Deviated Septum

The nasal septum is the structure inside your nose that separates the two nostrils and nasal cavities. Bone and cartilage make up the septum. The septum is lined with soft tissue called mucosa. Blocked airflow is the primary symptom of a deviated septum.

What is a deviated septum?

A deviated septum means that the septum is crooked. Sometimes this changes the shape and external appearance of the nose, but not always. 

The septum can be deviated in different locations. This determines:

• Which side of the nasal passage is obstructed
• Whether it causes a change in the external shape of the nose 

Not every deviated septum requires treatment. Treatment is only recommended if the deviation narrows one or both of the nostrils, obstructing airflow and making it hard to breathe. 

What causes a deviated nasal septum?

Causes of a deviated septum include:

• Congenital (you are born with it) 
• Injury to your nose
• Result of a nasal surgery

Deviated septum symptoms

The primary symptom of a deviated nasal septum is nasal obstruction (blocked airflow) in one or both of the nostrils. Other symptoms include: 

• Mouth breathing during sleep
• Nosebleeds
• Recurring sinus infections

Airflow blockage can also be a symptom of an enlarged turbinate. Turbinates are bony structures inside the nose, covered by soft tissue (mucosa). It’s common to have both a deviated septum and enlarged turbinates at the same time. Your Henry Ford ENT specialist will be able to make a correct diagnosis. 

Deviated septum and sleep apnea

A deviated nasal septum can cause additional breathing problems for people with obstructive sleep apnea. The condition can make it harder to use a continuous positive airway pressure (CPAP) machine. 

A CPAP machine works best when you are able to breathe through your nose. People with a deviated septum have blocked nasal passages and breathe through their mouth. Mouth breathing reduces the effectiveness of the CPAP machine.

Nonsurgical treatments for deviated septum

Nonsurgical treatments can include:

• Nasal saline spray or high-volume irrigation
• Nasal steroid spray· Nasal strips 

Deviated septum surgery

Your ENT doctor may recommend a septoplasty for a deviated nasal septum that does not improve with nonsurgical treatment. Septoplasty involves removing the deviated portions of septal bone and cartilage while keeping the tissue lining (mucosa) intact. This widens the nasal cavity where the septum was causing obstruction, resulting in increased airflow. 

A septoplasty will not affect the external appearance of the nose. Patients who want to change the shape of their nose as part of the deviated septum surgery would need to see a facial plastic surgeon for a rhinoplasty instead.