What is a deviated septum?
A deviated septum is when the bone and cartilage separating your nasal cavity (nostrils) are off-center. The nasal septum is the tissue that separates the right and left sides of your nasal cavity. A perfectly straight nasal septum creates two equally sized nasal cavities. Air flows freely through both.
However, approximately 8 out of 10 people—most of us—have a nasal septum that is slightly off-center. Many people are unaware of it because they have no symptoms.
However, if the deviation is more pronounced, it can make it harder for air to flow through your nose, making it difficult to breathe. This can increase your risk of nosebleeds and other problems.
Symptoms of a deviated nasal septum
A severely deviated septum can cause your nose to appear off-center. Other symptoms of a deviated septum may include:
Difficulty breathing through your nostrils (usually worse on one side)
Facial pain
Headache
Loss of smell
Nasal congestion
Noisy breathing
Noise bleeding
Nosebleeds
Snoring
Causes of a Deviated Septum
You may be born with a deviated nasal septum. A difficult birth can damage your nasal septum. As your nose grows, your septum also grows, sometimes deviating more to one side. This is the most common cause of a deviated septum. Other causes include injuries such as a nasal fracture.
Risk Factors
Activities or events that lead to nasal injuries increase your risk. Examples include:
Car accidents, contact sports, falls, fights, and inhaling addictive substances through your nose.
You can't avoid all risks. However, you can take precautions, such as wearing a seat belt. You can use protective equipment (such as a midface mask and helmet) when participating in contact sports.
Complications of this condition (undesirable situations)
A small deviated nasal septum may not cause any problems. However, a severely deviated septum can cause problems such as:
Chronic sinusitis
Dry mouth
Nasal congestion
Sleep apnea
Long-term or frequent ear infections (in children)
Diagnosis and Tests
How do doctors diagnose this condition?
Your doctor will examine your nose using a nasal speculum. This instrument gently opens your nostrils, allowing your doctor to see inside your nose. He or she will examine your septum to see if it affects the size of your nasal passages. You may also need tests that examine the tissue deeper inside your nose, such as:
Computed tomography scan
Nasal endoscopy
Management and Treatment
Most people with a deviated septum don't need treatment because they have few or no symptoms. You can treat mild symptoms with medication. However, if the deviated septum prevents you from breathing properly, you may need surgery.
Medications
A mild deviated septum can cause occasional symptoms. These symptoms may not appear until you are already ill. You can treat these symptoms with over-the-counter medications, including:
Antihistamines
Nasal steroid sprays
Nasal decongestants
However, avoid using nasal decongestants for more than three days in a row. This can cause recurrent congestion.
Surgery for a Deviated Septum
Septoplasty is the only way to correct a deviated septum. This surgery may be an option if you have breathing problems or other bothersome symptoms. During septoplasty, the surgeon reshapes your septum.
If your child needs surgery, the surgeon may postpone septoplasty until their nose is fully grown (around age 17-18).
Sometimes, septoplasty is performed in conjunction with rhinoplasty. This surgery reshapes your nose. It can be helpful if you're unhappy with the appearance of your nose.
When should I see a doctor?
If your symptoms are interfering with your breathing, disrupting your sleep, or negatively impacting other aspects of your life, consult an otolaryngologist.
Dr. Tuğçe Pütürgeli Özer
Kulak Burun Boğaz Hastalıkları Uzmanı
European Board Certified ENT Surgeon
