A deviated septum occurs when the thin wall of bone and cartilage, known as the nasal septum, is displaced to one side of the nasal cavity. This displacement makes one of the two nasal passages smaller than the other, which restricts airflow. While a slight deviation is present in many people and often causes no issues, a more pronounced misalignment can lead to noticeable symptoms. These symptoms frequently include difficulty breathing through the nose, chronic nasal congestion, frequent nosebleeds, and noisy breathing during sleep. Diagnosis typically begins with a general medical assessment before progressing to a specialist for confirmation.
The Initial Consultation: Primary Care Screening
The starting point for most people experiencing persistent nasal issues is a visit with their Primary Care Provider (PCP), such as a family doctor or general practitioner. This initial consultation focuses on gathering a complete medical history and understanding the patient’s reported symptoms. The PCP will ask about the duration and severity of issues like persistent nasal blockage, recurrent sinus infections, or sleep disturbances such as loud snoring.
The general practitioner performs a preliminary screening to determine the likely cause of the symptoms. They often conduct a basic visual inspection of the nasal passages using a simple light source. This initial look can sometimes reveal a significant septal displacement or other obvious causes of obstruction.
The PCP does not typically make the definitive diagnosis or plan for treatment. Their assessment serves to rule out temporary causes, such as allergies or a common cold, and to establish the need for specialized care. If the symptoms suggest a structural problem, the next step is a referral to a specialist for a thorough evaluation.
The Diagnostic Authority: The Otolaryngologist
The professional who holds the authority to definitively diagnose a deviated septum is the Otolaryngologist, commonly known as an ENT (Ear, Nose, and Throat) specialist. This medical doctor has extensive training focused on the anatomy and conditions of the head and neck, including the nasal passages. The ENT’s expertise allows them to accurately assess the degree of septal deviation and its impact on breathing function.
The specialist’s role is to distinguish a true septal deviation from other conditions that cause similar symptoms, such as turbinate hypertrophy (swelling of structures within the nasal passages) or chronic sinusitis. They use specialized tools to get a precise view of the nasal interior. Making the final diagnosis involves a comprehensive evaluation that correlates the patient’s symptoms with the visible structural abnormality.
The ENT specialist’s confirmation of the diagnosis is the point at which treatment options, including surgical correction, can be formally discussed. Their specialized perspective ensures that the proposed treatment directly addresses the structural problem causing the patient’s symptoms.
Confirming the Diagnosis: Examination Techniques
The confirmation process relies on a detailed physical examination using specific instruments designed to visualize the nasal cavity. During the exam, the Otolaryngologist uses a nasal speculum, an instrument that gently widens the nostril entrance, combined with a bright light source. This allows the specialist to directly inspect the anterior part of the septum and the surrounding structures.
For a more comprehensive view of the deeper nasal passages, the ENT may perform nasal endoscopy. This technique involves inserting a flexible tube equipped with a camera and light, known as an endoscope, into the nose. The endoscope transmits images to a screen, enabling the doctor to see the full extent of the deviation and how it is affecting airflow and the drainage pathways of the sinuses.
In complex cases, or when other sinonasal issues are suspected, the specialist may order a computed tomography (CT) scan. While a CT scan is not typically used solely to diagnose a deviated septum, it provides cross-sectional images helpful for evaluating bony structures and planning potential surgical intervention. These combined techniques ensure a precise diagnosis, which then guides the discussion of appropriate next steps for managing the condition.