Deviated Septum


The nasal septum is what divides your nose into two separate chambers called nostrils.

This wall of cartilage is sometimes a little off-center or misaligned. Normally, this isn’t a big deal. It can, however, can become a problem if what’s referred to as a deviated septum is affecting your ability to breathe or causing issues with nasal congestion.
The misalignment may even contribute to sleep apnea issues or make you a “mouth breather,” which can lead to dental and oral health problems.

Causes and Symptoms

It’s possible to be born with a deviated septum because of a birth defect, which is a genetic abnormality. Your nasal septum can also become misaligned because of an injury or unintended damage related to nasal surgery performed for other reasons. For instance, you might have had a cosmetic procedure that excessively shifted the position of your septum while your nose was reshaped.

Your septum can also be affected by chronic sinus infections, hay fever and other allergy issues, and age-related changes to nasal structures. Difficulty breathing is the most noticeable symptom associated with a deviated septum. If you have a misaligned nasal septum, you may also notice the following symptoms:

  • Recurring nosebleeds
  • Facial pain
  • A constant “stuffed up nose” feeling
  • Breathing that’s excessively noisy
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Diagnosing a Deviated Septum

Along with a physical exam and a review of your medical history, diagnosis of a deviated septum typically involves a look inside your nostrils with a specially designed handheld tool called a nasal speculum. A lighted scope (otoscope) may also be used to take a peek at interior structures.

Performed with a flexible, lighted tube with an attached camera, a nasal endoscopy is another method for evaluating nasal passages and sinus cavities to determine if there are contributing factors affecting how air flows along each side of your septum. A CT scan is sometimes performed as well.

Deviated Septum Treatments

A deviated septum that’s not causing severe or potentially life-threatening breathing difficulties may be treated with decongestants to reduce nasal swelling. If allergies are contributing to airflow issues, you may be advised to use antihistamines to control symptoms. Prescription nasal corticosteroid sprays can also be an effective way to ease nasal inflammation.

Should your septum be too far off from your nose’s natural mid-line, surgery at UCI’s Sinus Surgery Center may be the more appropriate treatment option. Septoplasty is the type of reconstructive surgery that’s performed to restore the correct alignment of the nasal septum. The exact way this type of surgery is performed will depend on how much your septum needs to be repositioned. In some situations, parts of the septum may need to be cut or removed.

Realigning your septum may alter the shape of your nose enough so that you’ll need a follow-up procedure (rhinoplasty) to restore its appearance. As far as prevention goes, it’s not possible to prevent everything that could be responsible for a deviated septum. What you can do, however, is be cautious when playing sports, avoid direct impacts to the nose whenever possible, and seek treatment for any noticeable difficulties with normal nose breathing as soon as possible.