The nasal septum is the thin wall of cartilage and bone that divides the nose into two separate passages. When this structure is significantly shifted away from the midline, the condition is known as a deviated septum. This displacement causes one nasal passage to be substantially narrower than the other, often leading to restricted airflow. Recognizing these indicators helps determine if this common physical disorder is the source of ongoing nasal discomfort.
Recognizing the Common Signs
The most frequently reported symptom is unilateral nasal congestion, where one nostril consistently feels more blocked than the other. This blockage often becomes more pronounced during a cold, allergy flare-up, or other conditions that cause the nasal tissues to swell. The narrowing of the passage reduces the flow of air, leading to a persistent feeling of stuffiness that is not fully relieved by standard decongestants.
A deviated septum can contribute to frequent nosebleeds, medically termed epistaxis, because the airflow over the displaced structure is disrupted. This irregular flow can dry out the mucosal surface of the septum, making the exposed tissue more fragile and susceptible to bleeding. The chronic irritation and dryness increase the likelihood of the delicate blood vessels rupturing.
Some individuals experience noticeable facial pain or pressure, which is often concentrated around the sinuses. When the septum is severely deviated, it can physically obstruct the natural drainage pathways of the sinuses, leading to a buildup of pressure or recurrent sinus infections. This congestion and inflammation contribute to discomfort that may be mistaken for a tension headache.
Noisy breathing during sleep is another common indicator, as restricted airflow causes a turbulent stream of air through the nose and throat. This symptom can manifest as loud snoring or contribute to more severe conditions like obstructive sleep apnea. Difficulty breathing through the nose at night may cause some people to prefer sleeping on a specific side to maximize airflow through the less obstructed nostril.
Underlying Causes and Development
A deviated septum develops through two primary mechanisms: congenital (present at birth) or acquired (later in life). The congenital deviation often results from development in the womb, where unequal growth of the bone and cartilage causes the septum to lean to one side.
In some cases, the congenital deviation may be the result of trauma experienced during the birthing process. An injury to the nose during delivery can displace the nasal structure in an infant. The degree of the deviation may then become more noticeable as the nose continues to grow throughout childhood and adolescence.
The second cause is acquired trauma resulting from an impact injury later in life. A blow to the face, such as those sustained during contact sports, a fall, or a motor vehicle accident, can forcibly move the septum out of alignment. This initial trauma is sometimes severe and immediately apparent, like a broken nose.
However, a septal injury does not always accompany a visible fracture, and a person may not even recall the specific event that caused the displacement. Even minor impacts can shift the cartilage and bone, causing a deviation that leads to symptoms years later. This acquired displacement disrupts the midline position of the septum, leading to the structural problems associated with the condition.
Confirming Diagnosis and Treatment Options
A medical professional, typically an otorhinolaryngologist, must perform a physical examination to confirm a deviated septum. The initial assessment involves using a nasal speculum, a handheld instrument that gently spreads the nostrils, combined with a bright light. This allows for a clear visual inspection of the internal nasal passages, revealing the septum’s position and any obstruction it may cause.
For a more detailed view of the entire nasal and sinus cavity, the physician may perform a nasal endoscopy. This procedure uses a thin, lighted tube with a camera at the tip to examine structures farther back in the nose, helping to assess the severity of the deviation and any related issues like chronic sinus inflammation. Only through this professional evaluation can a definitive diagnosis be established and the extent of the problem determined.
Treatment for a deviated septum falls into two categories: non-surgical symptom management and surgical correction. Non-surgical options utilize medications to alleviate the secondary symptoms without changing the physical structure of the septum. These treatments often include decongestants to reduce tissue swelling and nasal steroid sprays to manage inflammation and congestion caused by the narrowed passage.
If symptoms persist and significantly affect the quality of life or breathing, surgical correction, known as septoplasty, is the recommended course of action. This procedure involves straightening the displaced cartilage and bone, often by removing or reshaping the most severely deviated portions, to restore the septum to the midline. The goal of the surgery is to improve nasal airflow by creating two more equally sized nasal passages.