Deviated Septum and Relation to Obstructive Sleep Apnea and Allergies
Question:
Steve, I had a deviated septum straightened when I was 14 years old. During the same surgery they did a turbinectomy and a tonsilectomy. The turbinectomy is where they remove some small bones in the nose called the turbinates. This was back in 1987 or ‘88 and it was the first thing they did when I was diagnosed with OSA. The surgery itself went very well. On the whole I was able to breathe much better after I’d healed up. See, I’d never been able to breathe through my nose before the surgery. But, it didn’t fix my sleep apnea. Two years later they decided to retest me and that’s when I went on the BiPAP machine. Been on BiPAP ever since and it’s worked very well for me. So, I guess my answer to your question is two fold. If you have a "rather severely deviated septum" then it is probably a good idea to get it fixed. It may help you out a lot with your breathing and it may even help with the OSA. But, I’d caution you not to count on it definately fixing the OSA. Take the ENT’s prediction with a grain of salt. Just like any prediction, it could be wrong. Sincerely, James Hart "Steve Freides" <st…@fridayscomputer.com> wrote in message
news:3D73D4F7.A6C30932@fridayscomputer.com… – Hide quoted text — Show quoted text -> I just found out, via a comprehensive eval at my new ENT, that I have > (to quote the radiologist) a "rather severely deviated septum." I’m > pretty sure I had my nose broken when I was about 16 years old but my > father, who has managed to nearly let several family members nearly die > before allowing them to see a doctor, simply told me I had two black > eyes and to wait until they went away. > Being all that as it may, the ENT thinks that opening up my nasal > passages may help my OSA and my sinuses in general and I’m therefore > very tempted to agree to the surgery. (My sinuses looked very good on > the CT Scan but, while I have no recurrent sinus infections, I do suffer > from nasal allergies and am often on the borderline with vertigo.) I’ve > heard one horror story about a certain nerve getting nicked. > I have had, for as long as I can remember, a discomfort in the side of > my nose to to which the point in my deviated septum leans and I’d really > love that to go away as well. > Any reason _not_ to go ahead with this surgery? I understand the > recovery will be painful, relatively similar to recovering from a broken > nose, but I’m prepared, with the help of modern pain killers, to live > through that if the results are going to be as good as they seem they > might be. > Background: I do not use a CPAP but do have to be very careful about my > sleeping position. I started sleeping on my back after a herniated disk > and the OSA followed a few years later. So far, with a thin pillow, a > small neck roll, and less sleeping on my back as I’ve healed there, I > show no OSA symptoms at night, no longer need naps at all, feel fine, > etc. Any change that would allow me to be a little less careful with my > sleeping position, however, would be wonderful, as would anything that > would ease my allergy and asthma symptoms. > Thanks in advance. > -S-
Response:
- Hide quoted text — Show quoted text -Steve Freides wrote: > J wrote: > -snip- > > The pillows, rolls etc only go so far. > > It’s called Orthopnea > > http://www.nlm.nih.gov/medlineplus/ency/article/003076.htm > -snip- > The article you cited mentions needing a lot of pillows to sleep > properly – I’d love it if that were my situation! I sleep well when > lying on my back only with a single, very thin pillow plus a McKenzie > neck roll – the latter is basically what you’d get if you rolled up a > dish towel and put a couple of rubber bands around it and functions to > tilt my head back slightly compared to the position it would otherwise > assume.
Hey, my chronic sinusitis (and resulting thick yellow post nasal drip) is so bad that I’ve given up sleeping in a bed altogether. I sleep in a chair, upright. And yes, I hate it. — Steven D. Litvintchouk Email: sdlit…@earthlink.net
Response:
- Hide quoted text — Show quoted text -Steven Litvintchouk wrote: > Steve Freides wrote: > > J wrote: > > -snip- > > > The pillows, rolls etc only go so far. > > > It’s called Orthopnea > > > http://www.nlm.nih.gov/medlineplus/ency/article/003076.htm > > -snip- > > The article you cited mentions needing a lot of pillows to sleep > > properly – I’d love it if that were my situation! I sleep well when > > lying on my back only with a single, very thin pillow plus a McKenzie > > neck roll – the latter is basically what you’d get if you rolled up a > > dish towel and put a couple of rubber bands around it and functions to > > tilt my head back slightly compared to the position it would otherwise > > assume. > Hey, > my chronic sinusitis (and resulting thick yellow post nasal drip) is so > bad that I’ve given up sleeping in a bed altogether. I sleep in a > chair, upright. And yes, I hate it.
Steven, were you replying to me or to Steve? Anyhow I’m very sorry for your situation. I was getting similar many years ago. Nothing I took seemed to get rid of the yellow discharge (antibiotics, certain sinus problems). I eventually migrated to methods like saline sprays, removing irritants from my environment, one specific kind of sinus congestion pill, one specific type of allergy pill, vicks up the nose or just outside the nose, steam to loosen the congestion, and immediately following, lying with head down over the side of the bed. (some of) the sinuses are cup shaped and the discharge has no where to go, so the previous method helps the draining. Also neck and facial massages. Meantime, I was also treated for thyroid problems (have you been checked for that?), and changed jobs/living space. Somewhere in that mix, the problem disappeared. Yes, I occasionally get sinus problems. Instead of immediately hopping back on the antibiotic/pill thing, I first try the other methods. You see, in some of us, well in me, I take an antibiotic for one problem and another infection elsewhere roars up, it’s like a vicious cycle that I couldn’t break. Since you’re on the asthma newsgroup, of interest perhaps that I had recent cortisone (steroid) shots in the shoulder and wouldn’t you know, for the first time in 10? years, I did have sinus infection this summer. I sure hope you can get this figured out. Your situation sounds familiar in autoimmune diseases. (but they too take steroids and/or have allergies/asthma. My friend with Lupus has avoided infections /sinus problems for years by similar methods as I. She still does have to use the asthma inhaler tho. HTH J
Response:
J wrote:
-snip- > The pillows, rolls etc only go so far. > It’s called Orthopnea > http://www.nlm.nih.gov/medlineplus/ency/article/003076.htm
-snip- The article you cited mentions needing a lot of pillows to sleep properly – I’d love it if that were my situation! I sleep well when lying on my back only with a single, very thin pillow plus a McKenzie neck roll – the latter is basically what you’d get if you rolled up a dish towel and put a couple of rubber bands around it and functions to tilt my head back slightly compared to the position it would otherwise assume. Thanks much for all your comments. -S-
Response:
Steve Freides wrote: > The article you cited mentions needing a lot of pillows to sleep > properly – I’d love it if that were my situation! I sleep well when > lying on my back only with a single, very thin pillow plus a McKenzie > neck roll – the latter is basically what you’d get if you rolled up a > dish towel and put a couple of rubber bands around it and functions to > tilt my head back slightly compared to the position it would otherwise > assume.
Your method (above) also alters your upper body position. That said, if the septum surgery is successful, your potential change in sleep positions could either improve the apnea or confirm that there’s still problems. You haven’t mentioned the severity of the apnea. I’ll be interested in seeing your post-septum surgery apnea retest. HTH J
Response:
Steve Freides wrote: > Background: I do not use a CPAP but do have to be very careful about my > sleeping position. I started sleeping on my back after a herniated disk > and the OSA followed a few years later. So far, with a thin pillow, a > small neck roll, and less sleeping on my back as I’ve healed there, I > show no OSA symptoms at night, no longer need naps at all, feel fine, > etc. Any change that would allow me to be a little less careful with my > sleeping position, however, would be wonderful, as would anything that > would ease my allergy and asthma symptoms.
Steve, A few more thoughts. My brother does not have asthma, although I suspect he does have some (untreated) allergies hence the saline nasal spray. (or that was to address drying out of the nasal passages due to the CPAP?). I forget now. If you have a history of steroid use this can sometimes predispose to post-surgical infections and/or possible healing problems. In addition, he discussed the surgery several times with the ENT. They decided on not looking for perfection in straightening the septum (ie a less traumatic version of the surgery) in order to open his nasal passage but w/o possible complications that might come with the more extensive septum work. The pillows, rolls etc only go so far. It’s called Orthopnea http://www.nlm.nih.gov/medlineplus/ency/article/003076.htm There can be other contributing causes. If you feel that your asthma is well under control, despite the surgery you may wish a trial of CPAP anyway. HTH J
Response:
> Being all that as it may, the ENT thinks that opening up my nasal > passages may help my OSA and my sinuses in general
Assuming a good surgon it should. > Any reason _not_ to go ahead with this surgery?
Given that you are trying to address a number of problems with the surgery, not really. You should understand though that the septum will be prone to snapping back very easily to its deviated shape if you bump it. More so in the first year. If it snaps back future surgeries have a lower success rate/durability. I understand the > recovery will be painful, relatively similar to recovering from a broken > nose,
The risk in the early week or two is to start to think its not a big deal and becoming too active too soon. Take it easy and remember there are stiches and splints in there – you just had surgery. > Background: I do not use a CPAP but do have to be very careful about my > sleeping position.
Make sure that the surgon and hospital are aware of your OSA otherwise you could have complications during surgery and in post-op. Make them write it into your records. You should see some improvements, but be aware that OSA can get worse over the years for other reasons – not all understood – so monitor yourself closely.
Response:
Steve Freides wrote: > I just found out, via a comprehensive eval at my new ENT, that I have > (to quote the radiologist) a "rather severely deviated septum." I’m > pretty sure I had my nose broken when I was about 16 years old but my > father, who has managed to nearly let several family members nearly die > before allowing them to see a doctor, simply told me I had two black > eyes and to wait until they went away. > Being all that as it may, the ENT thinks that opening up my nasal > passages may help my OSA and my sinuses in general and I’m therefore > very tempted to agree to the surgery. (My sinuses looked very good on > the CT Scan but, while I have no recurrent sinus infections, I do suffer > from nasal allergies and am often on the borderline with vertigo.) I’ve > heard one horror story about a certain nerve getting nicked.
My brother’s story reads pretty well like yours except his apnea was very severe (by the time someone..me..diagnosed him), then verified by sleep tests, of course. He had his deviated septum repaired. It improved his nasal problems quite a bit. No pain meds, no disfiguration, no horror stories. Not saying he didn’t have pain, but his preference is no pain meds if posssible. He still has to use CPAP and he has a saline spray that he sprays before putting the mask on and going to sleep. It took about 18 months from first visit with ENT to finally being relatively satisfied that the apnea was well under control. (at last word about a month ago). There were rechecks of his apnea all along the way, and adjustments to his pressure, masks, equipement etc. Pretty typical, I think. Good luck. J
Response:
check out your doctor thoroughly and get references. My friend has had 5 additional cosmetic surgeries since her first deviated septum surgery where they messed up her nose. It’s still not right and she is breathing worse than she ever did before the first surgery. Many folks do very well with this surgery but it could impact your appearance and many people on this website agree it doesn’t always help your apnea. – Hide quoted text — Show quoted text -Steve Freides wrote: > I just found out, via a comprehensive eval at my new ENT, that I have > (to quote the radiologist) a "rather severely deviated septum." I’m > pretty sure I had my nose broken when I was about 16 years old but my > father, who has managed to nearly let several family members nearly die > before allowing them to see a doctor, simply told me I had two black > eyes and to wait until they went away. > Being all that as it may, the ENT thinks that opening up my nasal > passages may help my OSA and my sinuses in general and I’m therefore > very tempted to agree to the surgery. (My sinuses looked very good on > the CT Scan but, while I have no recurrent sinus infections, I do suffer > from nasal allergies and am often on the borderline with vertigo.) I’ve > heard one horror story about a certain nerve getting nicked. > I have had, for as long as I can remember, a discomfort in the side of > my nose to to which the point in my deviated septum leans and I’d really > love that to go away as well. > Any reason _not_ to go ahead with this surgery? I understand the > recovery will be painful, relatively similar to recovering from a broken > nose, but I’m prepared, with the help of modern pain killers, to live > through that if the results are going to be as good as they seem they > might be. > Background: I do not use a CPAP but do have to be very careful about my > sleeping position. I started sleeping on my back after a herniated disk > and the OSA followed a few years later. So far, with a thin pillow, a > small neck roll, and less sleeping on my back as I’ve healed there, I > show no OSA symptoms at night, no longer need naps at all, feel fine, > etc. Any change that would allow me to be a little less careful with my > sleeping position, however, would be wonderful, as would anything that > would ease my allergy and asthma symptoms. > Thanks in advance. > -S-
Response:
I just found out, via a comprehensive eval at my new ENT, that I have (to quote the radiologist) a "rather severely deviated septum." I’m pretty sure I had my nose broken when I was about 16 years old but my father, who has managed to nearly let several family members nearly die before allowing them to see a doctor, simply told me I had two black eyes and to wait until they went away. Being all that as it may, the ENT thinks that opening up my nasal passages may help my OSA and my sinuses in general and I’m therefore very tempted to agree to the surgery. (My sinuses looked very good on the CT Scan but, while I have no recurrent sinus infections, I do suffer from nasal allergies and am often on the borderline with vertigo.) I’ve heard one horror story about a certain nerve getting nicked. I have had, for as long as I can remember, a discomfort in the side of my nose to to which the point in my deviated septum leans and I’d really love that to go away as well. Any reason _not_ to go ahead with this surgery? I understand the recovery will be painful, relatively similar to recovering from a broken nose, but I’m prepared, with the help of modern pain killers, to live through that if the results are going to be as good as they seem they might be. Background: I do not use a CPAP but do have to be very careful about my sleeping position. I started sleeping on my back after a herniated disk and the OSA followed a few years later. So far, with a thin pillow, a small neck roll, and less sleeping on my back as I’ve healed there, I show no OSA symptoms at night, no longer need naps at all, feel fine, etc. Any change that would allow me to be a little less careful with my sleeping position, however, would be wonderful, as would anything that would ease my allergy and asthma symptoms. Thanks in advance. -S-
