The curvature of the nose is a change of symmetry of the nose and/or natural proportions that occur most often due to deformation of the nose and/or septum.
Pathology means not only a cosmetic defect. Its consequences can be more serious – the most common of these is the violation of nasal breathing. Some patients may experience headaches and snoring.
Among all the anatomical structures that form the nose, most of the deformation occurs in the side of his partition. The nasal septum to form bone and cartilage elements.
The anatomical conditions
The bony part of the septum consists of:
- perpendicular plate of the ethmoid bone;
- opener.
Between the Coulter and the disc is quadrangular cartilage of its upper edge also serves as the forefoot back of the nose. To the quadrangular cartilage with the two sides adjacent to the inner legs krylnyh cartilage. Unlike bone, skin and cartilage of the division septum, which is the front segment, moving – nevertheless, easily deformed even when not too severe mechanical action on it.
The nasal septum divides the nasal cavity vertical into two parts – they are usually not the same, this asymmetry is found in 75-90% of all people. If the nasal septum is curved, the cavity still more vary in size and internal structure, which may be unilateral deterioration of nasal breathing.
Reasons
The curvature of the nose is manifested as:
- a hereditary trait;
- the consequence of uneven growth of the bones of the nose;
- the result of the uneven growth of the remaining facial bones (and not only) of the skull;
- consequence of injuries of the nose;
- the result of a number of diseases.
The curvature of the nose as a hereditary trait can be observed from generation to generation – often about the consequences of the curvature (in particular, violation of nasal breathing) to the audiologist treated several members of one family.
The unequal growth of the nasal bones, which leads to its curvature, occurs:
- due to failures in the formation of the upper airway during fetal development;
- as a result of disease in the early postnatal period.
Irregular growth of facial bones, which may occur deformation of the nose, triggered by the same factors as the uneven growth of the nasal bones. If the architectonics of the skull (a combination of bone structures in the same unit) is changed, this causes a change in the “composition” of the nasal bones and, as a consequence of the weakness of their connections, causing the curvature of the nose.
Injuries of the nose is the most common cause of its curvature.
To described the pathology of lead:
- burns;
- mechanical traumatization.
Burns can be:
- chemical;
- thermal.
Their role is that in the recovery period nose appears scar tissue that can cause its deformation.
Deformity of the nose due to mechanical trauma occurs in the following way:
- in minor trauma, when the forces of traumatic agent was only enough to offset structures of the nose;
- as a result of improper restoration of the structures of the nose after severe trauma.
Traumatic damage to the bones and cartilage of the nose, leading to its curvature, is:
- unintentional;
- conventionally, unintentional;
- intentional.
Unintentional trauma is often observed:
- in a domestic environment;
- in the workplace.
A variety of household situations that can lead to deformity of nose, perhaps the greatest – until the absurd and comic situations.
Most often, this trauma is preceded by:
- fall flat on your nose – is observed at loss of balance. It happens when there is loss of consciousness, alcoholic intoxication or drug, the result of an epileptic seizure. Can also be fall in the loss of balance due to careless human actions, when he can drop literally out of the blue;
- the fall of man bulky items. It is pretty rare cause the subject to fall on the area of the facial skull;
- trauma due to careless behavior during group play, when down the water slides, overcoming obstacles in the Park entertainment and so on.
Production trauma of the nose with its subsequent deformation often occurs due to non-compliance of safety rules and ignoring safety regulations. In most cases, injured people engaged in physical labor:
- builders;
- repairers;
- professionals in the field of agriculture
and so on.
Injuries of the nose are often observed as a consequence:
- falling from height;
- blows farm animals – the horse’s hoof, sheep’s or cow’s horn
and others.
Unintended causes of the curvature of the fracture often causes a sharp deceleration of the vehicle (in particular, if the driver or passengers not wearing a seatbelt and hit his nose on the glass front of the showroom or car seat front).
Trauma leading to deformation of the nose, are deemed to have been unintended when playing sports.
Basically it is a sport which involves falling and the power struggle with rivals:
- football;
- hockey (no protective gear);
- basketball;
- volleyball;
- gymnastics
and several others.
Intentional injuries rarely result in curvature of the nose – often they are the cause of more severe violations on his part. However, deformation of the nose can occur due to unexpressed injury in the fight, when the man managed to Dodge the punch in the nose.
Also applies to intentional trauma during the fighting, mostly from the concussion of the facial skull.
Of pathologies that can cause a deviated septum, often “caught”:
- syphilis – a venereal disease caused by a pale Treponema. It can not only affect the sexual organs, but other organs and tissues – in this case, the structure of the nose. End result, the disease leads to permanent destruction of elements of the nose, but the earliest stages of this pathology can manifest its curvature;
- disease of bone;
- disease of cartilage.
Of diseases of bone tissue, which may cause distortion of the nose, most often mentioned:
- rickets – a disease of infants and young preschool age, in which the period of most intensive growth of the organism there is a disorder of bone formation, provoked by the deficit of vitamin D;
- osteoporosis – a chronic progressive decline in the density of the bone elements (and, consequently, bone strength), the violation of their structure at the micro level, increased fragility due to metabolic, and hence fracture risk. In simpler words: osteoporosis – bone fragility due to “washout” of these mineral compounds;
- degenerative changes in the bone tissue is its destruction (more often on the background of pathology of the metabolism).
Such destruction of bone tissue lead to its depletion – because of this comes the weakening of bone structures.
Defeat of the cartilage, can lead to curvature of the nose often develops on the background:
- chondrites – inflammation of the cartilaginous structures;
- degenerative changes in the cartilage – its destruction, which is due to any pathological factors, other than traumatic.
Chondrites can be of different origin:
- non-specific (caused by a trivial infection);
- TB;
- leprosy;
- parasitic;
- fungosa (caused by pathogenic fungi);
- tumor (develop against tumors).
Mainly degenerative changes in cartilage occur as a result of autoimmune pathologies – diseases in which the body perceives its own tissues as foreign and triggers the fight with them.
Most often deformity of the nose due to destruction of cartilage observed on the background of diseases such as:
- rheumatoid arthritis – a systemic lesion of the connective tissue, which manifests itself mainly by chronic inflammation of the joints;
- gout – disorders of metabolism in which urate (salt of uric acid) get deposited in the joints;
- chondrocalcinosis – the deposition of calcium salts in the cartilage;
- psoriasis is a chronic non-infectious pathology of the skin with the appearance on the characteristic reddish-pink rash and peeling;
- gemohromatose – violation of the metabolism of iron with its subsequent accumulation in the tissues
and several others.
Also identified factors that directly to the pathology of bone and cartilaginous structures of the nose is not lead, but on their background the chances of weakening the bone and cartilage of the nose (and thus, deformation of the relevant structures) are increasing.
It is the following factors:
- diseases of the blood vessels;
- diseases of the blood;
- endocrine diseases;
- metabolic;
- chronic, long flowing disease.
Of vascular disease contribute to the deterioration of the microcirculation in the tissues of the nose, and therefore, disruption of their supply with the subsequent weakening of cartilage and bone structures. Often:
- hypoplasia of the arteries and veins – their underdevelopment (most often congenital);
- hemorrhagic vasculitis – non-infectious inflammation of small arteries and veins with their subsequent destruction;
- periarteritis nodosa – inflammation of the artery wall in which are formed microaneurysm (a small protrusion of the vascular wall)
and several others.
The involvement of such abnormalities to the deformation of the nose lies in the fact that disturbed blood supply of the bone and cartilaginous structures of the nose – they do not get enough oxygen and nutrients, as a result becoming weaker and more sensitive to the action of a pathological factor.
Diseases of the blood involved in deformation of the nose in the sense that their background is also deteriorating nutrition of bone and cartilage structures of the nose. Most often it is:
- different types of anemias – pathology of the blood, which reduced the number of erythrocytes and hemoglobin;
- leukemia – neoplastic lesions of the hematopoietic system causing insufficient production of blood cells.
Endocrine disorders contribute to the curvature of the nose, because because of hormonal failures violated the metabolism (metabolism) and trophic (feeding) tissue. One of the most significant disorders is diabetes mellitus – a failure of carbohydrate metabolism due to persistent shortage of insulin.
Of chronic diseases often the background for the deformation of the nose are the following diseases and pathological conditions:
- hypovitaminosis – in addition to the previously indicated lack of vitamin D, has a value insufficient intake of B group vitamins;
- disorders of mineral metabolism – primarily calcium;
- involvement of the gastrointestinal tract (particularly the intestine, where vitamin D is absorbed)
and others.
The development of the pathology
If deviated septum is the bone and/or cartilage parts of it are also formed:
- thickening;
- curves;
- a protrusion.
Such small defects, however, impair nasal breathing, as develop on the background curvature.
Depending on which tissue structures of the nose have suffered, there are two types of curvature of the nose:
- bone;
- cartilage.
The violation of the symmetric shape of the nose is mainly observed in the region of the backrest or of the nasal septum.
A deviated septum can be of several types:
- C-shaped;
- S-shaped;
- a deviated septum in relation to the bone crest of the maxilla
- the combined curvature of the nasal septum and a maxillary bone crest.
The curvature depends on the choice of corrective surgery.
Symptoms
The signs of the curvature of the nose are:
- local;
- common.
Local signs include:
- violation of the natural shape of the external nose;
- obstruction of nasal breathing;
- discharge from the nose;
- snoring.
Common signs include:
Violation of the natural shape of the external nose is most often seen in:
- the presence of a hump of the nasal bridge;
- asymmetry the two halves of the nose.
Violation of nasal breathing leads to the fact that the person is breathing with an open mouth – this can lead to drying up of the mucous membrane of the mouth, which provokes unpleasant feelings.
Nasal discharge often appear when the accession of infectious complications.
Headaches and deterioration of health are developing due to the violation of nasal breathing and, as a consequence, violations of oxygen to the tissues.
Diagnosis
Diagnosis of curvature of the nose put on the basis of complaints and data inspection. Additional research methods (instrumental and laboratory) are mainly used to determine the cause of pathology and to clarify the extent of changes in the nose.
Data of physical examination:
- on examination – determines the sign of deformation of the external nose. The patient is asked to close one nostril and breathe in the other – in this regard the shortness of breath. When severe deformation of the nose violation of nasal breathing and determined without testing.
Instrumental methods of research that are informative for the diagnosis of curvature of the nose is:
- anterior rhinoscopy examination of the nasal cavity with nasal mirror and the reflector. Using this method you identify the location of the deformation;
- posterior rhinoscopy – inspection with the use of a nasopharyngeal mirror with which to examine the nasal cavity from the nasopharynx;
- x-rays of the nose – with its help detect the displacement of the bone and cartilaginous elements of the nose.
Laboratory methods are not determinative in the diagnosis of curvature of the nose. They are used based on suspicion of specific diseases, which could contribute to the development of the curvature of the nose. This:
- General analysis of blood – increase the number of leukocytes and ESR confirmed the presence of infectious-inflammatory process in the nose;
- bacterioscopic study – the study of smears from the nasal cavity for the presence of pathogens, triggering an infectious disease that, in turn, provoked the curvature of the nose;
- bacteriological examination – seeding smears from the nasal cavity on the nutrient medium, grown colonies identify infectious agent;
- immunological methods for diagnosis of immune and autoimmune pathologies;
- Wasserman – when diagnosed with syphilis, which with the progression may lead to deformity of nose
and several others.
Differential diagnosis of
Differential diagnosis is carried out between the pathologies that could trigger the development of curvature of the nose.
Complications
Complications that often accompany a curvature of the nose are:
- violation of nasal breathing, in marked curvature of the nose until it is turned off;
- rhinitis – inflammation of the nasal mucosa;
- otitis media – inflammation of the various departments of the ear;
- sinusitis – inflammation of the sinuses. Mostly sinusitis is an inflammation of the maxillary sinuses. Less commonly develop sinusitis (inflammation of frontal sinuses), etmoidit (an inflammatory lesion of the mucous membrane lining the cells of the ethmoid bone), sphenoidal (inflammation of the mucosa covering the sphenoid sinus);
- nosebleeds.
Treatment for curvature of the nose, surgery
A deviated nose can be corrected only with surgical intervention. It is carried out according to the indications:
- medical;
- aesthetic.
Medical indications for rhinoplasty are:
- deterioration of nasal breathing;
- vasomotor rhinitis, against which violation of nasal breathing due to the curvature of the nose greater;
- nosebleeds;
- sinusitis;
- snoring.
This involves such operations as:
- rhinoplasty – correction of the external nose;
- nanoplastics – the elimination of the curvature of the nasal septum;
- osteotomy – when it carried out the convergence of the bones of the nose
and others.
Surgical treatment of curvature of the nose is recommended after 18 years – after this age the turn completed bone growth of the nose. If the curvature of the nose provokes marked disorders (worsening of nasal breathing, headaches, and so on) in each individual case the possibility of rhinoplasty in the earlier period.
Rhinoplasty requires training and certain conditions:
- surgery in women is carried out not earlier than 10-14 days after your period (this is due to the risk of severe bleeding during the menstrual period);
- during exacerbation of inflammatory diseases of the nose or paranasal sinuses, they need to be cropped. Plastic surgery can be done not earlier than 2 weeks after the treatment.
In the basis of postoperative treatment is based on the following assignments:
- tamponade of the nose;
- receiving liquid diet exclusion from the diet of hot dishes;
- antibacterial drugs for prevention of postoperative infectious complications;
- painkillers;
- after removal of the tampon – careful cleansing of the nasal cavities of crusts, greasing of the nasal passages sterilized oil.
Nasal breathing is not restored immediately, the patient can breathe freely through the nose in just a few weeks after the operation, disappears when the soft tissue swelling and will cease to form a crust of sukrovichnye mucous secretions.
For 1 month after the operation the patient is contraindicated in any physical activity.
Possible complications of plastic surgery
Using appropriate surgical techniques complications plastic correction of the shape of the nose do not develop often, but about the possibility of their occurrence should be remembered. This:
- epistaxis – due to damage of vessels during surgery;
- formation of hematoma – formation in the soft tissues of the nose of blood clots as a result of nasal bleeding;
- the abscess of the nasal septum – abscess caused by penetration of an infectious agent in the surgical wound;
- perforation of the nasal septum as a result of wounds medical instruments during operation or the result of abecedarian;
- iatrogenic (caused by medical manipulations) deformation of the external nose. It may occur due to the need for a high resection of the quadrangular cartilage.
Prevention
The main prevention of curvature of the nose the following activities:
- avoidance of trauma to the nose;
- prevention of pathologies that can lead to distortion of the nose, and when available – early detection and treatment. This is especially true of rickets and perichondritis;
- the diseases that can contribute to the curvature of the nose.
Forecast
The prognosis for the curvature of the nose in General prosperous – thanks to the developed skills of plastic surgeons.
Some unpleasant consequences may arise exclusively from the unwillingness of the patient to deal with problems of their own noses.
