Crooked nose bones, is it dangerous?

The nose is the most prominent part of the face. Anatomically, the structure of the nose consists of the bridge of the nose, bridge of the nose, top of the nose, ala nasi, columella and nostrils. The right and left nostrils are separated by a dividing bone called the nasal septum. In general, the nasal septum is not perfectly aligned in the center or is bent. It is estimated that 75-85% of the world's population experience nasal anatomical deformities in the form of nasal septal deviation.

            A bent nasal septum can be caused by congenital abnormalities due to impaired bone growth, trauma / impact to the nose, infection or malignancy. The nasal septum can be bent in the form of a 'C' or 'S' protrusion in the horizontal or vertical plane of the bone structure or nasal cartilage.

            Nasal obstruction is the most commonly complained symptom. Nasal obstruction can occur on both sides, namely on the nostrils where the septum is bent and on the contralateral side due to swelling of the konka structures as compensation. A bent septum in the outflow of the sinuses can cause disruption in the drainage of sinus secretions, making it prone to sinusitis. Smell disturbances can also occur if the upper part of the nasal septum is bent, preventing the delivery of odor stimuli to the smell nerves at the tip of the nasal bridge.

            A simple examination can be performed to determine which side of the nostril is affected. A metal spatula is placed ± 1 cm in front of the nostrils and the patient is asked to breathe normally by closing the mouth, so that the image of dew on the spatula will be seen. On the side of the nose that is blocked, a smaller dewy appearance will appear. Another test uses a nasoendoscopy, which is a low-level invasive procedure by inserting a rigid type endoscope into the nostrils. This procedure can be done in an outpatient clinic and without the need for anesthesia. Nasoendoscopy can provide direct visual access to the condition of the nostrils and septum. An imaging examination that can be done to assess the anatomy of the nose and nasal septum is a computed tomography (CT) scan. This examination can not only assess the degree of curvature of the nasal septum, but also the complications it causes.

            In the nasal septum with mild curvature, it often causes no symptoms and therefore does not require therapy. Meanwhile, for nasal septal deviation that causes significant obstruction, surgery can be performed. Surgery may include submucosal resection, septoplasty, and open septoplasty. Submucosal resection is performed by removing most of the septal cartilage and leaving a formation like an inverted 'L' which serves as a support structure for the nose. This procedure has the potential to cause extensive damage and a risk of complications. The surgical technique for septoplasty is similar to submucosal resection, but less cartilage is removed. An open septolasty is the best approach for correcting a septum with extensive and severe curvature.