Deviated Nasal Septum

The nasal septum is the midline wall that separates the two sides of the nose. This partition is composed of both cartilage and bone and covered by a thin layer of mucosa (or skin that has a rich network of blood vessels running through it).

A deviated nasal septum occurs when this midline wall protrudes more into one side of the nose than the other. Causes for this disorder include:

  • Nose trauma
  • Passing through a narrow birth canal
  • Abnormal growth during childhood and adolescence

Many people with slightly deviated or off-center nasal septums do not show symptoms. Symptoms occur when the deviated septum shifts away from the midline enough to block airflow.

The symptoms of a deviated nasal septum can include:

  • Nasal blockage in one or both nostrils
  • Nasal congestion in one or both nostrils
  • Recurrent nosebleeds
  • Frequent sinus infections
  • Facial pain
  • Headaches
  • Post-nasal drip
  • Noisy nasal breathing, particularly at night

Septoplasty is the preferred surgical treatment to correct a deviated septum. Because the cartilaginous septum grows until around age 18, this procedure is not generally performed on children.

Diagnosing a Deviated Septum

A primary care doctor or an ENT physician can diagnose a deviated septum. An office visit with an ENT doctor will include a thorough evaluation of your symptoms and a nose examination. A nasal endoscopy can determine the cause of your nasal obstruction. A CT scan can reveal a deviated septum as well but is usually unnecessary.

After making the diagnosis, your doctor can discuss treatment options with you. If your symptoms are troublesome enough, you may qualify for surgery to straighten your septum.

Surgical Options

Surgery to correct a deviated septum is called a septoplasty. Sometimes, it accompanies other surgical procedures such as sinus surgery, nasal tumor removal or cosmetic nasal surgery.

The procedure starts by raising up the septum’s lining or mucosa. Sometimes, pieces of cartilage and bone will need to be removed. The lining is then laid back down and sutured in place.

Septoplasty can only be performed in the operating room under general anesthesia. The procedure is typically done on an outpatient basis with patients able to come in and go home on the same day.

During the healing process, your surgeon may place soft plastic or silicone splints inside your nose. In some instances, you may only need dissolving stitches. The surgeon can let you know if splints will be placed in your nose and how long they will stay in place.

Post-Operative Expectations

You can expect some pain, fatigue, nasal stuffiness and mild nasal drainage after surgery. Pain is generally mild and controllable with oral pain medications. The stuffiness typically results from swelling and splints inserted after the procedure; it usually improves quickly after the first week when the splints are removed. Drainage of some mucus and blood from your nose after surgery is a normal part of the healing process.

After your surgery, you will need to use saline sprays and/or irrigation. Please check with your surgeon about any post-operative care you will need to allow your nose to heal properly.