Do you have nasal allergy, allergic rhinitis or asthma? Would fixing a deviated septum help?
This is an especially bad pollen season; with the floods, add mold sensitivity to the allergy woes. After the New Orleans Katrina flood, and the Joplin tornado, mold overgrowth became a significant problem, including mold sinusitis. You can expect mold sinusitis in the Mississippi flood areas.
If you have a deviated nasal septum, will getting it fixed cure your allergy? Usually, the answer is no, but there are exceptions.
What is a deviated septum? In the perfect nose, the septum is what divides your two nasal chambers. It lies in the middle of your nose. If you place your fingers into each nostril, it is the firm divider between your fingers.
The nasal turbinates are the shelves on the outer parts of the nasal chamber. In allergic rhinitis, they swell up and add to nasal blockage. If your nasal septum is precisely midline, you are a rare bird. Kids fall, nose gets hit during athletics, and even the baby's head will strike the mother's nose. In 90% of people the septum is deviated. But usually it is not enough to cause symptoms.
In a deviated septum, the site that bows to the side of the nose is called the convex side; the side that bows away from the side to the opposite side is termed the concave side. To visualize, hold a sheet of paper straight up. Now push is down, one side will be convex, sticking out and the other side concave, curved like a cup.
Since 90% of people have a deviated septum, obviously it doesn't cause a serious problem to all persons. When it does, correction is usually indicated.
A convex septum may impact into the side of the nose, causing a narrowing of the airway. Here breathing is impaired. This can significantly affect sleep and sleep apnea, headaches and sinus infections. The deviation may care the sinus openings to be blocked; once a sinus is blocked with no outlet for bacteria, a sinus infection develops.
The opposite side, the concave side may be wide open so that the patient gets plenty of air through that side. But, often that side may be blocked too, sort of an S shaped deformity. I have had situations where both sinus drainage systems were severely obstructed by a bad septum.
A deviated nasal septum can have an effect on allergy. Ideally the pollen enters the nose and is whisked away by air currents. However even in the straight septum, some of the pollen is trapped in the mucus. In some situations, the convex septum is like a hill, and the pollen, dust and toxic chemicals get deposited "behind" the hill. Once deposited there, unmoved by air currents, they invade the body. This can be a significant factor in industrial situations: chemicals that normally move out of the nose, get deposited and cause problems.
On the concave (pushed in) side, air currents are slow because of the width of that area. Think of a garden hose with the opening wide open: the water dribbles at your feet. Here too pollen and dust may get deposited.
Nasal headaches may arise when a deviated septum directs airflow against a nerve ending. When this is suspected, the doctor can make the diagnosis by anesthetizing that spot to see if the headache vanishes.
In cases where there is already blockage of breathing due to septal deviation, the patient may get along before allergy season. Before the pollen starts, he breathes satisfactorily. But the slightest pollen inflammatory response will now completely block the nose. In my field of Ear Nose and Throat, we are routinely referred allergy patients who, despite the best allergy treatment still have poor breathing because of the septal blockage, and then get relief when the septum is straightened. With a straight septum, otherwise mild allergic rhinitis may not cause significant symptoms.
Despite all kinds of fancy measuring devices, the decision whether correcting a deviated septum will aid the allergic patient, is still a subjective call. This is because we daily see a patient with a clearly deviated septum who insists he has no nasal symptoms whatsoever. Most of these patients have good nasal cilia function that removes pollen and dust. In addition, patients may be fully relieved with non-surgical therapy. Because of the possibility of Empty Nose Syndrome or ENS after septal and turbinate surgery, it is important to seek relief without surgery.
For example: Jane has a deviated septum but is relatively free of symptoms. But she gets clogged up during the six weeks of the allergy season. She is symptom free if she takes her allergy pill for those six weeks. For Jane, fixing her septum would not be indicated.
One useful action is to have the patient use pulse wave irrigation. This is saline irrigation that pulses at a rate to restore good cilia function. When the cilia are restored, many of the allergic symptoms may be relieved and then surgery is not necessary. The cilia function to remove unwanted material from the nose. In the example of Jane above, some of my patients get relief this way- using pulse wave to restore the cilia, and can skip the pills.
Because this is going to be a bad season, remember to:
Avoid getting chilled. Avoid iced drinks.
Avoid hot spicy foods.
Use unscented lipstick.
Change clothes when you get home.
Close windows at 5 AM and 5 PM when plants pollinate
Keep moisture in bedroom at 50% to prevent dust mites
Make sure lawn sprinklers don't spray under the house to avoid mold.
Drive with windows closed.
Avoid driving behind diesel trucks.
Dust proof the bedroom.
If you own a yacht, stay on it during high pollen season. Seriously, you can use the pollen calendar information to locate best places to vacation that are low in pollen.
In summary, most persons do not have a deviated septum that is severe enough to significantly effect allergy symptoms. Those that do, however, should be tried first on pulse wave irrigation. However, in the final analysis it is up to the doctor to use his/her best judgment to decide if surgical correction is the best course.
It is important to understand that fixing a deviated septum will not cure an allergy. After the septum is made perfectly straight, the patient will still be allergic to pollen and cats. But the serious complications of allergy will be reduced. One of the complications we wish to avoid is poor sleep. In these situations, fixing a nasal septum that is blocking the breathing and aggravating the allergy, can give significant relief.
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