Septal Deviation of 5-6mm and Nasal Septal Spur: Severe Enough to Need Septoplasty?

Question

I have had constant nasal congestion, head aches, sinus infections, ear infections, pressure in my ears, and post nasal drip for a while now. I recently got health insurance because I no longer live with my parents and can't be covered under their policy. My dr. gave me claritan, an antibiotic, singular, nasonex, and flonase. nothing improved my breathing after two weeks on all of the meds so my dr. ordered the ct scan of my paranasal sinuses those were my results. Will I need surgery?

Frank Scaccia, MD, FACS · Answer

To better answer your question a thorough intranasal exam including a fiberoptic scope and a review of your actual sinus cat scan is necessary

Julian W. Dixon, MD · Answer

Great question. A septoplasty is largely an elective procedure, thus its not really proper to suggest that anyone "needs" or must have a septoplasty. That being said, if you do not breathe well through your nose and there is some discernible obstruction of the nose by your septum then surgery is an excellent option for most patients. Simply put, if you want to breathe better through your nose, and you have a deviated septum, in my opinion there is no single treatment that will improve your breathing more than a well done septal surgery. Septopalsty is exceedingly well tolerated due to little or no pain, and nearly universally successful in improving breathing. Hope this helps.

David Q. Santos, MD · Answer

The most important element of this larger picture is the overall story of persistent nasal problems despite medical treatment.  Essentially, if conservative medical treatment could resolve the problem then we wouldn't even need to discuss the septal spur findings on the CT scan.  When conservative management fails, then surgery is indicated and very commonly successful in alleviating much of the symptoms.  When surgery is deemed necessary, the septal spur and less than straight septum should be addressed.  Straightening the septum via resolving the septal spur is needed, but in of itself will not completely resolve the problem.  Nonetheless it should be addressed.On the other hand, one should not have surgery simply because a CT scan indicates that the septum has spurring.  The clinical picture has to be taken into account.

William Portuese, MD · Answer

A moderate to severe septal deviation documented on a CAT scan along with a history of symptoms that are unrelieved with medications is usually an indication for surgical intervention.  It is important to try medications first and make sure that they are not working prior to undergoing surgical intervention such as a septoplasty.  In addition, it is also important to address turbinates if they are hypertrophic and once lateralized can improve the airflow dynamics through the nose.  Chronic sinus infections are addressed through endoscopic sinus surgery if there are polyps located inside the sinuses.  This can all be done simultaneously.

David A. Bray, Sr., MD · Answer

In my practice, the indication for septoplast is based on clinical exam and patient history. If allergy is an issue then complete that part of the workup and treat before moving on to an invasive procedure.

Septal Deviation of 5-6mm and Nasal Septal Spur: Severe Enough to Need Septoplasty?

Answers (7)

Answer: Degree of septal deviation needed for septoplasty

Answer: Degree of septal deviation needed for septoplasty

Answer: Indications for septopasty

Answer: Indications for septopasty

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Everything you need to know about Septoplasty

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Septal Deviation of 5-6mm and Nasal Septal Spur: Severe Enough to Need Septoplasty?

Answers (7)

Answer: Degree of septal deviation needed for septoplasty

Answer: Degree of septal deviation needed for septoplasty

Answer: Indications for septopasty

Answer: Indications for septopasty

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Recommended reading

Everything you need to know about Septoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.