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slide 1 - female patient before and after procedure slide 2 - male  patient before and after procedure slide 3 - female patient before and after procedure side view come experience comfort - slide 4

Nasal Obstruction and the Deviated Septum

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Modern Rhinoplasty Textbook
Table of Contents

General Considerations
Nasal Aesthetics & Analysis
Nasal Anatomy
Functional Rhinoplasty

Management of the Nasal Tip

The Nasal Hump
Male Rhinoplasty
Ethnic Rhinoplasty

The Aging Nose
The Twisted Nose
Finesse Rhinoplasty
Revision Rhinoplasty
The Hanging Columella
The Retracted Columella
Alar Base Reduction

Procedure Details

Nasal Obstruction and the Deviated Septum

Nasal obstruction is a subjective sensation that does not always correlate with anatomic problems. In other words, some people can have a slightly deviated septum and complain profusely of their difficulty breathing, while other people are completely obstructed on one side of the nose without ever even realizing they have a problem. So if you have trouble breathing through your nose, it is important to let the nasal experts- Drs. Litner and Solieman- do a thorough evaluation.

Nasal obstruction is a complicated issue that is all too often ignored, attributed to “allergies or sinuses,” or to a “deviated septum.” It is true that oftentimes the nasal obstruction is due to:

  1. A Deviated Septum- where the midline cartilage and/or bone that separates the two sides of your nose is crooked
  2. Nasal Allergies- whether seasonal or year-round. If you experience nasal allergy symptoms, you should be thoroughly evaluated to see if there are any other factors that may exacerbate your breathing problems. When there are no other underlying issues, pills or nasal sprays can be used to help control the symptoms or a referral to an allergist for testing can be made when necessary.
  3. “Sinus Problems”- This diagnosis is unfortunately all too commonly applied to patients without proper evaluation. Drs. Solieman and Litner can check to see if your source of nasal obstruction is really due to sinus infections or polyps, or if there are other reasons for your symptoms, and they can then treat you accordingly.

Oftentimes, Drs. Litner and Solieman find that the diagnosis previously given to patients for their breathing problems does not fully account for all findings. In fact, reports suggest that 20%-30% of patients who undergo septoplasty find that their breathing symptoms are not adequately corrected. There are numerous possible explanations for this which you can discuss with Drs. Solieman and Litner. The complexity of this problem is one of the reasons that Drs. Litner and Solieman, both trained Head and Neck Surgeons, have devoted so much of their training and research to the proper diagnosis and treatment of these problems.

Evaluation of Your Nasal Breathing Problems

Drs. Solieman and Litner thoroughly examine and visually inspect all of their patients who complain of nasal airway obstruction because they realize that the preoperative evaluation is essential for diagnosis and treatment planning.

Attention is first directed toward visual assessment of the external appearance of the nose. This exam initially focuses on the size, shape, contour, symmetry, and straightness of the nose. Observing the sidewall motion during restful breathing and during forced inspiration allows Drs. Litner and Solieman to evaluate for external valve contributions to breathing problems as well as tip ptosis related obstruction (drooping of the nasal tip).

Anterior rhinoscopy (looking inside the nose) then allows visualization of:

  1. the septum
  2. the inferior turbinates, and
  3. the internal nasal valve

Other maneuvers are then performed to further delineate potential sources for your breathing problems.

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