Curvatures of the nasal septum are usually caused by different growth of the facial bones and cartilage during puberty. In some cases, they are also the result of nasal bone fractures, which can occur during birth in the birth canal.
It is very frequently additionally necessary to [treat/reduce] the nasal turbinates, which humidify and warm the breathing air (Nasal concha) to be reduced. This ensures the clear passage of both nasal cavities. Especially in allergy sufferers, the nasal turbinates are frequently enlarged significantly and require correction.
The operation is usually performed under general anaesthetic either as an inpatient or outpatient procedure.
The mucous membrane is detached from the cartilage and bone via a small internal incision on the front edge of the nasal septum. In some cases, tension bends can be released using special incision techniques; in other cases, severe bends must be loosened, removed, straightened outside and then reimplanted between the mucosal sheets (replacement technique).
The three-layered structure of the nasal septum should definitely be preserved in order to maintain mucosal moisture. To stabilise the straightened nasal septum and to press the blood vessel-bearing mucosa back against the cartilage and bone, bilateral silicone splints are inserted. These remain in the nose for approx. 4 days.
The turbinates are also reduced in size during the same procedure. Either the method of Conchotomy, i.e. the sharp removal of excess tissue, or different forms of energy are used for tissue reduction on or inside the nasal turbinate. The methods used here include the laser, mono- or bipolar coagulation, or, as a newer procedure, bipolar thermotherapy (thermocoagulation, RFITT). Since the nasal turbinates consist of highly vascular tissue, it is necessary to insert a nasal pack bilaterally to prevent secondary bleeding.
The nasal packing is removed on the first or second postoperative day. The inserted silicone splints remain in the nose for a further two days. In total, a two-week healing phase is to be expected. During this time, it is important to take physical rest in order to prevent secondary bleeding as a result of rising blood pressure.
Equally important during this phase is adequate mucosal care, including moisturising.
The nasal septum consists of cartilage and bone. It is lined on both sides with a protective mucous membrane. The so-called nasal septum divides the inside of the nose into two areas like a partition: a left and a right half. It stabilises the structure of the nose and controls the flow of air. The nasal septum is also important for the perception of odours.
In most cases, a deviated septum is congenital. However, it can also be acquired, e.g. as a result of the posterior bony and anterior cartilaginous parts growing at different rates. In addition, diseases or injuries to the nose, such as a fracture, can lead to a curvature or bending of the nasal septum.
A deviated septum is more common than you might think! Estimates suggest that around 90 per cent of people suffer from a more or less pronounced deviation of the nasal septum. However, this does not cause symptoms for everyone. Frequently, the patients who come to us do not even know that they have a deviated nasal septum.
Common conditions of the nasal septum that often require functional nasal surgery are:
A curvature or misalignment of the nasal septum causes narrowing of the nasal passages. As a result, less air can flow through one nostril than the other. Patients often find it harder to breathe, especially during physical exertion.
As a deviated nasal septum can impair breathing, many patients experience a lack of air, e.g. during physical exertion. To compensate for this, patients often (unconsciously) breathe through their mouth. This dries out the mucous membranes in the throat, making it easier for viruses and bacteria to colonise and spread. The susceptibility to respiratory infections increases.
Many of those affected therefore suffer more frequently from colds. This leads to swelling of the mucous membranes in the nose. Due to the curvature of the nasal septum, the thick mucus produced is more difficult for the body to remove. As a result, sinusitis develops more frequently than in other patients and can even become chronic.
As different as people are, so different can their nose shapes be. They can be divided into certain "categories" (e.g. broad nose, hooked nose, snub nose ...). The so-called crooked nose is common.
It has a laterally displaced, crooked shape and leans visibly to the left or right. The shape of the nose can be caused by accidents or injuries. A crooked nose is also often the result of a deviated septum and is associated with restricted nasal breathing. Surgery can provide a remedy here - both from a plastic/aesthetic point of view, as the nose is straightened visually, and from a functional point of view, as breathing is improved.
To detect a curvature of the nasal septum, we look at the nose from the outside by looking into the nostrils and lifting the tip of the nose, as well as from the inside using a nasal endoscopy. We also use nasal flow measurement to recognise whether there are differences in the airflow when breathing in and out. In some cases, an X-ray examination or CT scan may also be necessary.
For minor ailments such as mucosal problems or a dry nose, we generally advise treatments with saltwater rinses, sea salt nasal sprays or ointments. Increasing the humidity in the room (e.g. by using a humidifier) can also have a beneficial effect.
If these measures do not achieve the desired improvement or if the symptoms have persisted for a long time, an operation may be advisable. We straighten the nasal septum surgically under anaesthetic. This is known as a septoplasty.
Please do not blow your nose for the first few days after the surgery, otherwise the wound may open up again. After a few weeks, you can carefully blow your nose again with your mouth open. This way, little pressure is exerted on the inside of the nose. Avoid medications that thin the blood (e.g. aspirin).
It is also important that you take good care of your nose to support the healing process. This is because the self-cleaning function of the nose is still limited in the first few days and weeks after the operation. We recommend regularly moisturising the mucous membranes with seawater sprays or rinses and using special creams.
Furthermore, for a few weeks after the nasal septum operation, you should not perform any movements or activities that cause an increase in blood pressure or dilation of the blood vessels. This means: no heavy physical labour, no sport, don't lift anything heavy, don't bend over too much and stay away from extreme heat (no hot showers/baths, sunbathing or visits to the sauna or solarium).
For the nasal septum operation, the general and universally applicable surgical risks (e.g. thromboses, wound infections) apply. Also possible are bleeding beneath the mucosa with the formation of a haematoma, temporary sensory disturbances in the nose, upper lip, palate and front teeth, crusting in the nose, tenderness to pressure at the tip of the nose and – very rarely – an impairment of the sense of smell.
Depending on the findings, i.e. the intensity of the curvature of the nasal septum or damage to the nasal septum, you can expect the procedure to take around 45 to 60 minutes.
If the curvature of the nasal septum leads to health problems and the operation is medically necessary - i.e. it has a medical indication - the costs of the operation are covered by the health insurance company. In the case of surgery for plastic/aesthetic reasons, it is a self-payment service.
Various documents must be submitted to the health insurance company for the costs to be covered. We will help you to compile the necessary documents.
Sometimes the symptoms caused by a deviated septum can be treated with saline rinses, sea salt nasal sprays or ointments. If the findings make surgery necessary, in individual cases a turbinate operation can also lead to an improvement in nasal breathing instead of a septoplasty.
The turbinate surgery can be performed with the laser on an outpatient basis under local anaesthetic and without tamponades. If desired, the operation can be performed on one side or successively on both sides. It generally has a shorter downtime. We will be happy to clarify with you in a personal consultation whether this alternative option is suitable for you.
An unpleasant odour from the nose is usually first noticed by those around you and causes irritation. This symptom is often caused by a chronic disease of the nasal mucosa, known as stinky nose or ozaena.
Anyone who snores regularly, is exhausted in the morning and suffers from concentration problems during the day should consider the possibility of sleep apnoea. The traditional route to diagnosis is to go to a sleep laboratory. A well-founded clarification is now also possible on the move.
Restless sleep, constant tiredness during the day and the feeling of never being properly rested - many people put up with these complaints without knowing the cause. However, there is often a serious phenomenon behind it: breathing pauses at night.
A blocked nose can have a considerable impact on everyday life. Many people then turn to nasal sprays, which can provide quick relief. But what happens if the medication doesn't work? There can be various reasons for this.
Recurrent sinusitis can have a significant impact on quality of life and is often associated with persistent symptoms such as a feeling of pressure in the centre of the face, headaches and a blocked nose.
Free, undisturbed nasal breathing contributes significantly to quality of life and well-being. However, anyone who suffers from restricted nasal breathing knows the effects on sleep, concentration and general fitness only too well. In the following, we will show you effective options and modern treatment methods that will allow you to breathe freely again.
Interrupted breathing during sleep is a serious condition that often goes unrecognised. Sleep apnoea can significantly impair quality of life and lead to long-term health problems. It is important to recognise the signs early and take appropriate measures.
Some people suffer repeatedly or even permanently from the feeling of a blocked nose. In this case, you may have enlarged turbinates. During a laser conchotomy, we can laser the inside of your nose and allow you to breathe freely.
Loud snoring can turn sleep into torture. In some cases, snoring surgery can be the solution so that you can sleep peacefully again. We offer this form of snoring therapy at our ENT clinic in Frankfurt.
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As the central feature of the face, the nose is a real eye-catcher. If the nose is crooked, it is not only this unit of attractiveness that can be disturbed. A crooked nose can also lead to functional disorders such as breathing problems. In this article, we explain how we can help you here.
Snoring can affect your health, but it can also have an impact on your partner's healthy sleep. You should therefore have it checked why you snore. In this article, we explain what treatment is possible and when you need an operation to stop snoring.
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When the nose is blocked, it is very unpleasant and annoying. Treatment varies depending on the underlying cause. It ranges from nasal irrigation to the use of nasal sprays and tablets. In some cases, surgery may also be necessary.
Many patients with chronic sinusitis suffer from troublesome symptoms for years. Even if sinusitis is chronic, this does not mean that it cannot be treated. In this blog post, we show you various treatment methods.
Sympathy, empathy, experience, expertise: these are some of the main qualities that patients looking for a nasal specialist want from their doctor. In this article, we will show you why Dr Thomas Fischer is your ideal partner for rhinology.
Almost everyone has a vice, big or small: some people love to eat but don't exercise enough, others smoke and others drink too much alcohol. There are also people who are addicted to medication. Tens of thousands of Germans resort to nasal sprays because they are addicted.
Patients who come to us are often unaware of their deviated nasal septum or the symptoms it can cause. Yet this phenomenon is not at all uncommon. You can find out more about the possible consequences and treatment approaches in this article.
Our nose is a fascinating organ: it has a multitude of different tasks. This enormous performance can also lead to problems and limitations. Here you can find out what nasal complaints there are, how they affect the activity of the nose and when an operation is necessary.
In addition to preventive measures relevant to all ENT areas, such as endoscopies and sampling, we also carry out specific diagnostic and treatment measures in the area of the throat, nose and ears. In this article, we will show you which measures our ENT medicine includes in detail.
Have you ever wondered why the person who snores is always the first to fall asleep? This "tree-sawing" can have serious consequences for a partnership. If one person snores constantly, there is the threat of an unromantic consequence: separate beds.
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