Crooked Nose

Have you ever noticed your siblings or younger ones, hissing like a snake while sleeping? The hissing sound is so intense that wakes you up from sleep and in some instances you avoid sharing a bed with your loved ones. I have been through it until my parents decided to do something about it. It was shocking when we came to know that my perfectly normal looking 10-year-old brother was suffering from a condition known as Deviated Nasal Septum (DNS) - A condition unknowingly borne by nearly 80 percent of world population.  
A DNS is a condition in which nasal septum (the bone and cartilage) that divide the nasal cavity of the nose in half is significantly off centre, or crooked. The nasal septum is displaced or deviated making one nasal passage smaller. When this deviation is severe, it can block one side of your nose and reduce airflow, making breathing difficult. In some cases, the altered airflow pattern within the nose due to the deviation can cause nasal septum to become dry and cracked, which can cause frequent nosebleeds.

Causes of Deviated Septum
Some people are born with deviated septum due to abnormal fetal development. Others can acquire this condition due to trauma at birth. – Birth injury to the nose.  Some adults and teenagers develop such condition from injuries during traffic accidents or rough sports.

Symptoms
! Nasal congestion ( usually one-sided) - the most common symptom shown by DNS sufferers.
! Repeated sinus infections- chronic sinusitis
! Frequent nose bleeds
! Headache, Facial Pain, Postnasal drip
! Loud breathing during sleep (in infants and children)
! Dry mouth - due to chronic mouth breathing.
In some case, people with mildly deviated septum have symptoms when they suffer from cold or other respiratory infections. Once the infection subsides the symptoms subside too.
If you or your loved ones have been showing such symptoms, its wise to consult a physician, usually an ENT specialist, for further evaluation of the condition and solution.

Treatments and medications
Most people won't require treatment, but in severe cases, surgery is a must. Initially some oral medications would be provided for inflammations, if present, to subside. But complete cure can be achieved only after surgery.
Decongestants and antihistamines are usually prescribed to reduce nasal tissue swelling and preventing allergies accordingly. They come in both oral and spray forms. Sometimes nasal steroids are also prescribed for clearing obstruction. It is necessary to regularly follow the medications, as they may take some time to show results.
The surgery is called Septoplasty. It is a surgical procedure performed entirely through the nostrils; hence there are no external signs or marks. Another surgery called Rhinoplasty maybe needed to re-shape the nose, if it is crooked. This is done externally.
Septoplasty requires one to two hours, depending on the deviation; hence it is done on outpatient basis. Children have to wait for the surgery till they reach their 16th birthday, when they have stopped growing. During Septoplasty, your nasal septum is straightened and repositioned in the centre of your nose. Parts of the septum are cut and then reinserted in proper position.

Complications
Surgeries are often accompanied with complications, Septoplasty isn't an exception. Though complications such as infection, bleeding, perforation or loss of ability to smell are rare, it is better to be aware of them.
Before going for surgery, discuss with your physician about the improvements and risks involved, as level of improvement depends on the severity of your deviation. Some patients may need multiple surgeries for perfect correction.

Preventions
Deviated Nasal Septum from birth cannot be prevented, but can be cured if you are aware of its symptoms. Adults can avoid developing this irritating condition by being a bit more careful of their noses. Such as- wearing seat belts in automobiles and wearing appropriate protective headgear when playing sports.
DNS isn't a life-threatening condition, but its irritating, as you suffer from cold-like symptoms round the year. Plus there are chances of attention deficiencies in young ones, as healthy brain development may be hampered due to long term improper breathing.

The writer is a Research Physician
Centre for Child and Adolescent Health (CCAH), ICDDR,B