Deviated Septum - SNA

[mb1685]

I searched the boards for information on this but couldn't find anything very definitive.

I went to an ENT doctor today and found out that I have a deviated septum. I went because I fractured my nose in a minor car accident a few years ago but never had a follow-up appointment. I've never had any nasal pain, sinus problems, or trouble breathing. The doctor did a pressure test through my ears to see how my Eustachian tubes react and found them to be normal and a hearing test to see if my hearing could be affected by it, but no other tests (not even an x-ray, which I found surprising).

I can't find any reference to nasal septum deviation in the NAMI waiver guide, but I know that the biggest concern is that my sinuses are normal and won't be adversely affected by pressure changes.

Does anyone know how big of a concern a deviated septum could be? Are there any other tests I could have an ENT doctor do to determine how fit my nasal system is to handle pressure changes (other than the Eustachian tube pressure test)? Lastly, if I were to have surgery to fix the deviated septum, is there any kind of mandatory waiting period (past the initial recovery period, which the doctor said would be approximately one week) that I'd have to undergo in order to become physically qualified? Although it would be a big pain financially, I definitely wouldn't mind having the surgery done to keep me from being NPQ, but unfortunately I turned 26 last month so a lengthy mandatory waiting period could make things really tricky.

 

[Swanee]

I've got one. It was never an issue. Doctor said I might want to look into getting it fixed before I leave the military, but there is no rush.

 

[Scaevola]

I had to get a waiver for a deviated septum to pass the general medical qualification check with N3M, but all that required was a letter from a civilian ENT specialized saying that the condition would not prevent me from serving on active duty. No surgery needed, although my doc said my case was really minor so you mileage may vary. It's one of the items they ask about on the medical paperwork for the pre-commissioning physical that everyone takes so you will need to disclose it.

When all your medical paperwork goes up to N3M for review, if they are concerned about anything you get issued a TNPQ letter where they request further evaluations for specific items. I had three of these items and just needed the test results and letters stating that I was fit for service from my normal civilian providers. Sent those in and got my PQ letter with no issues about a week later.

Did not apply SNA so I can't speak to any additional NAMI requirements.

 

[AUtiger]

I had one. Got it fixed in meridian. As long as you don't get the full sinus surgery there is no waiver required as of 2011. Was about a 2 week recovery. I did it during the wait to class up so no idea what total down period is.

 

[mb1685]

Thanks for all the feedback!

The doctor made it sound like it was pretty significant, and since I fractured my nose in the car accident, I get the feeling my nose will be under a lot of scrutiny by N3M (and/or NAMI). After reading a bit more about the surgery, I feel like I might as well pony up and get it done ASAP just in case, I just hope N3M doesn't turn around and say "it hasn't been long enough since you had the surgery, get an ENT to look at it in 6 months and then we'll consider PQing you".

Maybe this sounds crazy, but since the deviated septum in itself isn't NPQ, would it be worth trying to get documentation from an ENT that says something along the lines of "although the patient has a deviated septum, my tests and analysis have concluded his nasal system functions normally and would handle barometric pressure changes with no complications" and have that ready to submit to N3M? I feel that it's likely they'll want some kind of word from an ENT regardless (unless the check at MEPS is sufficient for them) since the medical records from my hospital visit after the car accident definitely say that they wanted me to return for a follow-up appointment to determine if I needed surgery, but I didn't do so.

 

[TimeBomb]

mb1685,
I'd recommend getting the ENT to do up a letter indicating what tests he's done and what the outcome was. Attaching a CT of your sinuses to your medical paperwork for N3M to review could avert some heartache as well. The extent of the deviation is what they're going to be concerned about. If the septal deviation is sufficient to distort or alter the function of the opening to the sinus cavity, you may run into problems with sinus barotrauma with altitude. That really wrecks your day, and gets you grounded until the swelling goes down in a few weeks, then you get lined up for surgery. I wouldn't recommend preemptive surgery. You don't have anything medical can't make worse.
R/

 

[mb1685]

Thank you for the great advice!

I'll be visiting the ENT again and I'll explain the situation to him and ask him to conduct more tests. I've flown in unpressurized aircraft numerous times and skydived from 10,000 ft MSL and never had any discomfort or pain, so I hope that may be an indicator that I don't have any problems.

 

[mb1685]

My package is finished now, and since I just barely missed the 30 Jun board, it looks like there will be a decent wait before the next board and going to OCS if selected. I figure it would make the most sense to go ahead and knock out the septoplasty now since I'll have plenty of time to recover.

I didn't have any issues at MEPS and I don't think the deviated septum even had to be specifically notated anywhere, although the medical records from the car accident are on file, so the deviated septum would be apparent from the CT scan.

I know that the NAMI waiver guide states that septoplasty requires no waiver, but could getting the surgery mess up my N3M PQ status? Would I have to get cleared at MEPS again and/or would there be any complications with the NAMI doctors at OCS? I would of course be glad to bring the medical records from the surgery, but I've also read something along the lines of "If you bring medical records with you to OCS that you didn't already need to include in your package, you're asking for trouble" here.

I know it's possible that the deviated septum won't be an issue at all with NAMI, but if it's not going to complicate things too much, I figure the surgery would be beneficial. It never hurts to breathe better.

 

[mb1685]

One last thread bump. Still curious whether getting septoplasty after having already been PQ'd by N3M but before OCS/NAMI would cause any issues. My concern is invalidating my N3M PQ and/or the NAMI doctors having an issue with it (like perhaps there being some kind of lengthy waiting period after the surgery before being able to be PQ'd, like with PRK).

I sent an e-mail to the information address I found on NAMI's Facebook page, but haven't heard anything back. If it wouldn't be an issue, I'd like to get it done ASAP.

 

[mb1685]

I got a reply from NAMI and wanted to share a brief synopsis in case anyone else is ever considering septoplasty prior to OCS and comes across this post.

The doctor told me that they typically down aviators for 4-6 weeks after the surgery or until they are able to wear an oxygen mask and emergency equipment without discomfort. He advised against starting OCS less than 6 weeks after the surgery, and of course stressed the importance of needing to be in good shape when arriving at OCS and mentioned that obviously a significant portion of the recovery period will prevent physical exercise. Other than the recommendation of a 4-6 week recovery period, it does not appear there is any kind of mandatory absolute waiting period before being able to be PQ'd (such as with eye surgery).