A deviated septum is a common anatomical variation where the thin wall of cartilage and bone (the nasal septum) is displaced to one side of the nasal cavity. This displacement narrows the air passage in one or both nostrils, mechanically restricting airflow. Reduced airflow often leads to chronic nasal congestion, difficulty breathing, and disturbed sleep. While the structural issue is permanent without intervention, many strategies exist to manage symptoms and significantly improve breathing comfort, ranging from daily habits and medications to surgical correction.
Daily Non-Surgical Relief Strategies
Simple, non-medical adjustments provide immediate, physical relief from restricted airflow. External nasal dilators, commonly sold as nasal strips, work by physically lifting and expanding the flexible cartilage of the nasal walls, which offers noticeable improvement in airflow, especially during sleep or exercise.
Regular nasal irrigation using a saline solution, often with a neti pot, flushes out excess mucus, crusting, and irritants from the nasal cavity, reducing congestion. Using a humidifier, particularly in the bedroom, adds moisture to the air, soothing dry nasal passages and helping thin mucus.
Avoiding environmental triggers like dust, pollen, and strong fragrances helps minimize irritation and subsequent swelling. For nighttime breathing, sleeping on the side that corresponds to the less-obstructed nostril may use gravity to temporarily maximize the available airspace in the wider passage.
Medication Options for Symptom Control
Medications focus on reducing the inflammation and swelling of the nasal lining, which often compounds the physical obstruction of a deviated septum. Topical nasal steroid sprays are a primary treatment, working over time to suppress the inflammatory response in the nasal tissues. Consistent, daily use is necessary for these sprays to achieve their maximal effect, which often takes one to three weeks.
These corticosteroid sprays decrease the size of swollen turbinates, structures inside the nose that can further narrow the restricted passage. Antihistamines may also be helpful if allergies contribute to the nasal congestion, as they block the histamine response that causes swelling and a runny nose.
Oral and nasal decongestants provide temporary relief by shrinking the blood vessels in the nasal lining. Nasal spray decongestants should only be used for a few days, as prolonged use risks rebound congestion, where the swelling returns worse than before. All these medications treat the symptoms of swelling, not the underlying structural displacement of the septum.
When to Consider Surgical Correction
When conservative management, including daily remedies and pharmaceutical options, fails to provide adequate symptom relief, surgical correction becomes the definitive solution. Criteria for considering surgery often involve severe, persistent issues like chronic nasal obstruction, recurrent sinus infections, frequent nosebleeds, or significant sleep disruption. Surgery is the only method that physically corrects the displaced wall of cartilage and bone.
The procedure to correct a deviated septum is called septoplasty. During this surgery, an ENT specialist works entirely through the nostrils to straighten the cartilage and bone, often removing or reshaping the most deviated sections. Septoplasty is distinct from rhinoplasty, which changes the external shape of the nose for cosmetic reasons, though the two procedures are sometimes performed together.
A consultation for septoplasty involves a thorough physical examination and a review of your medical history. Imaging, such as a CT scan, may be ordered to assess the extent of the deviation and any related issues, such as chronic sinusitis. The surgery is generally performed on an outpatient basis, meaning most patients go home the same day.
Initial recovery involves mild to moderate discomfort and congestion for the first week, often managed with prescribed pain medication. Surgeons may use soft splints inside the nose to support the newly straightened septum, which are usually removed within a week. Most people return to desk work or school within seven to ten days. Strenuous activity is restricted for four to six weeks to prevent bleeding or injury. While initial swelling subsides quickly, the full benefit of improved breathing may take several months to realize as the internal tissues completely heal.