Nasal Septal Deviation

What is Nasal Septal Deviation?

A deviated septum is a condition in which the nasal septum -- the bone and cartilage that divide the nasal cavity of the nose in half -- is significantly off center, or crooked, making breathing difficult. Most people have some sort of imbalance in the size of their breathing passages. In fact, estimates indicate that 80% of people, most unknowingly, have some sort of misalignment to their nasal septum. Only the more severe imbalances cause significant breathing problems and require treatment.

Signs and symptoms

Only more severe cases of a deviated septum will cause symptoms of difficulty breathing and require treatment. Symptoms of a deviated septum include infections of the sinus and sleep apnea, snoring, repetitive sneezing, facial pain, nosebleeds, difficulty with breathing and mild to severe loss of the ability to smell.

The nasal septum is the bone and cartilage in the nose that separates the nasal cavity into the two nostrils. The cartilage is called the quadrangular cartilage and the bones comprising the septum include the maxillary crest, vomer and the perpendicular plate of the ethmoid. Normally, the septum lies centrally, and thus the nasal passages are symmetrical. A deviated septum is an abnormal condition in which the top of the cartilaginous ridge leans to the left or the right, causing obstruction of the affected nasal passage. The condition can result in poor drainage of the sinuses. People can also complain of difficulty breathing, headaches, bloody noses, or of sleeping disorders such as snoring or sleep apnea.

It is common for nasal septa to depart from the exact centerline; the septum is only considered deviated if the shift is substantial or causes problems. Many people with a deviation are unaware they have it until some pain is produced. By itself, a deviated septum can go undetected for years and thus be without any need for correction.

Causes

It is most frequently caused by impact trauma, such as by a blow to the face. It can also be a congenital disorder, caused by compression of the nose during childbirth. Deviated septum is associated with genetic connective tissue disorders such as Marfan syndrome, Homocystinuria and Ehlers–Danlos syndrome.

Treatment

Sometimes symptoms of a deviated septum can be relieved with medications. If medicine alone doesn't offer adequate relief, a surgical procedure called septoplasty may be needed to repair a crooked septum and improve breathing.

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