Deviated Septum

What causes a deviated septum?

You may be born with a deviated septum. Or it can result from injury or damage from past treatments.

What are the symptoms of a deviated septum?

Other people normally can’t tell you have a deviated septum. Trouble breathing through the nose, or one side of the nose, is the most common symptom. You may also have stuffiness, congestion, or a feeling of fullness. A deviated septum can also impair normal drainage from the sinuses. This can lead to sinus infections that keep coming back (recurrent).

How is a deviated septum diagnosed?

Your healthcare provider will take a health history and do a physical exam. They will ask questions about any previous injury, and symptoms. The physical exam may be done with a handheld tool (nasal speculum) that lets your provider gently open the nostril a little. Or your provider may use a small lighted scope (otoscope) to look into the nostrils. Your provider may also use a lighted instrument to look at your nasal or sinus passages (nasal endoscopy). This is done using a skinny, flexible or rigid lighted tube with a camera in it. If needed, a CT scan of the nose and sinuses may be done.

How is a deviated septum treated?

Depending on the severity of your symptoms, surgery may be advised. Septoplasty is a reconstructive surgery done to correct a deviated nasal septum. The procedure is done through the nostrils. During the procedure, parts of the septum may be removed. Or they may be readjusted and reinserted into the nose.

Septoplasty may be done with traditional open surgery from inside the nose. When open surgery is done, small scars are made on the base of the nose. They are often not noticeable. Scarring is not visible when internal surgery is done. Depending on the severity of the deviation, septoplasty may be done in:

• A surgeon's office
• An outpatient surgery center
• A hospital as an outpatient
• A hospital as an inpatient

The surgeon will let you know when you can get back to normal activities. Many people recover in a few days. They can go back to school or to nonactive work in a week or so.

After surgery, you may have nasal packs or soft splints in your nostrils to stabilize the septum. If an additional procedure is done, such as rhinoplasty, a splint or bandage may be placed on the outside of your nose.

Short-term side effects of surgery may include:

• Face will feel puffy
• Tip of nose and nostrils may be swollen
• Nose may ache, upper teeth may be sore or painful
• Dull headache
• Swelling around the eyes
• Small amount of bleeding in first few days
• Small burst (ruptured) blood vessels may look like tiny red spots on the skin

Healing is a slow process. You may have some swelling for months, especially in the tip of the nose. Final results of nasal surgery may not be clear for 6 months or more. Usually, within a few weeks after surgery, you will be able to notice an improvement in breathing.

As with any surgery, there can be complications. People vary greatly in their anatomy and the ability to heal. The outcome is never fully predictable. Complications include:

• Infection
• Nosebleed or blood clot
• Hole (perforation) in the septum
• Reaction to the anesthesia

Key points about deviated septum

• The septum is cartilage that divides the nose into 2 separate chambers. A deviated septum is when the septum is shifted away from the midline.
• The most common symptom is trouble breathing through the nose.
• You may be born with a deviated septum. Or it may be caused by an injury or damage from previous treatments.
• Reconstructive plastic surgery may be done to correct a deviated septum. It may be part of a rhinoplasty or it can be done alone).
• Final results of nasal surgery may not be clear for several months or more.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Sumana Jothi MD

Medical Reviewer: Dan Brennan MD

Medical Reviewer: Tara Novick BSN MSN

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