Closed Reduction Performed at 7 Days but I Still Have a Deviated Septum, What Can Be Done?

Question

My nose was injured and 7 days later an ENT consultant told me my nose was broken and did not mention my deviated septum. He reset the bridge of the nose and this clicked in place however did not use tools inside my nose. A letter stated my nose was manipulated as it was bent to the left and only then learnt of a mild right deviated septum that was not causing breathing difficulties. The bottom of my nose is now twisted to the right with uneven nostrils. Will a septoplasty alone solve this?

Aaron Stone, MD · Answer

Without a photo or face to face examination it is impossible to say whether a septoplasty alone will suffice to straighten your nose. Sometimes there is remaining asymmetry in the bones despite the reduction at 7 days. You will have to wait for all of the swelling to resolve and then you can check for nasal bone symmetry by placing a finger along each side of the nose just under each eyebrow. If the fingers are not in symmetric positions relative to the midline and the back of the head then a septoplasty alone will not suffice. Something will also have to be done to the nasal bones.

	My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Stephen Prendiville, MD · Answer

In general, a closed reduction is a relatively simple procedure which allows a return of the nasal bones to their original (or straight) position) after acute trauma. Although some would advocate immediate surgery for an acutely fractured septum, I think it is better to allow a period of healing before Septoplasty is attempted. The nasal septum provides support for the dorsal height of the nose and overaggressive intervention can lead to nasal collapse. Whether or not a Septoplasty will address the appearance of the bottom of your nose is a question that only a physical examination will answer.

Babak Larian, MD · Answer

It is challenging to answer this question without seeing a picture, however if the septum which is normally nestled on a boney projection on the floor of the nose (the maxillary crest) is displaced off by the injury, then the nostril will appear uneven. This can be corrected by a comprehensive septoplasty that involves repositioning of the septum and securing it back onto the maxillary crest.

Sumit Bapna, MD · Answer

Depending on the degree of septal deviation and external deviation, a septoplasty may be an adequate procedure. The saying is "the nose follows the septum." So in may instances, correcting a deviated septum will help straighten the nose. If the external deformity is severe, some rhinoplasty maneuvers may be required as well.

	Keep in mind, your septum and nose do not need to be fixed unless you are having nasal airway obstruction or the external deformity bothers you.

Closed Reduction Performed at 7 Days but I Still Have a Deviated Septum, What Can Be Done?

Answers (4)