Deviated Nasal Septum: Symptoms, Causes & Treatment

The nasal septum is the thin wall made of cartilage and bone that divides the nasal cavity into two nostrils (right and left). It is normal for this septum to be roughly in the center, but in many people it is tilted or deviated to one side, called a deviated nasal septum. It is very common and may be present from birth or result from a nose injury. It is important to know that a slight deviation exists in many people without causing any symptoms and needs no treatment.

When the deviation is large enough to narrow the air passage on one or both sides of the nose, symptoms appear, foremost: chronic nasal blockage (often clearer on one side), difficulty breathing through the nose especially with a cold or allergy, mouth breathing, snoring, and sleep disturbance, recurrent sinus infections, sometimes recurrent nosebleeds or dryness, and headache or facial pressure. The patient may notice that one side of their nose is constantly blocked more than the other. Symptoms worsen with an accompanying nasal allergy or inflammation.

A deviated nasal septum is diagnosed by examination of the nose by the doctor (sometimes with an endoscope). A slight symptomless deviation needs no treatment. When there are symptoms, treatment often begins with addressing the accompanying factors that increase blockage, such as treating allergy and inflammation using nasal sprays and decongestants or antihistamines, as this may relieve symptoms without needing a procedure. But if the deviation is the main cause of the bothersome symptoms and they do not improve with medications, septoplasty surgery may be recommended, a procedure that returns the septum to a straighter position to improve the air passage. It is important to distinguish blockage caused by a deviated septum from other causes of nasal blockage (such as polyps or allergy), so seeing an ENT specialist to assess the real cause and choose appropriate treatment is advised.

• Chronic nasal blockage often clearer on one side.
• Difficulty breathing through the nose, mouth breathing, snoring, and sleep disturbance.
• Recurrent sinus infections, and nosebleeds or dryness sometimes.
• Headache or facial pressure.

• A deviation present from birth.
• A nose injury causing the septum to tilt.
• (A slight deviation is very common without symptoms.)

• Examination of the nose by the doctor (sometimes with an endoscope).
• Distinguishing a deviated septum from other causes of blockage (polyps, allergy).
• Assessing the accompanying factors that increase blockage.

A slight symptomless deviation

• Needs no treatment.

When there are symptoms

• Treating accompanying factors (allergy and inflammation) with nasal sprays and decongestants or antihistamines.

Surgery

• Septoplasty when the deviation is the main cause and symptoms do not improve with medications.

This content is educational and does not replace consulting an ENT specialist.

• Recurrent sinus infections and effects on breathing and sleep.
• Snoring and sometimes sleep apnea.
• Dryness and recurrent nosebleeds.

• Protecting the nose from injuries (sports protective gear).
• Treating nasal allergy and inflammation to reduce symptoms.
• Seeing a doctor to precisely assess the cause of chronic blockage.