A deviated septum (DS) is a common condition where the thin wall of bone and cartilage separating the left and right nasal passages is significantly off-center. This displacement causes one nasal passage to be smaller than the other, severely restricting airflow. Obstructed airflow leads to chronic symptoms that interfere with normal breathing, especially during sleep or physical activity. Understanding which medical professionals diagnose and treat this structural issue is the first step toward finding relief.
Recognizing the Need for Consultation
A severely displaced septum often causes chronic symptoms that prompt medical attention. The most frequent complaint is chronic nasal congestion, typically worse on one side due to the narrowed passage. This restriction can lead to noisy, labored breathing, particularly during sleep, and may contribute to snoring. Irregular airflow can dry out the nasal lining, making the septum vulnerable to irritation and resulting in frequent nosebleeds. Furthermore, a deviated structure can impair sinus drainage, increasing the likelihood of recurrent sinus infections.
Initial Assessment by a General Practitioner
The first point of contact for recurring symptoms is usually a general practitioner, such as a family doctor or internist. These providers conduct a preliminary assessment, distinguishing a deviated septum from other common causes of nasal congestion. They take a detailed medical history to rule out issues like seasonal allergies, a persistent cold, or other inflammatory conditions. During the physical examination, the practitioner uses a nasal speculum to gently open the nostril for a basic visual inspection of the nasal cavity. This allows them to observe the front portion of the septum and assess the size difference between the nasal passages. General practitioners do not perform corrective procedures themselves. Their primary role is to manage mild symptoms with initial treatments and provide the necessary referral to a specialist for definitive diagnosis and treatment planning.
The Definitive Specialist: Otolaryngologist
The medical specialist focusing on the diagnosis and treatment of a deviated septum is the Otolaryngologist, commonly known as an ear, nose, and throat (ENT) doctor. These physicians have specialized training in managing head and neck disorders, with expertise in nasal anatomy and function. The ENT’s diagnostic process often includes a procedure called nasal endoscopy. During this procedure, the ENT inserts a thin, flexible tube with a camera and light source into the nasal cavity, allowing a detailed view of the entire septum and surrounding structures. This helps the specialist determine the precise location and severity of the deviation, identifying if bone, cartilage, or both are misaligned. Otolaryngologists are trained in both medical management and surgical correction, making them the primary experts. Some facial plastic surgeons also perform septoplasty, often combining it with a rhinoplasty to change the external appearance of the nose.
Determining the Treatment Path
The specialist determines the appropriate course of action based on the deviation’s severity and the impact of symptoms on the patient’s quality of life. For mild deviations causing manageable symptoms, the first approach is medical management focused on symptom relief. This non-surgical treatment uses medications to reduce inflammation and congestion within the nasal passages. Common options include decongestants, which shrink swollen tissues, and antihistamines, which address allergic inflammation. Steroid nasal sprays are prescribed to reduce chronic swelling of the nasal lining, creating more space for airflow without correcting the underlying structural issue. If medical interventions fail to provide sufficient relief, or if symptoms are severe, surgical intervention is considered the definitive fix. The procedure to correct a deviated septum is called septoplasty. This surgery involves making an incision inside the nose to access the septum, where the surgeon straightens, repositions, or removes the crooked portions of cartilage and bone. Septoplasty is a functional procedure designed to centralize the nasal septum and maximize airflow, offering a long-term solution.