Nasal Septum Deviation

Deviated Nasal Septum

A nasal septum deviation happens when the wall between your nasal passages (known as nasal septum) is displaced to one side. It is common for this wall dividing your nasal passages to be off-centre (otherwise known as ‘deviated’), resulting in one nasal passage to be smaller in size than the other.

The nasal septum is the centre partitioning between the 2 nasal passages. Displacement of this dividing wall in the nose can happen due to injury, or as in many cases, the person is simply born with it. Having a deviated septum is very common. Research from American Academy of Otolaryngology – Head and Neck Surgery, 80% of septums in people are deviated to a certain degree.

Contact sports that have 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 within the nose. Other sources of injury include falling and vehicle-related accidents.

It should be noted that many people that have a deviated septum only show a very slight deviation. This rarely causes deviated septum symptoms and the person might be unaware of the uneven nasal passages he/she might have.  The symptoms will occur more frequently in increasingly severe cases of septum deviation. Breathing difficulties and symptoms of such a condition are discussed in more detail below.  

A crooked nasal septum, or one that is displaced to one side can lead to breathing disorders with blocked nose.  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 that it is easier to breathe through one side of the nose.

This condition of having a deviated septum may even be associated with nasal obstruction conditions like obstructive sleep apnea. 

In some cases, the turbulent airflow generated as a result of the deviated septum can cause dryness in one nostril and crusting around the septum and can lead to nosebleeds (epistaxis). Uncommonly, a deviated nasal septum may also result in headaches (Sluder’s neuralgia).

Other symptoms that people with a deviated septum encounter an increased risk of sinus infections or sinusitis. As a result of sinus infections, nasal congestion and obstruction is also more common as a result.

In severe cases, facial pain can 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 and feel it affects your quality of life. 

In most cases, there is no necessity for treatment or need to seek medical advice as it presents little to no problems to daily life. However, should you feel that your quality of life is affected, seeking a professional opinion from a doctor or ENT Specialist may be the best way.

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 your nostrils and nasal passages.   

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

Often, surgical treatment is not required. Symptoms can be managed and alleviated 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 not improve with usage of medication or other attempts at treating them, your doctor or Ear, Nose and Throat (ENT) specialist may suggest a type of reconstructive surgery for your nose and deviated septum known as Septoplasty.

Septoplasty is a surgical correction of the deviated septum usually performed under general anaesthesia. It is important to be careful during the correction 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 procedure that can be performed as a Day Surgery procedure.

During this surgery, the surgeon cuts the septum and removes 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 2 weeks before and after surgery as such drugs may increase the risk of bleeding. If you have a smoking habit, it is highly encouraged for you to quit smoking during this period of time as it may hamper the healing process.

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