A deviated septum is a common anatomical variation where the thin wall of cartilage and bone separating the nasal passages is displaced to one side, which can narrow the airway and lead to breathing difficulties. While non-surgical methods cannot physically correct this structural misalignment, they are highly effective at managing the resulting symptoms, such as congestion, turbulent airflow, and inflammation. The primary goal of these conservative treatments is to reduce the swelling of the nasal lining, which is often exacerbated by the deviation, thereby improving nasal airflow.
Reducing Inflammation with Medication
Pharmacological treatments focus on reducing the swelling of the nasal tissues, known as the turbinates. Corticosteroid nasal sprays are a primary tool for long-term symptom management because they work by suppressing the inflammatory response within the nasal lining. Regular use of these sprays, such as fluticasone or mometasone, can significantly reduce the size of the turbinates and improve breathing over a period of one to three weeks.
For immediate, short-term relief, decongestant medications constrict blood vessels in the nasal passages to shrink swollen tissues, quickly opening the airway and providing temporary ease of breathing. Decongestant nasal sprays, however, should be used for no more than three days to prevent rebound congestion (rhinitis medicamentosa). This rebound effect occurs when the nasal lining becomes dependent on the medication, causing severe, persistent congestion when the spray is stopped.
If symptoms are worsened by environmental triggers, antihistamines may also be beneficial in managing the inflammatory response. These medications block the effect of histamine, which helps reduce nasal drainage and swelling. Antihistamines are particularly helpful when a deviated septum coexists with allergies, as the combination of structural narrowing and allergic swelling can severely restrict airflow.
Using Physical Devices for Airflow Improvement
Physical devices and environmental adjustments offer mechanical solutions to open the nasal passages or clear irritants. External nasal strips, which are adhesive bands placed across the bridge of the nose, use a spring-like action to gently pull the sides of the nostrils outward. This physical lifting helps to widen the narrowest part of the upper nasal passage, known as the nasal valve, thereby reducing airflow resistance.
Internal nasal dilators are small, soft devices, often cone-shaped, that are inserted directly into the nostrils to prop open the passages from the inside. These dilators apply gentle outward pressure to the internal nasal valve, an area that external strips may not affect as effectively. Internal dilators are often preferred for structural issues like a deviated septum because they target the constriction deep within the nasal cavity, offering a reusable, non-adhesive option for improved nighttime breathing.
Regular saline irrigation, performed with a neti pot or a squeeze bottle, uses a saltwater solution to flush the nasal passages. This process washes away thick mucus, allergens, and environmental irritants that contribute to congestion and inflammation. Saline irrigation also helps to moisturize the nasal lining and may improve the function of the cilia, the tiny hairs responsible for clearing the nasal cavity.
Using a humidifier in the bedroom can introduce moisture to the air. This soothes dry, irritated nasal passages and helps prevent the mucous membranes from drying out and worsening obstruction.
When Non-Surgical Methods Cannot Provide Relief
Non-surgical methods treat the symptoms of a deviated septum, such as inflammation and congestion, but do not correct the underlying physical displacement of the cartilage and bone. The effectiveness of these treatments depends on the severity of the structural deviation and the degree to which inflammation contributes to the blockage. For mild to moderate deviations, symptom management with medication and devices is often sufficient to restore comfortable breathing.
Non-surgical approaches are considered to have failed when they no longer provide adequate relief, indicating that the physical misalignment is the dominant cause of obstruction. Indicators that professional evaluation is needed include chronic, severe difficulty breathing through the nose, especially on one side, or if the deviation leads to secondary complications. These complications can involve frequent, recurring sinus infections or a diagnosis of obstructive sleep apnea directly caused by the nasal blockage.
The only method capable of physically straightening the nasal septum is a surgical procedure called a septoplasty. During a septoplasty, a surgeon reshapes or repositions the bone and cartilage to center the septum and create a wider, unobstructed airway. If the physical blockage is so severe that it prevents adequate airflow even when the nasal lining is minimally swollen, septoplasty may be the only path to a lasting improvement in nasal breathing.