The nasal septum is the thin wall of cartilage and bone that divides the nose into two separate chambers. A deviated septum occurs when this wall is displaced or crooked, making one nasal passage smaller than the other. This structural issue is common, and mild deviations often cause no problems. However, a pronounced deviation can obstruct airflow, leading to uncomfortable symptoms. While recognizing symptoms is the first step, a definitive diagnosis requires professional medical evaluation.
Identifying the Signs of Nasal Septum Deviation
The most frequent sign of a potential septal deviation is persistent obstruction in one or both nostrils, making breathing difficult. This blockage is often noticeably worse on one side of the nose. Many individuals experience chronic congestion, even without a cold or allergies.
Difficulty in airflow can lead to other disruptive symptoms. These include frequent nosebleeds, which occur because irregular airflow dries out the septal surface. Some people also report recurring facial pain or headaches associated with pressure points within the nasal cavity.
During sleep, a severe deviation can cause loud or noisy breathing, including heavy snoring, and may contribute to sleep apnea. The nasal obstruction may also lead to a preference for sleeping on a particular side to maximize airflow. Furthermore, compromised sinus drainage due to the blockage can result in repeated sinus infections.
Limitations of Self-Assessment
While a person can identify symptoms of nasal obstruction, confirming a deviated septum is difficult because the structure is deep inside the nasal cavity. The severity of the deviation is often not visible externally, meaning inspection in a mirror cannot provide a definitive answer. Even if the nose appears straight on the outside, the internal bone and cartilage may still be significantly displaced.
The main limitation of self-assessment is that the symptoms are not unique to a septal deviation. Conditions such as chronic sinusitis, nasal polyps, or allergies can all cause similar issues like congestion and difficulty breathing. Another frequent cause of obstruction is turbinate hypertrophy, which is the swelling of the bony structures that humidify and warm the air inside the nose.
These other issues mimic the effects of a deviated septum so closely that only direct visualization of the internal structures can distinguish the cause. An at-home breathing test can indicate airflow asymmetry, but it cannot reveal the precise underlying anatomy. Relying on self-diagnosis risks misattributing symptoms that are actually caused by a different, treatable condition.
Seeking Professional Confirmation and Care
A professional diagnosis begins with a thorough physical examination, including reviewing the patient’s medical history and the nature of their symptoms. A healthcare provider uses a nasal speculum and a bright light to examine the front part of the nasal passages for an initial assessment of the septum and surrounding tissues.
For a more detailed view, a doctor may perform a nasal endoscopy, inserting a thin, camera-equipped instrument into the nasal passage. This provides a clear view of the deeper areas and helps rule out other causes of obstruction, such as polyps or enlarged turbinates. In complex cases, a computed tomography (CT) scan may be used to obtain a detailed image of the bony structure and sinuses.
Treatment options depend on the severity of symptoms. For mild cases, a doctor may recommend medical management using decongestants, antihistamines, or nasal steroid sprays to reduce swelling. Medication only manages symptoms and does not correct the physical misalignment. If symptoms significantly affect quality of life, septoplasty is the surgical procedure used to physically straighten the septum and restore airflow.