What to Know About a Deviated Septum

A deviated septum is when the cartilaginous or bony structure that divides the nose in half (the septum) is off-center (deviated). Research supports that for most people, the nasal septum is off-center to some extent and doesn't divide the nose equally. This can affect breathing through one or both nostrils or cause sinus infections.

This article describes what a deviated septum feels like, the symptoms it causes, and how healthcare providers diagnose and treat it.

What Causes a Deviated Septum?

Sometimes, a deviated septum occurs naturally throughout the growth and development process. However, the nasal septum is made of bone and cartilage, making it susceptible to damage. So, injury or trauma to the nose, such as a punch or fall, can break the nasal septum and cause it to heal crookedly, resulting in a deviated septum.

Deviated Septum Symptoms

Many of those who have a deviated septum are unaware of the condition because they do not experience any signs or symptoms, such as difficulty breathing through the nose. If you suspect that you may have a deviated symptom, here are some of the common signs and symptoms associated with the condition that you may experience:

• Hard to breathe through one or both nostrils
• Nosebleeds
• Sinus infections
• Mouth breathing during sleep for adults or noisy breathing during sleep in infants and small children

Deviated Septum

How Is a Deviated Septum Diagnosed?

There is no standard test that can diagnose a deviated septum. However, there are several different options endorsed by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) that healthcare providers can use to help them diagnose the condition:

• Visual inspection: A healthcare provider looks into the nose with a light so they can more fully observe the nasal septum.
• Fiberoptic nasolaryngoscopy: A healthcare provider inserts a small flexible tube with a light into the nose for more detailed inspection.
  

Deviated Septum Treatment

Because many people with a deviated septum have no symptoms (or minimal symptoms), no treatment is required. If symptoms worsen or new ones appear, it is essential to see a qualified healthcare provider, such as a primary care physician or an otolaryngologist. They may recommend surgery to repair a deviated septum.

Surgery for a Deviated Septum

Surgery is the only treatment that corrects the structural deviation of the septum. If non-surgical treatment options don't provide symptom relief, a healthcare provider might recommend surgery. There are two different types of surgeries for deviated septa:

• Septoplasty: Septoplasty is the preferred surgery for a deviated septum. The surgery for a septoplasty works through the nostrils, so bruising and incisions are rare. Depending on the severity of the deviation, a rhinoplasty or sinus surgery might take place at the same time, which might require an overnight hospital stay.
• Rhinoplasty: Rhinoplasty changes the shape and appearance of the nose. You may have visible incisions, bruising, and swelling following rhinoplasty. To ensure the nose heals correctly, a temporary nose splint might be applied to the outside of the nose for five to seven days after surgery.

What’s Recovery Like After a Septoplasty?

Septoplasty might resolve your deviated septum symptoms, but as with any surgery, there may be potential complications during recovery, including:

• Bleeding
• Pain
• Infection
• Numbness in the upper jaw or nose due to possibly nerve damage during surgery
• Changes in nose shape
• A perforation, or hole, from one side of the nose to the other through the nasal septum
• Leaking of cerebrospinal fluid
  

What Happens if a Deviated Septum Goes Untreated?

Though up to 80% of people have a deviated septum, few experience symptoms or total nasal obstruction. The AAO-HNS does not recommend any treatment for people with a deviated septum who are not experiencing any symptoms.

If you have a deviated septum and start to experience frequent nosebleeds, recurring sinus infections, or trouble breathing, seeing a healthcare provider for an examination and to determine appropriate treatment is essential.

Deviated septum treatment typically includes non-surgical and surgical options, as described above. Nasal septal surgery is not always effective in alleviating all symptoms, so working with a healthcare provider to manage the condition is crucial.

When to See a Healthcare Provider

A deviated septum doesn't always produce symptoms. However, you should see a healthcare provider if you have any of these symptoms or if they worsen:

• Frequent nosebleeds
• Difficulty breathing through one or both nostrils
• Sinus infections
• Mouth breathing during sleep for adults or noisy breathing during sleep in infants and small children
  

Summary 

Many are often unaware they have a deviated nasal septum because they are asymptomatic, which is OK. After all, treatment is unnecessary, in this case. However, if you develop new or worsening symptoms, follow up with a healthcare provider for treatment. Untreated deviated septum symptoms can impact breathing and lead to infection. A healthcare provider will recommend non-surgical or surgical treatment options, depending on the severity of the symptoms. All interventions aim to alleviate symptoms to prevent breathing problems or repeated infections.