The nasal septum is a thin, dividing wall inside the nose that separates the nasal cavity into two distinct passages. It is composed of cartilage toward the front and bone toward the back, providing support and directing airflow through the nostrils. When this wall shifts significantly away from the centerline, the condition is known as a deviated septum. While minor misalignment is common, a substantial deviation can lead to functional issues that affect breathing and overall health.
What a Deviated Septum Is
The septum is composed of flexible cartilage in the anterior portion and bone in the posterior portion. Ideally, this partition is straight, allowing for symmetrical airflow through both sides of the nose. A deviation occurs when the bone or cartilage is displaced or bent, making one nasal passage notably smaller than the other.
The origin of a septal deviation can generally be traced back to two primary causes. The first is developmental or congenital, meaning the condition is present from birth, sometimes due to pressures placed on the nose during fetal development or birth. The second, and often more common cause, is trauma sustained later in life.
An injury to the face, such as from contact sports, a fall, or an automobile accident, can cause the cartilage and bone to shift out of alignment. Even minor, unrecognized trauma during childhood can lead to a deviation that becomes more noticeable over time. The natural aging process can also cause changes in the nasal structures, potentially worsening a previously minor deviation.
Common Health Impacts
A significant deviation restricts the flow of air, leading to the most common symptom: difficulty breathing through one or both nostrils. This nasal obstruction is often more pronounced on the side toward which the septum is displaced. The restricted airflow can also cause chronic nasal congestion, which often feels worse during allergy flare-ups or when battling a cold.
Turbulent air moving across the narrowed passage can dry out the mucosal surface of the septum, increasing the likelihood of frequent nosebleeds. The obstruction may also interfere with the normal drainage of the sinuses, contributing to recurrent or chronic sinus infections. Individuals may also experience facial pain or headaches related to pressure buildup within the nasal cavities.
Breathing issues frequently extend into sleep, causing loud breathing, snoring, or a preference for sleeping on a specific side to ease airflow. Severe cases can contribute to sleep disorders, such as obstructive sleep apnea, where the airway is repeatedly blocked. Chronically breathing through the mouth due to nasal blockage can also result in a persistent dry mouth.
Assessment and Correction Options
Diagnosing a deviated septum typically begins with an ear, nose, and throat (ENT) specialist performing a physical examination. The doctor uses a handheld nasal speculum to gently spread the nostrils and view the septum and nasal passages. For a more detailed look at deeper structures, the specialist may use a nasal endoscope, which is a thin, lighted tube with a camera.
For individuals with mild symptoms, non-surgical management focuses on reducing inflammation and improving airflow. This involves using over-the-counter or prescription nasal steroid sprays, which reduce swelling in the nasal lining. Decongestants offer short-term relief by shrinking swollen nasal tissues, while saline nasal irrigation helps clear mucus and moisturize the passages.
When symptoms are severe and conservative measures do not provide adequate relief, a surgical procedure called septoplasty is recommended. Septoplasty is performed entirely through the nostrils, meaning it does not change the external appearance of the nose. The goal is to straighten the bone and cartilage, repositioning or removing parts of the septum to improve breathing function.
Recovery from septoplasty involves a period of rest, with most patients able to return to desk work within about one week. Swelling and congestion are common during the initial days. Doctors often advise patients to avoid blowing their nose and strenuous activity for several weeks. While significant improvement in breathing can be noticed quickly, the internal tissues continue to heal and fully stabilize for several months following the procedure.