Nasal septum curvature surgery in children

The curvature of the nose is among the important reasons that prevent growth and development and reduce school success in children. Surgical intervention for the growing nasal septum in children has been the focus of discussions for almost a century. In children, this intervention has remained as TABU for many years, with the concern that it will prevent the development of the septum. Today, surgeries for this problem are generally performed by a small number of Ear Nose and Throat surgeons all over the world. In children who cannot get enough oxygen due to nasal curvature and therefore growth-development is retarded, with correct diagnosis and appropriate surgery, the growth and development of children can accelerate and their school success may increase.

What is the nasal septum?

The nasal septum is a wall of cartilage and bone that divides the inside of the nose into two and ensures that the air reaches the lungs equally.

What are the causes of nasal septum curvature?

Various factors affect nasal growth and lead to nasal septum curvatures. Trauma during birth, blow to the nose in early childhood, and the most important of these are hereditary features inherited from parents.

What are the complaints of patients with nasal septum curvature?

Nasal congestion, runny nose, nasal discharge, crusting in the nose, decreased sense of smell, snoring, sleeping with an open mouth, dryness in the mouth, decrease in sleep quality, urination on the bed at night, headache and facial pain are the main complaints of patients with curvature of the nasal septum. The curvature of the nasal septum paves the way for upper and lower respiratory tract infections and reduces the quality of life. As a result of abnormal breathing, facial development ends with asymmetry due to the decrease in the aeration of the sinuses. Mouth breathing leads to deterioration of the structure of the lower-upper jaw and teeth. In addition, insufficient oxygen intake causes serious problems in the intellectual and physical development of children; It can lead to a decline in school success and retardation in growth.

Should surgery be performed for nasal septum curvature in children?

Nasal septum surgery in children has remained taboo for many years because of the concern that it will prevent the development of the growing septum. However, with the development of conservative surgical techniques since 1950, this idea is a thing of the past. As a result of the studies of world-renowned otolaryngologists, it has been reported that the correction of the nasal septum in the early period positively affects the growth of the nose and face.

At what age can nasal septum curvature surgeries be performed in children?

The cartilage septum grows very rapidly in the first 2 years of life, then the growth rate slows down and comes to a near standstill around the age of 5. Therefore, septum surgery can be performed in children from this age. Septal deformity, which severely impairs nasal breathing and causes mouth breathing even at rest, should be treated primarily. If a very bad nose is not intervened, the development of the nose and midface will be adversely affected. Most importantly, if the septum is brought into the right shape during the development period, then the growth will be in the right way. The longer the intervention is delayed, the longer the child will have to endure nasal congestion and its adverse effects.

Is the surgery performed in children the same as in adults?

We perform this surgery with the closed technique (using the endoscope) in children as in adults, and the results are satisfactory. In order not to harm the child’s nose development, only certain parts are intervened and as little cartilage is removed as possible.

What are the success rates of this surgery in children?

Since as little cartilage is removed as possible during septum surgery in childhood, approximately 1/3 of them may need to be operated again in adulthood. Our main goal here is to facilitate the respiratory function of the child until adulthood, to prevent possible growth retardation and abnormal nose-face development and to increase the quality of life. The idea of ​​performing this surgery in the post-adolescent period, unless it is necessary, is still valid. However, it is appropriate not to wait stubbornly after puberty in children with respiratory distress and to perform septoplasty surgery with a conservative approach, paying attention to their growth points.