Deviated Septum

A deviated septum happens when the wall of tissue in the middle of the nose is off-center. Most people have septums that are off-center, but this can sometimes cause symptoms like difficulty breathing, sinus infections, and congestion.

A deviated septum may cause one or more of these symptoms:

• Blockage of one or both nostrils
• Nasal congestion, sometimes on just one side of your nose
• Frequent nosebleeds
• Frequent sinus infections
• Pain in your face or headaches
• Flow of mucus behind the nose (postnasal drip)
• Noisy breathing during sleep (more common in infants and young children)

If your septum is not severely deviated, you might only notice these symptoms if you have a cold. This happens because the cold and the deviated septum both make breathing through your nose more difficult.

You should talk to your doctor if you have any of the symptoms of a deviated septum, or if you notice these symptoms when you get a cold.

Sometimes, a deviated septum is congenital (present from the time you were born). However, nasal trauma — like being hit in the nose or being in an accident that hurts your nose — can cause the septum to shift.

A deviated septum can be diagnosed by your doctor after:

• Getting your medical history. To diagnose a deviated septum, your doctor will ask if you have ever had trauma to your nose (for instance, if you have been hit in the nose or been in an accident that hurt or broke your nose) or if you have ever had nasal surgery. These questions will help your doctor decide if your problem is a deviated septum or a different condition.
• Performing an exam of the nose. Next, your doctor will look at your nose and the position of your nasal septum. To do this, your doctor will use a bright light and a nasal speculum (a mirror that helps your doctor see in your nose) to look at the inside of your nostrils.

A CT scan is an imaging test that can show a deviated septum, but this is usually not needed to diagnose the condition.

Treatment for a deviated septum may involve surgery. If your deviated septum is causing symptoms like sinus infections, pain, or nasal congestion, your doctor may recommend surgery. The most common surgery for a deviated septum is septoplasty [SEP-toe-plas-tee]. This surgery is done inside of your nostrils, and will not cause any bruising or external signs. The surgery takes about 1 ½ hours.

During the surgery, your doctor:

• May remove deviated parts of your septum. Or, they may be adjusted and put back into the nose in a position that makes it easier for you to breathe and reduces your symptoms.
• Will use local or general anesthesia [ann-ess-THEE-see-uh] so that the surgery doesn’t hurt you.
• Local anesthesia. This keeps you from feeling anything near your nose.
• General anesthesia. This puts you to sleep and prevents feeling in your whole body.

Sometimes, your doctor may combine a septoplasty with a surgery of the outer nose or sinuses. Surgery of the outer nose, called rhinoplasty [RAHY-nuh-plas-tee], changes the way the outside of your nose looks. If you have problems with your sinuses, your doctor may also recommend sinus surgery to help you with these symptoms.

After surgery, nasal packing will be put into your nose to help prevent bleeding after the operation. You might have some symptoms after the surgery, including:

• Pain
• Fatigue
• Nasal stuffiness
• Runny nose

These symptoms are usually mild and can be reduced with pain medicine. Usually, recovery from septoplasty takes about a week, and outcomes are usually successful. Your doctor might ask you to use a saline (salt) spray to keep your nose clean and healthy after the surgery.

There is no way to prevent a deviated septum that is present from birth, but you can practice safety tips to reduce the chance that your nose will be hurt in an accident.

The septum [SEHP-tum] is a wall of tissue that runs down the middle of your nose. It divides the space inside your nose (nasal cavity) into two halves. About 8 out of every 10 people have nasal septums that are off-center, but this usually does not cause any problems. A deviated septum is when the septum is very off-center, crooked, or makes it hard to breathe through the nose.