The nasal septum is a wall of bone and cartilage that divides the inside of the nose into two separate nasal passages. When this structure is off-center or displaced, it is known as a deviated septum. This is a common condition, with up to 80% of the general population having some degree of nasal septum deviation.
Understanding a Deviated Septum
The nasal septum is composed of both bone and cartilage. Normally, this septum is positioned centrally, allowing for symmetrical airflow through both nostrils. However, when it shifts, it can take various shapes, such as a C-shape or S-shape, or it may have bony projections called spurs, which can narrow one or both nasal passages.
A deviated septum can arise from several causes. Some individuals are born with a deviated septum, a condition that can develop during fetal growth or due to an injury sustained during childbirth. Alternatively, it can result from trauma to the nose later in life, such as from sports injuries, car accidents, or falls. While many people have some degree of septal deviation, it typically only becomes a concern when the displacement is significant enough to obstruct airflow or cause other problems.
Common Symptoms and Daily Impact
A deviated septum can lead to a range of symptoms, with their severity depending on the degree of deviation. A common symptom is difficulty breathing through one or both nostrils, which can worsen during colds or allergy seasons when nasal passages swell.
Individuals with a deviated septum may also experience frequent nosebleeds, as the uneven airflow can dry out the nasal septum’s surface, making delicate blood vessels more prone to rupture. Loud breathing during sleep, known as snoring, is another common issue, and in some cases, a deviated septum can contribute to or worsen sleep apnea. Facial pain or pressure, often felt around the nose or sinuses, can also occur.
The obstruction caused by a deviated septum can impair the natural drainage of mucus from the sinuses, leading to recurrent sinus infections. These infections can cause persistent congestion, headaches, and facial pressure. The reduced airflow may also affect a person’s sense of smell.
Diagnosis and When to Seek Care
Diagnosing a deviated septum typically involves a physical examination by a healthcare provider. The doctor will look inside the nose using a bright light and a nasal speculum, a handheld instrument that gently spreads the nostrils to allow for a clearer view of the septum and nasal passages. In some instances, a more detailed assessment might be performed using an endoscope, a thin, lighted tube with a camera that provides an enhanced view of the nasal and sinus passages.
It is advisable to seek medical attention if symptoms become bothersome, persistent, or significantly affect your quality of life. This includes experiencing severe breathing difficulty through the nose, frequent nosebleeds, or chronic sinus issues that do not improve with over-the-counter treatments. Consulting a healthcare professional, especially an ear, nose, and throat (ENT) specialist, can help determine if a deviated septum is the cause of your symptoms and guide you toward appropriate treatment.
Management and Treatment Options
Not all deviated septums require treatment, particularly if symptoms are mild or absent. For those with mild symptoms, non-surgical approaches can help manage the condition. Medications like nasal corticosteroid sprays can reduce inflammation and swelling within the nasal passages, which may improve airflow. Decongestant sprays can also provide temporary relief from congestion, though their use should be limited to a few days to avoid rebound congestion. Antihistamines can be beneficial if allergies contribute to nasal swelling.
When non-surgical methods do not adequately alleviate symptoms, surgery is often considered. Septoplasty is the surgical procedure designed to straighten the septum. During a septoplasty, which is typically an outpatient procedure lasting between 30 and 90 minutes, the surgeon works through incisions made inside the nose, usually leaving no external scars. The surgeon reshapes or removes portions of the bone and cartilage that are misaligned to reposition the septum to the center of the nose, thereby improving airflow and making breathing easier.
After the septum is straightened, the mucosal lining is repositioned over it. In some cases, temporary packing or splints may be placed inside the nose for support during initial healing. Recovery involves a few days of rest, with initial swelling subsiding within a few weeks, though full healing can take several months. Patients should avoid strenuous activities, nose blowing, and keep their head elevated post-operatively to minimize swelling and bleeding.