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A deviated septum is a condition characterized by the displacement of the thin wall, known as the nasal septum, between the two nasal passages. This displacement causes the septum to be off-center, resulting in one of the nasal passages being smaller than the other. Interestingly, up to 80% of the general population may have some degree of nasal septum deviation, with some individuals unaware of their condition due to the absence of noticeable symptoms.
However, when a deviated septum is severe, it can lead to significant problems. The blockage of one side of the nose can reduce airflow, making it challenging to breathe comfortably. In more severe cases, the constant exposure of the deviated septum to the drying effect of nasal airflow can contribute to issues such as crusting and occasional bleeding.
To alleviate these symptoms, various treatment options are available, including medications to reduce swelling. In cases where conservative measures are insufficient, surgical intervention is necessary to correct the deviated septum and restore proper nasal function.
Symptoms
Most septal displacements often go unnoticed, with no apparent symptoms. however, certain septal deformities can lead to the following signs and symptoms:
- Nasal obstruction: one or both nostrils may become blocked, making it challenging to breathe through them. this obstruction can become more noticeable during episodes of cold or allergies when nasal passages tend to swell and narrow.
- Nosebleeds: dryness on the surface of the nasal septum can increase the likelihood of nosebleeds.
- Facial pain: while there is ongoing debate about the potential nasal causes of facial pain, severe deviated septums that result in surfaces within the nose touching each other can generate pressure and potentially contribute to one-sided facial pain.
- Noisy breathing during sleep: nocturnal noisy breathing can be attributed to factors like a deviated septum or swelling of nasal tissues.
- Awareness of nasal cycle: typically, individuals do not consciously notice the nasal cycle, which involves alternating obstruction between the two nostrils. being aware of this cycle can suggest nasal obstruction.
- Sleeping position preference: some individuals may prefer sleeping on one side to optimize their ability to breathe through the nose, especially if one nasal passage is narrowed.
Causes
There are various factors that can cause a deviated septum:
- Congenital condition: Some individuals are born with a deviated septum, which means the displacement of the nasal septum was present from birth.
- Nasal injury: An injury to the nose can also lead to a deviated septum by pushing the nasal septum out of its normal position. This can happen during childbirth in infants, while children and adults can experience nose injuries due to accidents, contact sports, falls, fights, or other physical encounters. A broken nose is a common result of such injuries and can cause a deviated septum.
- Aging: As a person ages, changes in nasal structures can worsen an existing deviated septum, potentially causing increased obstruction over time.
- Infection-related swelling: Swelling and irritation of the nasal or sinus cavities due to infections can further narrow the nasal passage, contributing to nasal obstruction.
Risk factors
The risk factors associated with this condition include:
- Not using a seat belt while traveling in a motorized vehicle.
- Playing contact sports
Diagnosis
History taking: Your healthcare provider will inquire about your symptoms during the assessment. They may ask questions such as:
- Providing a detailed description of your symptoms and their duration
- Inquiring about the presence of breathing difficulties
- Assessing the impact on your sleep quality and any snoring
- Exploring your medical history concerning sinus issues or nasal congestion
Physical examination: During the examination of your nasal passages, the physician will use a bright light and occasionally a specialized tool to gently widen your nostrils. In some cases, a slender, tube-shaped scope equipped with a bright light at the tip may be used to inspect the deeper regions of your nasal passages. The doctor may also evaluate your nasal tissues both before and after applying a decongestant spray.
Treatment
Medication: Initial treatment for a deviated septum often focuses on symptom management. Your doctor may recommend the following approaches:
- Decongestants: These medications aim to reduce swelling in nasal tissues, thereby facilitating improved airflow through both nostrils. Decongestants come in both pill form and nasal sprays. However, it is crucial to exercise caution when using nasal sprays, as excessive and prolonged use can lead to dependency and exacerbate symptoms upon discontinuation. Oral decongestants may also have stimulating effects, potentially causing restlessness, elevated blood pressure, and an increased heart rate.
- Antihistamines: These medications can prevent allergy symptoms and alleviate a stuffy or runny nose. They may also offer relief for non-allergic conditions like a cold. Some antihistamines can induce drowsiness and affect your ability to perform tasks requiring physical coordination, such as driving.
- Nasal steroid sprays: Prescription nasal corticosteroid sprays can reduce nasal swelling and aid in drainage. It typically takes 1 to 3 weeks for these sprays to achieve their maximum effect, so it’s essential to follow your doctor’s instructions for their use.
Surgery:
- Septoplasty: During a typical septoplasty procedure, the nasal septum is straightened and repositioned in the center of the nose. This may involve cutting and removing portions of the septum before reinserting them in their correct position. The degree of improvement achievable through surgery depends on the severity of the deviation. Surgery can potentially alleviate symptoms related to the deviated septum, particularly nasal obstruction. However, it cannot cure other nasal or sinus conditions, such as allergies, affecting the nasal lining tissues.
- Rhinoplasty: In certain cases, rhinoplasty (nose reshaping surgery) may be performed alongside septoplasty. Rhinoplasty involves altering the bone and cartilage in your nose to change its shape, size, or both.
