What is a Deviated Septum? Symptoms, Causes, & Treatment

A deviated septum happens when the thin wall between your nostrils leans heavily to one side instead of sitting straight down the middle. This shift can make one nasal passage much smaller than the other, potentially affecting how you breathe.

You're definitely not alone if you have this condition. Studies show that up to 80% of people have some degree of septal deviation, though many never realize it because their symptoms are so mild. The good news is that when a deviated septum does cause problems, there are effective ways to manage and treat it.

What is a deviated septum?

Your nasal septum is the wall that divides your nose into two separate breathing passages. Think of it as a divider that should ideally run straight down the center, creating two equal-sized nostrils.

When you have a deviated septum, this wall has shifted or curved to one side. The deviation can be slight, causing no symptoms at all, or more pronounced, leading to breathing difficulties and other issues. Some people are born with a deviated septum, while others develop it after an injury.

The severity of symptoms often depends on how much the septum has shifted and whether it blocks airflow through one or both nostrils. Even a minor deviation can sometimes cause significant problems if it affects the narrowest part of your nasal passage.

What are the symptoms of a deviated septum?

Many people with a deviated septum experience no symptoms at all and live their entire lives without knowing they have the condition. However, when symptoms do occur, they can range from mildly annoying to significantly disruptive to your daily life.

The most common symptoms you might notice include:

• Difficulty breathing through one or both nostrils, especially when lying down
• Frequent nosebleeds, particularly from the side with less airflow
• Facial pain or pressure, often concentrated around your nose and forehead
• Loud breathing or snoring during sleep
• Recurring sinus infections or congestion
• Headaches, especially in the morning
• Postnasal drip that doesn't improve with typical treatments

Some people also experience a reduced sense of smell or taste, since proper airflow helps these senses work effectively. You might find that symptoms worsen during cold and flu season or when your allergies flare up, as any additional swelling can further narrow your already restricted nasal passages.

What causes a deviated septum?

A deviated septum develops through two main pathways: you can either be born with it or acquire it through injury. Understanding the cause doesn't change treatment options, but it can help explain why you're experiencing symptoms now.

The most common causes include:

• Congenital development where the septum forms off-center during fetal growth
• Birth trauma during delivery that shifts the nasal structures
• Facial injuries from sports, accidents, or falls that bend or break the septum
• Previous nasal surgeries that may have altered the septal position
• Natural aging process that can cause cartilage and bone changes

In rarer cases, certain medical conditions can contribute to septal deviation. Connective tissue disorders might affect how your nasal cartilage develops or maintains its shape over time. Some people also develop secondary deviation after chronic inflammation from conditions like severe allergies or repeated sinus infections.

It's worth noting that even minor childhood injuries that seemed insignificant at the time can sometimes lead to gradual septal changes as you grow and develop.

When to see a doctor for a deviated septum?

You should consider seeing a healthcare provider if your nasal symptoms are affecting your quality of life or sleep. While many people live comfortably with mild septal deviations, persistent problems deserve medical attention.

Schedule an appointment if you experience frequent sinus infections, chronic congestion that doesn't respond to over-the-counter treatments, or regular nosebleeds. Sleep disruption from breathing difficulties or loud snoring also warrants evaluation, especially if your partner notices periods where your breathing stops during sleep.

Seek prompt medical care if you develop sudden onset facial pain, severe headaches, or signs of infection like fever and thick, colored nasal discharge. These symptoms might indicate complications that need immediate treatment rather than just the deviated septum itself.

What are the risk factors for a deviated septum?

While anyone can develop a deviated septum, certain factors can increase your likelihood of having this condition or experiencing symptoms from it. Understanding these risk factors can help you make sense of your situation and discuss concerns with your doctor.

The primary risk factors include:

• Family history of nasal structural abnormalities or breathing issues
• Participation in contact sports or activities with higher injury risk
• Previous facial or nasal trauma, even from childhood
• Chronic nasal inflammation from allergies or environmental irritants
• Certain occupations with higher risk of facial injury

Age can also play a role, though in different ways. Babies and young children might have congenital deviations that become more apparent as they grow. Adults might develop deviations from accumulated minor injuries or age-related tissue changes.

Some people with connective tissue disorders or genetic syndromes affecting facial development may have higher rates of septal deviation, though these represent relatively uncommon scenarios.

What are the possible complications of a deviated septum?

While a deviated septum itself isn't dangerous, the breathing difficulties and drainage problems it causes can sometimes lead to other health issues. Most people with septal deviations never develop serious complications, but it's helpful to know what to watch for.

The most common complications you might experience include:

• Chronic sinusitis from poor drainage and air circulation
• Sleep apnea or sleep disruption from breathing difficulties
• Recurring respiratory infections due to inadequate nasal function
• Persistent dry mouth from mouth breathing during sleep
• Dental problems related to chronic mouth breathing
• Frequent nosebleeds from disrupted airflow patterns

In rarer situations, severe septal deviations can contribute to more significant breathing problems or chronic fatigue from poor sleep quality. Some people develop secondary issues like temporomandibular joint problems from altered breathing patterns and jaw positioning during sleep.

The good news is that these complications are preventable and treatable when you work with your healthcare team to address the underlying septal deviation and its effects on your breathing.

How is a deviated septum diagnosed?

Diagnosing a deviated septum typically starts with your doctor asking about your symptoms and examining your nose. This initial assessment can often determine whether septal deviation is likely contributing to your breathing problems.

During the physical examination, your doctor will use a special light and instrument called a nasal speculum to look inside your nostrils. This allows them to see the position of your septum and assess how much it's blocking airflow. They'll also check for signs of inflammation, infection, or other nasal problems.

If your symptoms are severe or surgery is being considered, your doctor might recommend additional tests. A CT scan can provide detailed images of your nasal and sinus structures, helping to plan treatment and rule out other conditions. In some cases, nasal endoscopy uses a thin, flexible camera to get a closer look at areas that are hard to see during a regular examination.

Sometimes your doctor will perform a simple breathing test, asking you to breathe through each nostril separately while the other is gently blocked. This helps assess how much the deviation is actually affecting your airflow.

What is the treatment for a deviated septum?

Treatment for a deviated septum depends on how much your symptoms affect your daily life. Many people with mild deviations never need any treatment, while others benefit from medications or surgical correction.

Your doctor will likely start with conservative treatments to see if they can manage your symptoms effectively. These might include nasal decongestants, antihistamines for allergies, or nasal corticosteroid sprays to reduce inflammation. Saline rinses can also help keep your nasal passages clear and moist.

If medications don't provide adequate relief and your symptoms significantly impact your quality of life, surgery might be recommended. The most common procedure is called septoplasty, where the surgeon repositions or removes parts of the deviated septum to improve airflow. This is typically done as an outpatient procedure under general anesthesia.

Some people also benefit from additional procedures performed at the same time, such as turbinate reduction to address enlarged nasal structures, or functional rhinoplasty to improve both breathing and appearance. Your surgeon will discuss which combination of procedures might work best for your specific situation.

How to manage symptoms at home during a deviated septum?

While home treatments can't fix a deviated septum, they can often help you breathe more comfortably and reduce symptoms. These strategies work particularly well for managing flare-ups or while you're considering other treatment options.

Saline nasal rinses are often the most effective home remedy you can try. Using a neti pot or saline spray helps flush out mucus and allergens while keeping your nasal passages moist. Make sure to use distilled or previously boiled water to avoid introducing harmful bacteria.

Keeping your head elevated while sleeping can significantly improve nighttime breathing. Try using an extra pillow or raising the head of your bed slightly. A humidifier in your bedroom can also help prevent your nasal passages from drying out, especially during winter months.

Nasal strips placed across the bridge of your nose can help open your nasal passages mechanically, providing temporary relief during sleep or exercise. Avoiding known allergens and irritants like smoke, strong perfumes, or dust can also help minimize inflammation that worsens breathing difficulties.

How should you prepare for your doctor appointment?

Preparing for your appointment can help ensure you get the most accurate diagnosis and appropriate treatment recommendations. Start by writing down all your symptoms, including when they occur and what seems to make them better or worse.

Make a list of all medications you're currently taking, including over-the-counter drugs, supplements, and nasal sprays. Your doctor needs to know what you've already tried and how well it worked. Also, bring information about any allergies you have and previous nasal injuries or surgeries.

Think about questions you want to ask, such as whether your symptoms are likely related to a deviated septum, what treatment options are available, and what to expect from different approaches. Don't hesitate to ask about the risks and benefits of surgical versus non-surgical treatments.

If possible, avoid using nasal decongestant sprays for a day or two before your appointment, as these can temporarily improve symptoms and make it harder for your doctor to assess your baseline breathing difficulties.

What's the key takeaway about deviated septum?

A deviated septum is an incredibly common condition that affects most people to some degree, though many never experience bothersome symptoms. When symptoms do occur, they can significantly impact your breathing, sleep quality, and overall comfort.

The most important thing to remember is that effective treatments are available, ranging from simple home remedies and medications to surgical correction for more severe cases. Working with your healthcare provider can help you find the right approach for your specific situation and symptom severity.

Don't let breathing difficulties become your new normal. Whether your symptoms are mild or severe, discussing them with a medical professional can help you understand your options and improve your quality of life. Many people are surprised by how much better they feel once their breathing issues are properly addressed.