I was recently hospitalized for a case of Epiglottitis which was treated with intravenous antibiotics in the hospital, and followed up with 10 days of PenVK500 4x/day. The Epiglottitis was finally diagnosed after over 6 weeks of symptoms ranging from sore throat to ear pain and difficulty swallowing, during which period I even took about 12 days worth of amoxycillin. Three strep tests were also administered during this period, all of which were negative. I was incredibly relieved when the antibiotic therapy finally worked. Two days after finishing the oral antibiotics, however, I again had a sore throat. I consulted the otolaryngologist and he told me that he believed a deviated septum to be the culprit.
I have had countless cases of strep throat from childhood through today (I am 29), and experience several colds each fall and winter. I have no allergies.
I have read all of the previous responses regarding surgical correction of deviated septums and understand that the procedure is simple, but will it work for me?
Reply: -----------------------
Frankly, I do not find anything in your post that would lead me to automatically suspect a deviated septum as the primary cause of your problem. It is true that a significant deviation of the septum which chronically interferes with nasal breathing could contribute to frequent mild sore throat problems. There are 2 basic reasons why this can happen:
1) Since one of the main functions of the nose is to humidify the air you breathe, nasal airway obstruction causes the mucosal lining of the throat to dry out which can cause throat discomfort. This type of problem is usually most notable in the early morning such as when one wakes and usually improves through the course of the day. It is usually not severe but more of a nuisance.
2) Significant nasal airflow obstruction may lead to problems with post-nasal drainage which could cause a persistent, but again usually mild, throat irritation.
However, the main reasons to consider a septoplasty operation are as
follows:
1) The presence of daily year round nasal airflow obstruction in one or both nasal passages that is clearly associated with a deviation of the septum on physical examination of the nose and which is not improved with a trial of decongestant medicine or (more preferably) a trial of nasal steroid spray over several weeks. (Breathe Right nasal strips might also be tried.)
2) Chronic sinus infections where a deviated septum is responsible for obstruction to the sinus drainage pathway - this would be evident in an x-ray known as a CT scan.
3) Where sinus surgery is necessary because of chronic sinusitis failing to resolve with non-surgical measures and a deviated septum limits the ability of the surgeon to pass an endoscope into the sinuses to perform the surgery.
4) In rare circumstances where the deviation of the septum is such that the septum impacts against the side wall of the nasal passage (known as the turbinate) and causes what is known as a rhinogenic headache. Such headaches can be diagnosed by applying a local anesthetic into the nose during a headache to see if the headache is relieved.
5) When severe or frequently recurrent nosebleeds due to localized drying of the membrane of a deviated septum occur or when persistent or recurrent bleeding occurs in a crevace or behind a spur or bend of a deviated septum and other measures such as packing or cautery have failed.
Unless one of these circumstances is present, I might question the indication for a septoplasty.
--
Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
Click here to review
previous Ear, Nose and Throat Clinic consultations