Deviated Septum

A deviated septum is a condition in which the thin wall between the nasal passages is off-center, making one nasal passage narrower than the other. A severe deviated septum can cause difficulty breathing and lead to crusting or bleeding.

A deviated septum may lead to the following symptoms:

• Difficulty breathing through the nostril or nostrils, especially during a cold or allergy
• Nosebleed
• Facial pain in which surfaces within the nose touch and cause pressure
• Noisy breathing during sleep
• Awareness of the nasal cycle, which is when the nose alternates between being obstructed on one side to the other
• Preferring to sleep on a particular side to optimize breathing through the nose at night

A severely deviated nasal septum can lead to dry mouth (as a result of chronic mouth breathing), a feeling of pressure or congestion in the nasal passages, and disturbed sleep caused by difficulty breathing through the nose at night.

The causes of a deviated septum may include:

• Fetal development
• Injury to the nose as a result of childbirth or trauma during contact sports, rough play or car accidents
• Normal aging process
• Swelling and irritation of the nasal cavities (rhinitis)
• Sinus cavities (rhinosinusitis)

Patients experiencing frequent nosebleeds and recurring sinus infections should schedule an appointment with their physician to determine if a deviated septum may be causing the symptoms.

During an initial visit, the physician will ask about symptoms and examine the nose using a bright light and an instrument designed to spread open the nostrils. The physician may use a long tube-shaped scope with a bright light at the tip to inspect the nose further back. Another option is to examine the nasal tissues before and after applying a decongestant spray.

During the visit, the physician may ask the following questions:

• How long have you had nasal obstruction?
• Have you experienced any trauma to the nose?
• Do you have allergies affecting the nose?
• Do you have nosebleeds?
• Do you take any medications to help you breathe?
• Do you use a decongestant and if yes, does it help?
• Is your nasal obstruction worse when you are lying down?
• Have you had any nasal surgery?

The symptoms of a deviated septum may treated with:

• Decongestants, to reduce nasal tissue swelling and help keep the airways open.
• Antihistamines, to help prevent allergy symptoms, such as a stuffy or runny nose.
• Nasal steroid sprays, to reduce swelling in the nasal passage and support drainage.

A deviated septum will typically require a surgery called septoplasty. During the procedure, the nasal septum is straightened and repositioned in the center of the nose. Septoplasty may resolve nasal obstruction, but other nasal or sinus conditions affecting the tissue lining of the nose will not be resolved with surgery.

A rhinoplasty, a procedure done to reshape the nose, may also be necessary to modify the bone and cartilage of the nose and adjust its shape or size or both.