (e.g. cleft palate) contributes to this abnormality.

Curvature of the nasal septum in newborns and infants up to 6 weeks of age

The nasal septum curvature, and thus partial or complete nasal obstruction, is a particularly dangerous condition for babies up to 6 weeks of age. This is due to the fact that newborns and infants during this period are able to breathe only through the nose and respond to impaired nasal patency with a sap (a type of heavy breathing in newborns and infants), snoring, severe purulent runny nose, difficulty feeding, choking, and even inspiratory dyspnea and cyanosis.

SNP in this age group it is usually congenital in nature and most often results from perinatal trauma (more often it occurs in children of women giving birth for the first time and at the time of prolonged second stage of labor). Fortunately, in most cases it undergoes a spontaneous attitude process and only in a few cases requires surgical intervention (when life-threatening breathing disorders occur).

Nose curvature - symptoms

Depending on the type and degree of curvature of the nasal septum, this defect may give varying degrees of symptoms. Of these, the most common in the pediatric population are:

  • Nasal obstruction - are described as a feeling of stuffy nose or the presence of a foreign body.
  • Recurrent upper respiratory tract infections - especially recurrent infections of the paranasal sinuses of the nose and throat.
  • Recurrent middle ear infections and stuffiness of the ear - are the result of impaired patency of the Eustachian tube connecting the tympanic cavity to the upper throat.
  • Snore - the result of being unable to breathe through your nose.
  • Recurrent nosebleeds - secondary to damage to the nasal mucosa that may occur with prolonged obstruction.
  • Headaches and worsening of smells - headaches can be a symptom of chronic sinusitis, and worsening of the sense of smell, like recurrent bleeding, is secondary to damage to the nasal mucosa.

Indications for nasal septum correction surgery

Surgical correction of the nasal septum (septoplasty) is the only effective treatment for SNP. The procedure is usually performed in children over 6 years of age (postoperative cooperation of the patient is required), and the indications for its implementation include:

  • Significant impairment of nasal patency impairing the normal functioning of the child.
  • Recurrent infections of the upper respiratory tract and middle ear not receiving conservative treatment.
  • SNPs coexisting with other birth defects (for example, cleft palate).
  • Clinically significant curvature of the nasal septum in newborns and infants up to 6 weeks of age.

At this point it is worth noting that the list of indications for surgical correction of the nasal septum in children is much narrower than in adults. This is due to the fact that boys up to 18-20 years old and girls up to 16-18 years old continue to grow nasal cartilage processes, and thus it is difficult to predict the long-term effects of surgery and there is a high risk of recurrence of septum curvature.

To sum up, the nasal septum curvature is a very common and also troublesome condition. Surgical correction usually solves this problem, but in children it is performed only in special cases, when postponing the procedure is unfavorable for the child.