Overview of the Nose and its Function

The nose is part of the respiratory system that allows you to breathe. It filters the air, removing debris, allergens, and other irritants. In addition, it humidifies and warms the air so it can adequately go through the respiratory system. The nose provides you with a sense of smell, impacts the way you sound when you speak, and contributes to your overall facial appearance.

Common Nasal Conditions

Certain ailments and conditions can affect the nose and its proper functioning, such as: 
  • Allergic rhinitis 
  • Trauma or injury 
  • Nasal polyps
  • Upper respiratory infection
  • Enlarged turbinates
  • Nosebleeds
  • Nasopharyngeal cancer
Another common condition of the nose is what is known as Nasal Septum Deviation, wherein one nasal passage is smaller because the bone and cartilage dividing the nose are not centrally aligned. Understanding nasal septum deviation is crucial because it can significantly affect one’s overall health and well-being. It can cause breathing difficulties, affect sleep quality, increase the risk of sinus infections and nasal congestion, cause facial pain, and more.

What is Nasal Septum Deviation?

Nasal septum deviation happens when the wall between your nasal passages (known as the nasal septum) is displaced to one side. When this is off-centre (otherwise known as ‘deviated’), it will result in one nasal passage being smaller in size than the other.

Incidence of Nasal Septum Deviation Among Adults and Children

Nasal septum deviation has a wide range of prevalence. An international study published in 2008 showed almost 90% of ENT patients in different geographic regions globally had one of the seven types of septal deformities. Meanwhile, the American Academy of Otolaryngology – Head and Neck Surgery estimates that 80% of people have a septum that is off-centre to a certain degree

Nasal septum deviation in children can occur during fetal development. Sometimes, it is a result of injury to the child’s nose. A 2019 study cites that the incidence of deformity in the nasal septum among the paediatric population ranges between 0.93% and 55%. Moreover, it differs according to age and type of deformity.

What Causes a Deviated Septum?

Nasal septum deviation is caused by the displacement of the nasal septum in the nose, which can happen due to injury or, as in many cases, simply from birth. However, it should be noted that having a deviated septum is very common. Contact sports with a high risk of trauma to the face, such as competitive fighting, rugby, and ice hockey, can result in injury to the nose and, as a result, displace the septum. Other sources of injury include falling and vehicle-related accidents.

Living with a Deviated Septum

People with slight septum deviation rarely have symptoms and might be unaware of the uneven nasal passages they might have. Symptoms such as breathing difficulties will only occur more frequently in severe cases of septum deviation.

The afflicted person can have difficulty breathing through the nose and might have to rely on using the mouth to breathe more often. They might also find breathing through one side of the nose easier. Other symptoms include an increased risk of sinus infections or sinusitis, leading to nasal congestion and obstruction.

Additionally, a deviated septum may be associated with other nasal conditions like obstructive sleep apnoea.

In some cases, the uneven airflow generated by a deviated septum can cause dryness in one nostril. This can cause crusting around the septum, which may lead to nosebleeds (epistaxis).

In some rare cases, a deviated nasal septum may also result in headaches (Sluder’s neuralgia). In severe cases, facial pain may be experienced.

It is recommended to visit your doctor or ENT specialist to seek medical advice if you have breathing difficulties or frequently encounter the above symptoms, impacting your quality of life.

How is a Deviated Septum Diagnosed?

The process for diagnosis involves an examination of your nostrils. The doctor uses a nasal speculum to check the placement of the septum within the nose. The focus is on how the septum’s current position affects the size of your nostrils and nasal passages.

The doctor will also ask questions about symptoms experienced, such as the quality of sleep and snoring, frequency and degree of sinus problems, and difficulty in breathing.

In most cases, there is no need for treatment or medical advice as it presents little to no problems in daily life. However, should your quality of life be affected, seeking a professional opinion from a doctor or ENT Specialist is recommended.

How is a Deviated Septum Treated?

Often, surgical treatment is not required. Symptoms can be managed through medication meant to improve the quality of life in most people with a deviated septum. Common medications include decongestants, antihistamines, nasal steroid sprays, and nasal strips.

Should the symptoms fail to improve with medication or other attempts at treating them, your doctor or ENT specialist may suggest a type of reconstructive surgery for your nose and deviated septum, known as Septoplasty.

What is Deviated Septum Surgery (Septoplasty)?

Septoplasty is the surgical correction of the deviated septum and is usually performed under general anaesthesia. The correction has to be performed with extreme precision to avoid affecting the support structure of the nose. Otherwise, rare complications such as saddle nose deformity can occur. Generally, most patients will do well after surgery with minimal problems. It is a straightforward “day surgery” procedure.

During the surgery, the surgeon cuts the septum and removes the excess cartilage and/or bone. This process straightens the passages in the nose and septum. The incision is then closed with sutures.

It is advised to avoid medication such as aspirin or ibuprofen for two weeks before and after surgery, as such drugs may increase the risk of bleeding. If you have a smoking habit, it is highly encouraged to quit smoking during this period as it may hamper the healing process.

Book an Appointment

If you want to learn more about nasal septum deviation and its treatment, schedule a consultation with Dr Dennis Chua today.