A deviated septum occurs when the thin wall of bone and cartilage that separates your nasal passages is off-center. This common condition can affect the airflow through your nose, potentially leading to various symptoms.
Understanding a Deviated Septum
A deviated septum is a displacement of the nasal septum, the partition dividing the nasal cavity into two nostrils. While some degree of displacement is common, it is considered “deviated” when the shift is substantial enough to cause problems. This structural abnormality can make one nasal passage significantly smaller than the other, restricting airflow.
Individuals with a deviated septum may experience difficulty breathing through one or both nostrils, particularly during colds or allergies when nasal tissues swell. Other common symptoms include persistent nasal congestion, frequent nosebleeds due to dryness, and recurrent sinus infections due to impaired drainage. Some people also report facial pain, headaches, noisy breathing during sleep, snoring, or a reduced sense of smell. These symptoms can vary in severity, with only more severe deviations typically requiring treatment.
Your First Doctor’s Visit
When you suspect you have a deviated septum based on your symptoms, your initial step should be to consult your primary care physician (PCP). Your PCP serves as the first point of contact in the healthcare system and can help determine the appropriate course of action. They will discuss your symptoms, their duration, and any history of nasal injuries.
During this visit, your PCP will likely perform a basic physical examination, which may involve looking inside your nose with a bright light. They might also ask if you’ve noticed if one side of your nose feels more blocked than the other or if over-the-counter remedies like nasal strips offer any relief. Based on this initial assessment, your PCP can then decide if a referral to a specialist is necessary for further diagnosis and potential treatment.
The Role of the ENT Specialist
For a definitive diagnosis and comprehensive treatment plan for a deviated septum, an Ear, Nose, and Throat (ENT) specialist is the appropriate doctor to consult. These specialists possess specific training in conditions affecting the ears, nose, and throat, including the intricate structures of the nasal passages. They are equipped to perform a thorough examination, often using an endoscope—a thin, lighted tube—to visualize the septum and the back of the nasal passages in detail.
After confirming the diagnosis, an ENT specialist will discuss various treatment options. For managing mild symptoms, non-surgical approaches may be suggested, such as nasal steroid sprays to reduce inflammation and swelling, decongestants to temporarily shrink blood vessels, or antihistamines if allergies contribute to congestion. These medications aim to alleviate symptoms but do not correct the anatomical deviation itself.
If symptoms persist or are severe, the ENT may recommend septoplasty, a surgical procedure designed to straighten the nasal septum. During septoplasty, the surgeon typically makes an incision inside the nose to access the septum, then repositions or removes portions of bone and cartilage to center the septum and improve airflow. This outpatient procedure usually takes about 60 to 90 minutes and is performed under local or general anesthesia.