Are X-rays required for deviated septum surgery?

Question

Went to ENT to get nose looked at for deviated septum. Dr agreed it was and said surgery was needed. He did a 30 exam and said he didn't need X-rays. Kinda nervous for surgery with such little diagnosis. I agree it's broke but don't most surgeons want X-rays?

Anand G. Shah, MD · Answer

Hello.  As always, the definitive answer rests with an in-person consultation.  Generally speaking, a deviated septum is made on examination.  Hope this is helpful.

Stephen Weber MD, FACS · Answer

X-rays are actually of very limited value. A better study to evaluate the nasal bones after trauma would be a CT scan. However, this exposes you to unnecessary radiation and does not contribute to the treatment. Broken noses are most often a clinical diagnosis made based on the evaluation of your nose inside and out and your history of injury. When patients are referred to me for nasal fractures and they come with an X-ray, I always review it after seeing the patient. This has never changed my initial treatment plan. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Lee Kleiman, MD · Answer

X-rays are not necessarily indicated for isolated deviated septums unless the symptoms are indicative of other sinus symptoms or other facial fractures are suspected .

Andrew S. Frankel, MD · Answer

The diagnosis of a deviated septum is one that does NOT require x-rays. A thorough examination and careful history are all that is needed to assess the nasal passages. While there are times when a scan or plain films are warranted to assess the entire clinical picture of a patient, these are rare instances and nearly 100% of the noses I operate on are done without obtaining a preoperative x-ray.

William Portuese, MD · Answer

A plain x-ray is only performed in our practice when a patient has  had a very recent nasal fracture. After one month the bone heals and that x-ray will not show anything. The diagnosis of a deviated septum is made upon examination of the internal portion of the nose. When patient's have chronic sinusitis, a CAT scan of the sinuses is performed which can also help evaluate and document a deviated septum.

Are X-rays required for deviated septum surgery?

Answers (5)

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