Deviated Nasal Septum

Subject: Medical and Surgical Nursing II (Theory)

Overview

A physical disease of the nose including a displacement of the nasal septum is known as nasal septum deviation or deviated nasal septum (DNS). The thin wall between the nostrils may get moved to one side, either to the right or left, leading to a deviated septum. A disorder that was present at birth may result in a deviated septum. A deviated septum can occasionally form during fetal development and become obvious at delivery. Nosebleeds, headaches, post-nasal drip, and other nasal-related conditions are among its primary symptoms, as are genetic, hereditary, and other variables. Its diagnosis is possible by a history, physical exam, X-ray, and CT scan. Septoplasty and submucous resection are the two surgical procedures used to treat it.

Deviated nasal septum

A physical disease of the nose including a displacement of the nasal septum is known as nasal septum deviation or deviated nasal septum (DNS). When the flimsy wall between the nostrils shifts to one side, either to the right or left, it might result in a deviated septum. 80% of people experience some form of relocation, most often without their knowledge.

Etiology :

A deviated septum can be caused by:

A condition present at birth.A deviated septum can occasionally develop during fetal development and become obvious at birth.
Injury to the nose. Injuries that cause the nasal septum to shift out of place can also result in a deviated septum. During childbirth, such an injury can happen to infants.
Hereditary factors
Genetic factors: Additionally, genetic connective tissue diseases like Marfan syndrome and Ehlers-Danlos syndrome are linked to a deviated septum.

Types of DNA

Anterior dislocation: - One of the nasal chambers may receive a dislocation of the septal cartilage.
C- Shaped deformity: - Septum veers in a straight line to one side.
S- Shaped deformity: - Septum may exhibit an S-shaped curvature in the anterior-posterior or vertical planes.
Spurs: - A shelf projection known as a spur is frequently located where cartilage and bone converge.
thickening: - It might be caused by a planned hematoma or by the septal fragment's overriding a dislocation.

Signs and symptoms:

Nosebleeds
Facial pain
Headache
Postnasal drip
Loud breathing and snoring during sleep
Nasal obstruction
Nasal congestion, sometimes one-sided
Middle ear infection
Anosmia
External deformity

Investigation:

History taking
Physical examination
X-rays
Ct scan

Treatment:

Minor septal deviations without symptoms are frequently observed in patients and do not need to be treated. An operation is only necessary when a deviated septum causes mechanical nasal obstruction or the aforementioned symptoms.

Operational procedures:

Septoplasty
Submucous resection (SMR)

Nursing management:

Preoperative management:

Surgery consent needs to be verified and validated.
The usual evening care was completed.
Pre-anaesthetic checklist completed and anesthesia assessment.
Checks of the blood before surgery.
Vital signs should be obtained orally nil.
Patient comforted
The administration of premedication

Postoperative management:

Remind patients that mouth breathing is required while nasal packing is in place. They should only anticipate a small amount of bloody mucous nasal discharge, but they should see a doctor right away if they experience new-onset epistaxis.
Take your vital signs, please.
Checking the dressing for additional bleeding is necessary.
During the first 24-48 hours, patients should sleep with their heads raised.
In most cases, antibiotics are not required until nasal packing is put in place for longer than 24 hours.
The majority of patients do not experience significant pain following septoplasty; however, narcotic pain medication can be used for those patients during the first few days if pain relief is required. Patients must call their doctor right away if they are in excruciating discomfort.

Complication

Hematoma or hemorrhage
Local infection (Pathogens thrive in contaminated nasal packing as a culture medium.)
Aspiration
Pressure necrosis (from packing)
Trauma
Synechiae

Things to remember

It is a physical ailment of the nose that results in the nasal septum shifting.
Hereditary factors, nasal injuries, congenital malformations, etc. are the causes.
A CT scan, history-taking, physical examination, and X-rays can all be used to diagnose it.
Minor septal deviations without symptoms are frequently observed in patients and do not need to be treated.
In most cases, antibiotics are not required until nasal packing is put in place for longer than 24 hours.

Questions and Answers

Define deviated nasal septum.

A common physical condition of the nose that involves the displacement of the nasal septum is called a deviated nasal septum.

list out the nursing management for deviated nasal septum.

Nursing Management:

Preoperative Management

Surgery consent needs to be verified and validated.
The usual evening care was completed.
Assessment of the anesthetic with the pre-anesthetic checklist completed.
Checks of the blood before surgery.
Take your vital signs, please.
By mouth, zero.
Patient is comforted.
Prescription medication must be administered.

Postoperative management:

Remind patients that mouth breathing is required when nasal packing is in place. They should only anticipate a small amount of bloody mucous nasal discharge, but they should see a doctor right away if they experience new-onset epistaxis.
Take your vital signs, please.
Checking the dressing for additional bleeding is necessary.
During the first 24-48 hours, patients should sleep with their heads raised.
In most cases, antibiotics are not required until nasal packing is put in place for longer than 24 hours.
The majority of patients do not feel significant pain following septoplasty; nevertheless, narcotic pain medication can be given for those patients during the first few days if pain relief is required. Patients must call their doctor right away if they are in excruciating discomfort.