Overview
Congenital deviation of the nasal septum, also known as nasal septal deviation, is a structural anomaly present at birth that can obstruct airflow through the nasal passages, leading to symptoms such as nasal congestion, recurrent sinusitis, and sleep disturbances. 1Diagnosis
Physical examination by nasal endoscopy to visualize the deviation and assess its severity.
No specific diagnostic tests required beyond clinical evaluation, though imaging (CT/MRI) may be used to assess extent and complications 1.Management
First-line treatments:
- Septoplasty surgery for significant symptomatic deviations 2.
- Local anesthesia with sedation as a safe and effective alternative to general anesthesia for day-case procedures 2.
Adjunctive treatments:
- Conservative management with nasal splints or dilators for minor deviations 1.
- Symptomatic relief with saline irrigation and decongestants for associated symptoms 1.Special Populations
Pediatrics: Local anesthesia with sedation is safe and acceptable for pediatric septoplasty procedures 2.
Elderly: No specific considerations mentioned; general anesthesia or local anesthesia with sedation can be tailored based on patient condition 2.
Comorbidities: No specific guidelines provided; anesthesia choice should consider overall health status 2.Key Recommendations
Septoplasty can be effectively performed as a day-case procedure under local anesthesia with sedation, offering a viable alternative to general anesthesia 2 (Evidence: Strong).
Training models combining realistic anatomical features, such as those using pig ears and 3D-printed components, can significantly enhance surgical skills for septoplasty 1 (Evidence: Moderate).
Bleeding rates and overnight admission rates should be monitored closely in day-case septal surgeries, with rates around 10-11% noted in recent audits 2 (Evidence: Moderate).References
1 Kim J, Patel T, Helou V, Jabbour N. Development and Validation of a Hybrid Simulation Model for Septoplasty Training. The Annals of otology, rhinology, and laryngology 2025. link
2 Srinivasan V, Arasaratnam RB, Jankelowitz GA. Day-case septal surgery under general anaesthesia and local anaesthesia with sedation. The Journal of laryngology and otology 1995. link