Deviated Septum
A deviated septum occurs when the thin wall (septum) between your nostrils is displaced to one side, making one nasal passage smaller than the other. Most people have some degree of septal deviation, but when it's severe, it can block one side of the nose and reduce airflow, causing difficulties with breathing and other symptoms. A deviated septum may be present at birth, can develop during growth, or can result from injury to the nose.
Causes
- Congenital factors - Some people are born with a deviated septum due to compression of the nose during fetal development or the birth process.
- Injury or trauma - Nose injuries, including those that don't result in a visible fracture, can cause septal deviation. Common sources include sports injuries, falls, or physical altercations.
- Aging process - As you age, natural changes can occur in the structure of the nose, potentially worsening a deviation.
- Connective tissue disorders - Certain connective tissue diseases may affect nasal structures.
- Developmental abnormalities - The septum can deviate during growth, even without trauma.
Signs and Symptoms
- Nasal obstruction or congestion - Difficulty breathing through one or both sides of the nose.
- Frequent nosebleeds - Due to the surface of the nasal septum becoming dry, cracked, or irritated.
- Noisy breathing during sleep - Including snoring or noticeable breathing sounds.
- Frequent sinus infections - Blockage can prevent proper sinus drainage, leading to recurrent infections.
- Facial pain or headaches - From pressure buildup in the nasal and sinus cavities.
- Postnasal drip - Mucus that drains down the back of the throat.
- Dry mouth - From chronic mouth breathing due to nasal obstruction.
- Nasal cycles - A sensation of the obstruction switching from one side to the other.
- Sleep disturbances - Including sleep apnea in severe cases.
Diagnosis
Physical Examination
Your doctor will use a bright light and nasal speculum to look inside your nose, checking for septal deviation and other abnormalities that might cause nasal obstruction.
Nasal Endoscopy
A thin, flexible tube with a light and camera (endoscope) is inserted into your nose to examine the inside of your nasal passages and sinuses in more detail.
Imaging Studies
CT scans or MRI may be used in some cases to provide detailed images of your nasal structures and sinuses, especially if other conditions are suspected.
Allergy Testing
Since allergies can worsen symptoms of a deviated septum, your doctor may recommend allergy testing to identify potential triggers.
Acoustic Rhinometry or Rhinomanometry
These specialized tests measure nasal airflow and the cross-sectional area of the nasal passages to objectively assess the degree of obstruction.
Treatment Options
Medications
While medications can't correct a deviated septum, they can help manage symptoms. Options include decongestants to reduce nasal congestion (short-term use only), antihistamines for allergies that may worsen symptoms, nasal steroid sprays to reduce inflammation, and nasal saline sprays to moisten the nasal passages.
Nasal Breathing Strips
External nasal dilator strips applied to the outside of the nose can help pull nasal passages open, improving airflow for temporary relief, especially during sleep.
Surgical Correction (Septoplasty)
For severe symptoms that don't respond to medication, surgery may be recommended. Septoplasty straightens the nasal septum by trimming, repositioning, or replacing cartilage or bone. This is sometimes combined with rhinoplasty (nose reshaping) in a procedure called septorhinoplasty.
Home Remedies
Nasal Irrigation
Using a neti pot or nasal rinse kit with saline solution can help clear nasal passages, reduce congestion, and improve breathing. This can be particularly helpful before bedtime.
Humidification
Using a humidifier, especially in dry climates or during winter, can add moisture to the air and prevent nasal passages from drying out, reducing irritation and improving comfort.
Elevating the Head While Sleeping
Sleeping with your head elevated can help improve nasal drainage and reduce congestion, making it easier to breathe through your nose at night.
Avoiding Irritants
Staying away from cigarette smoke, strong perfumes, and other airborne irritants can help reduce nasal inflammation and improve breathing.
Steam Inhalation
Breathing in warm, moist air from a shower or bowl of hot water can temporarily relieve nasal congestion by moistening nasal passages and thinning mucus.
Preventive Care
- Protect your nose from injury during sports or activities with a high risk of facial trauma by wearing appropriate protective gear.
- Seek prompt medical attention for any nose injuries to ensure proper healing.
- Practice good nasal hygiene, including gentle blowing and avoiding picking or inserting objects into the nose.
- Manage allergies proactively to reduce nasal inflammation that can worsen symptoms of a deviated septum.
- Avoid smoking and secondhand smoke, which can irritate the nasal passages and worsen breathing difficulties.
- Stay hydrated to help keep nasal passages moist.
- Use a humidifier in dry environments to prevent nasal dryness and irritation.
- Apply nasal saline sprays as needed to moisturize nasal passages.
- Avoid overuse of nasal decongestant sprays, which can lead to rebound congestion.
- Attend regular follow-up appointments with your ENT specialist if you have a known deviated septum.
Surgical Options
Septoplasty
A surgical procedure to straighten the nasal septum by trimming, repositioning, and replacing cartilage, bone, or both. It's performed entirely through the nostrils, so no external incisions are made. The goal is to create an even passage on both sides to improve airflow and breathing.
Learn More About This ProcedureSeptorhinoplasty
A combined procedure that includes septoplasty to straighten the septum and rhinoplasty to reshape the nose. This approach may be recommended when both functional improvements (breathing) and cosmetic changes are desired.
Learn More About This ProcedureTurbinate Reduction
Often performed alongside septoplasty, this procedure reduces the size of the turbinates (structures on the sides of the nasal passages) to further improve airflow. Methods include radiofrequency reduction, partial resection, or outfracture.
Learn More About This ProcedureEndoscopic Sinus Surgery
When a deviated septum contributes to chronic sinusitis, endoscopic sinus surgery may be performed in conjunction with septoplasty to open the sinus passages and improve drainage.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of deviated septum, our expert team is here to help you find the right treatment approach for your specific needs.