Correcting A Deviated Septum

Often the primary cause of nasal obstruction is a deviation of the nasal septum, the wall of bone and cartilage that separates the left and right nostrils. In patients with nasal obstruction due to a deviated nasal septum, this wall is crooked and blocks airflow. This condition can lead to nasal congestion, sinus infections, snoring, and sleep apnea. While some of these symptoms can be treated medically, actual correction of a deviated septum requires a procedure called septoplasty.

What is a deviated septum?
The nasal septum is the central membrane of cartilage and bone in your nose. The septum divides the inside of your nose into left and right sides called the nasal cavities. When the septum is crooked or leans to one side of the nasal cavity, it is referred to as a “deviated septum” by healthcare providers.

How common is a deviated septum?
Deviated septum is a very common condition. It is estimated that up to 80% of people have a deviated septum. Many of these patients have a severe deviation that causes breathing problems. In most patients there is no external sign of the septal deviation.

What happens if I have a deviated septum?
If your deviated septum is mild, you may have very few symptoms or even no symptoms at all. However, if you have a severely deviated septum, it may cause you to have a sleeping disorder, difficulty breathing, headaches/facial pain, and sinus/nasal infections.

Symptoms And Causes

What causes a deviated septum?
A deviated septum can occur naturally. It may also be present at birth or, more commonly, be the result of normal childhood development. As bones and cartilage of the face and nose develop, the septum may grow more to one side. A deviated septum can also be caused by injuries to the face from impacts similar to those that cause a broken nose. Such injuries can also lead to simultaneous nasal and septum fractures. Causes of nasal injuries that can lead to a deviated septum include:

  • Auto accidents
  • Falls
  • Sports injuries
  • Fights
  • Nasal surgery

What are the symptoms of a deviated septum?
The most common symptom of a deviated septum is difficulty breathing through one or both sides of the nose. In extreme cases of severe septal deviation, the entire nose may appear crooked. Common symptoms include:

  • Nasal congestion, blockage, or stuffiness
  • Sleep apnea
  • Snoring
  • Nosebleeds
  • Headaches or facial pain
  • Noisy breathing
  • Inflammation or infection of the sinuses (sinusitis)

Diagnosis And Testing

How is a deviated septum diagnosed?
A deviated septum can usually be diagnosed by an ear, nose, and throat (ENT) physician upon examination of the inside of the nostrils with a light. In some cases, a special scope may be needed to see deep inside the nostril and examine all areas of the nasal septum. On occasion, medical imaging in the form of a CT (computed tomography) scan may also be recommended, especially if the ENT physician suspects sinus infections or inflammation.

Management And Treatment

How is a deviated septum treated?
If you have a mildly deviated septum without symptoms, treatment may not be needed, or your physician may recommend use of a nasal steroid spray, such as Flonase, Rhinocort, or Nasacort, to decrease any nasal swelling that is contributing to nasal congestion.

However, to actually correct a deviated nasal septum, surgery is required. The surgical treatment for a deviated septum is called a septoplasty. This procedure may be an appropriate option if you suffer from significant breathing problems, frequent sinus infections, snoring/sleep apnea, or facial pain/headaches. Surgical treatment of a deviated septum should only be performed by an ENT surgeon or a facial plastic surgeon.

What happens during a septoplasty?
A septoplasty is a relatively minor surgery that typically lasts about an hour. It is usually performed as an outpatient procedure, meaning that you would go home the same day. It is almost always performed under general anesthesia, which means you would be completely unconscious and feel no pain.

During a septoplasty, a patient is first placed under anesthesia and a breathing tube is carefully placed in the patient’s upper airway to protect it and to control the breathing rate and oxygen level. Next, a small incision is made, usually inside the nostril where it is not visible. The surgeon works beneath the lining of the nose to straighten any crooked areas of bone or cartilage of the deviated septum before closing the incision. In some cases, special splints or packs may be placed in the nose to improve the results or to prevent bleeding.

During a septoplasty, the surgeon may also perform a size reduction of the inferior turbinates to further improve the nasal breathing, or a rhinoplasty (a.k.a., a “nose job”) to improve the outside shape of the nose. If your ENT determines that you also have chronic inflammation or infection of the sinuses, sinus surgery would likely be done at the same time as a septoplasty in order to open and clean out the sinuses.

What will my recovery be like?
If you are having a septoplasty alone, or septoplasty combined with other outpatient procedures, you will most likely go home the same day. You should expect your nose to be sore for the first several days, but significant bruising or swelling is uncommon. You may notice that it is actually harder to breathe through your nose at first, either due to swelling from the surgery or because of splints or packing that were placed by your surgeon at the end of the surgery. Your physician may prescribe medicine for pain or nausea, and/or antibiotics to help prevent infection. Sometimes, minor nosebleeds can occur after surgery for the first one to two days. Most people fully recover within two weeks.

Who is a candidate for a septoplasty?
You may be a candidate for a septoplasty if you suffer from moderate or severe nasal obstruction, snoring/sleep apnea, or other symptoms associated with a deviated septum. Your surgeon will also consider other important factors such as:

  • Age
  • Previous surgeries
  • Medical risk factors
  • Alcohol, drug, and tobacco use
  • Overall health
  • Preexisting conditions

If you suspect you have a deviated septum, an exam by a medical professional is the first step to finding relief. The ENT specialists at CornerStone Ear, Nose & Throat have years of experience diagnosing and treating deviated septum and performing septoplasty to relieve nasal obstruction. To learn more or to make an appointment with CornerStone Ear, Nose & Throat, call 704-752-7575.