Pediatric Deviated Septum

What is a deviated septum?

The nasal septum is made of cartilage, and divides the nose into two separate chambers. A deviated septum is an abnormal configuration of the cartilage that divides the two sides of the nasal cavity, which may cause problems with proper breathing or nasal discharge. Estimates are that 80% of all nasal septums are off center. A deviated septum is when the septum is severely shifted away from the midline.

The most common symptom from a deviated septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and in some cases the drainage of the sinuses is curtailed and results in repeated sinus infections. A deviated septum may be present at birth, caused by an injury, or result from damage from previous medical treatments.

Treatment

Children vary greatly in their anatomy and healing ability, and the outcome is never completely predictable. Complications may occur, including, but not limited to, the following:
- Infection
- Nosebleed
- Reaction to the anesthesia
The following short-term side effects may occur. If symptoms do not subside, consult your child's physician.
- Face will feel puffy
- Nose may ache
- Dull headache
- Swelling around the eyes
- Bruising around the eyes
- Small amount of bleeding in first few days
- Small burst blood vessels may appear as tiny red spots on the skin's surface
Healing is a slow and gradual process. Some swelling may be present for months, especially in the tip of the nose. Final results of nasal surgery may not be apparent for a year or more.
Septoplasty is a reconstructive plastic surgery performed to correct an improperly formed nasal septum. The procedure is performed entirely through the nostrils. During the procedure, badly deviated portions of the septum may be removed entirely or they may be readjusted and reinserted into the nose.
In addition to correcting a deviated nasal septum, septoplasty may also be performed to correct other problems such as cleft defects that affect the nose and nasal cavity, and a fistula in the maxillary sinuses.
Septoplasty may be performed with the traditional open surgical technique from inside the nose. When open surgery is performed, small scars will be located on the base of the nose, but they usually are not noticeable. Scarring is not visible when internal surgery is performed. Depending on the severity of the deviation, septoplasty may be performed in the following settings:
- A surgeon's office
- An outpatient surgery center
- A hospital as an outpatient
- A hospital as an inpatient
The surgeon will provide guidelines for resuming normal activities. Many children are up and around within a few days and able to return to school in a week or so.