What is a Deviated Septum?

26 Aug What is a Deviated Septum?

Causes and Solutions for a Deviated Septum

A deviated septum occurs when the thin wall (nasal septum) between your nasal passages is displaced to one side. In many cases, this displacement makes one nasal passage smaller than the other, which can affect breathing through the nose. The nasal septum is ideally situated in the centre of your nose, equally dividing the two sides. However, about 80% of people have some form of misalignment, though not all require correction. In this blog, Perth Specialist Plastic Surgeon Dr. Guy Watts will discuss the nature of a deviated septum, explore its various causes, and outline effective solutions for correction.

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Symptoms of a Deviated Septum

If you have a deviated septum, you might be experiencing some of these common symptoms:

• Difficulty breathing through the nose
• Nasal congestion, usually one side more than the other
• Frequent nosebleeds
• Frequent sinus infections
• Facial pain
• Snoring or loud breathing during sleep

These symptoms can range from mild to severe and might be more noticeable when you have a cold or allergies that cause nasal swelling.

Causes of a Deviated Septum

The causes of a deviated septum can vary widely. Here are the primary factors:

• Congenital Factors: Some individuals are born with a deviated septum. During foetal development, the nasal septum may not form correctly and can be crooked at birth.
• Injury or Trauma: A deviated septum is often the result of an injury that causes the nasal septum to be knocked out of position. Common sources of such injuries include contact sports, physical fights, or accidents. Even minor injuries, like bumping your nose, can lead to deviations if they occur before the nose is fully developed.
• Other Possible Causes: In some cases, the deviation might develop as part of the natural ageing process as the structures and tissues of the nose may change and shift over time.

Complications of Ignoring a Deviated Septum

Failing to address a deviated septum can result in a range of complications that extend beyond mere discomfort, potentially leading to more serious health issues over time. Here’s a deeper look into how these complications can affect one’s wellbeing:

Breathing Difficulties

The most immediate impact of a deviated septum is often experienced through breathing difficulties. The obstruction of one or both nasal passages can severely restrict airflow, making it hard to breathe through the nose. This condition can exacerbate other respiratory issues, particularly during physical activities or when respiratory demands are higher. Chronic nasal obstruction can also lead to habitual mouth breathing, which itself can cause dry mouth, increased risk of dental decay, and sore throat.

Sleep Issues

Sleep disturbances are one of the most problematic outcomes of an untreated deviated septum. Obstructed nasal passages can lead to snoring and more seriously, obstructive sleep apnoea—a condition where breathing repeatedly stops and starts during sleep. These disruptions can significantly impair sleep quality, leading to daytime fatigue, cognitive impairment, and even mood disturbances. Over time, untreated sleep apnoea can increase the risk of more severe health problems, including hypertension, cardiovascular disease, and diabetes.

Sinus Problems

A deviated septum can also complicate the normal drainage of the sinuses, leading to recurrent sinus infections or chronic sinusitis. This condition can manifest as nasal congestion, sinus pressure, nasal discharge, and discomfort in the face. Chronic sinusitis can be particularly debilitating because it often leads to prolonged episodes of discomfort and a reduced sense of smell. Furthermore, consistent inflammation and infection in sinus cavities can lead to further complications, such as the spread of infection to adjacent structures, or in rare cases, an increased risk of meningitis.

These potential complications illustrate why it is crucial not to ignore symptoms that might suggest a deviated septum. Seeking early consultation and appropriate can prevent the progression of these complications and help maintain both your nasal health and overall wellbeing.

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Diagnosing a Deviated Septum

Diagnosing a deviated septum is a critical step in addressing any nasal obstruction issues and ensuring appropriate treatment. When you consult with a specialist plastic surgeon like Dr. Guy Watts, a comprehensive and methodical approach is adopted to accurately assess and diagnose a deviated septum.

Medical Examination

The diagnostic process begins with a thorough medical history review where Dr. Watts will ask about your symptoms, their duration, any incidents that might have led to nasal injuries, and your overall health. Understanding the history helps in correlating the physical findings with your symptoms.

Following the history, a physical examination is conducted. Dr. Watts will use a nasal speculum and a bright light to visually inspect the inside of your nasal passages. This examination helps in assessing the septum’s alignment and identifying any visible signs of deviation. The use of a bright light illuminates the nasal cavity adequately, allowing for a detailed view of the nasal structures. This examination is important as it helps in determining the presence and severity of the septal deviation, as well as identifying other possible nasal abnormalities such as polyps or signs of inflammation.

Imaging Tests

In cases where the physical examination does not conclusively determine the extent of the deviation or if complex structural issues are suspected, Dr. Watts may recommend imaging tests. An X-ray can provide a basic view, but a CT scan is generally more effective as it offers detailed images of the nasal structures, allowing for precise assessment of the septum and surrounding tissues. These images are vital for planning any surgical interventions, such as a septoplasty, ensuring that all areas needing correction are clearly identified and addressed during the procedure.

Self-assessment Tips

While a professional diagnosis is imperative, there are simple self-assessment techniques that can suggest the presence of a deviated septum. You can perform a basic check by attempting to breathe through each nostril separately while closing the other. If you find that one side is significantly more restricted than the other, it might indicate a deviation. This self-test can be helpful in deciding whether to seek a professional evaluation, but it should not replace a medical examination.

Treatment Options for a Deviated Septum

When treating a deviated septum, the approach taken often depends on the severity of the symptoms. Treatment options range from conservative non-surgical methods to more definitive surgical interventions.

Non-surgical Treatments

For those experiencing mild symptoms of a deviated septum, a number of non-surgical options are available that can help manage and alleviate these symptoms:

• Nasal Decongestants: These medications are useful for temporary relief from nasal congestion. They work by reducing swelling in the nasal passages, facilitating easier breathing. However, they are not advisable for long-term use as they can lead to rebound congestion.
• Antihistamines: Particularly effective for individuals whose nasal congestion is exacerbated by allergies, antihistamines can help reduce nasal tissue swelling and relieve allergy symptoms such as runny nose and sneezing.
• Nasal Steroid Sprays: These sprays reduce inflammation in the nasal passages and are often used for prolonged periods. They can be very effective in improving nasal breathing and are considered safe for long-term use under the guidance of a healthcare professional.

These treatments are generally recommended when the septal deviation is less severe and does not significantly impair breathing or lead to other complications.

Surgical Treatments (Septoplasty)

In cases where non-surgical treatments fail to provide adequate relief, or when the deviation causes significant breathing difficulties, surgical correction might be necessary. Septoplasty is the standard surgical procedure to correct a deviated septum.

Septoplasty is typically performed under general anaesthesia. During the surgery, Dr. Watts makes a small incision within the nostrils to access the septum. He will then carefully reposition and straighten the nasal septum, sometimes removing or reshaping portions of bone or cartilage to clear the nasal passage and restore proper alignment. This realignment allows for better airflow and can dramatically improve nasal breathing.

Post-septoplasty, patients commonly experience mild to moderate swelling and some bleeding, but these symptoms are generally manageable with medications prescribed, such as pain relievers and nasal saline sprays. Most patients are advised to take 1-2 weeks off work to ensure they recover without complications. During this time, patients should avoid strenuous activities, follow post-operative care instructions closely, including keeping the head elevated to reduce swelling and managing pain. Follow-up visits are critical to monitor healing and ensure that the nasal passage heals properly.

FAQs about Deviated Septum – Causes and Solutions

Are there specific signs that indicate a deviated septum is getting worse?

• A deviated septum itself does not necessarily worsen over time; however, the symptoms associated with it can. If you find that nasal congestion, breathing difficulties, or recurrent sinus infections are becoming more frequent or severe, it might indicate that the condition is exacerbating underlying issues such as allergies or other nasal problems.

Can children have a deviated septum, and how is it treated in younger patients?

• Yes, children can have a deviated septum. Some are born with the condition, while others might acquire it through injuries typical in childhood, such as falls or sports-related impacts. Treatment in children is generally conservative at first, focusing on managing symptoms with medications like nasal sprays and antihistamines. Surgery is usually reserved for severe cases or situations where the child experiences significant breathing difficulties, sleep disturbances, or problems with growth and development. In such cases, surgical intervention might be considered once the child’s nasal structures have developed sufficiently, typically in late adolescence.

Does a deviated septum affect sleep quality, and can it lead to sleep apnoea?

• A deviated septum can significantly impact sleep quality due to obstructed nasal passages that lead to difficulties in breathing at night. This condition can increase the likelihood of snoring and nocturnal breathing pauses known as sleep apnoea. Sleep apnoea is a serious condition where the airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs and momentarily waking you from sleep. If you suspect your sleep issues may be related to a deviated septum, it’s important to undergo a thorough examination by a specialist.

Are there any lifestyle changes or home remedies that can help manage the symptoms of a deviated septum?

While medical treatment is often necessary to fully address the issues caused by a deviated septum, certain lifestyle changes and home remedies can help alleviate symptoms:

• Humidifiers: Using a humidifier in your bedroom can keep your nasal passages moist, easing congestion and reducing discomfort.
• Saline Sprays: Regular use of saline nasal sprays can help flush out irritants and keep the nasal passages clear.
• Avoiding Irritants: Reducing exposure to allergens like pollen, dust, and pet dander, as well as irritants like smoke and strong odours, can help lessen nasal congestion.
• Sleep Position: Elevating your head with extra pillows while sleeping can help reduce nasal congestion and improve breathing at night.
• Breathing Exercises: Some patients find relief through breathing exercises that help strengthen the respiratory muscles and improve airflow.

These remedies and lifestyle adjustments can complement medical treatments, providing relief for those affected by a deviated septum. However, for long-term relief, especially in severe cases, consulting with a specialist for appropriate treatment is essential.

Can a deviated septum return after surgery?

While septoplasty aims to correct a deviated septum, there are rare instances where deviations can recur. This might happen due to a few reasons:

• Incomplete Correction: Sometimes, the initial surgery might not completely straighten the septum, or slight deviations could remain. This can be due to the complexity of the original deviation or limitations during the surgery.
• Post-Surgical Healing: The healing process can sometimes lead to the formation of scar tissue, which might cause the septum to shift slightly. Additionally, if the nasal cartilage and tissues do not heal in the desired position, they might gradually move back towards their original state.
• New Trauma: Just as an injury can cause a deviated septum initially, any trauma to the nose after surgery can also result in a new or worsened deviation.

Further Reading about Rhinoplasty with Perth Specialist Plastic Surgeon Dr. Guy Watts

• Read Dr. Guy Watts’ Blog about How to Reduce Bruising after Rhinoplasty
• Read Dr. Guy Watts’ Blog about Recovery after Nose Surgery
• Read Dr. Guy Watts’ Blog about Turkish Rhinoplasty
• Read Dr. Guy Watts’ Blog about Nose Shapes
• Read Dr. Guy Watts’ Blog about Top 5 ways to improve your nose  

Medical References about Deviated Septum

• Nasal Septal Deviation: A Comprehensive Narrative Review
• Deviated septum – Diagnosis & treatment – Mayo Clinic
• Nasal Septal Deviations: A Systematic Review of Classification Systems
• A systematic review of the nasal septal turbinate
• Olfaction and quality of life in patients with nasal septal deviation treated with septoplasty