Deviated Septum in Children

What is a deviated septum?

The nasal septum is made of cartilage and bone. It divides the nose into two separate chambers. A deviated septum is a septum that has shifted away from the midline. This may block airflow or drainage of the sinuses. It is estimated that 80% of people have a deviated septum, although many do not realize it.

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, drainage of the sinuses is blocked. This can lead to repeated sinus infections. A deviated septum may be present at birth, caused by an injury, or result from damage from previous medical treatments.

What is septoplasty?

Septoplasty is surgery to correct a deviated septum. The procedure is done 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, this procedure may also be done to correct other problems such as cleft defects that affect the nose and nasal cavity, or an abnormal opening between the sinuses.

About the procedure

Septoplasty is most often done through the nose with no incisions on the outside. Endoscopic septoplasty uses lighted telescopes to assist in this procedure. This surgery is most often done along with sinus surgery. In some cases, it may be done with a rhinoplasty to correct the external nose cosmetically and functionally. When an open septoplasty and rhinoplasty are done, small scars will be made at the base of the nose, but these scars are not typically noticeable.

Typically, septoplasty is reserved for children age 14 and above. Having the procedure earlier than this may affect midface growth. 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.

What are the complications associated with nasal surgery?

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

  • Buildup of blood and swelling in the septum (septal hematoma)

  • A hole or crack in the septum (septal perforation)

  • Numbness of the front teeth

  • Change in sense of smell

  • Cerebrospinal fluid leak

  • Meningitis

  • Reaction to the anesthesia

What are the short-term side effects of nasal surgery?

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