Many patients have been told that they have a deviated septum, but most aren’t sure exactly what that means or even if it needs to be treated. The nasal cavity is separated into left and right sides by a partition (wall) that is made up of cartilage and bone. Ideally this wall is straight so that each side of the nose has equal space for breathing. However, very commonly this wall is not completely straight, in which case it is called “deviated.”
This could mean that it is bent to one side (>), bent to both sides (S), or there could be a part of the septum that sticks out like a thorn on a rose stem, which we call a spur. All of these configurations block the breathing space on one or both sides. This can cause it to feel like it is hard to breathe through the nose on one or both sides or that the breathing ability is different on one side or the other. This can give problems with exercise, sleep, or just feeling like you can’t get enough air. All of these can make you feel tired and frustrated or that you’re not able to perform to the best of your ability. In some cases it can even contribute to snoring or sleep apnea.
A septum may be deviated as a result of trauma to the nose, but some people may have a deviation just from their normal growth and development. Sometimes a deviation can be seen just by looking inside the front of the nose, but many times the deviation is further back and it requires an in-office endoscope or CT scan to fully identify. There may be other abnormalities that can contribute to the nasal obstruction, including swelling from allergies or sinusitis, nasal polyps, enlarged adenoids, or in rare cases, tumors. Your physician will decide which of these evaluations is appropriate based on your history.
As we always want to try non-surgical options first, your physician may opt to give a trial of medications to see how your symptoms respond. However, if the obstruction is purely structural and not due to swelling, or if medicines have failed to improve your symptoms, then a surgical procedure may be discussed.
Surgery for a deviated septum is a short outpatient procedure that is performed entirely inside your nose. It will not change the outside appearance of the nose and there are no external incisions or bruising. It consists of straightening or removing deviated portions of the septal cartilage and bone to relieve any obstruction in the nose. No nasal packing is required. Time away from work is usually 4-7 days. Other procedures may be required at the same time like turbinate reduction or polyp removal depending on your situation.
Nasal breathing is very important from both a medical and lifestyle standpoint. If you feel your nasal breathing is not what you think it should be, make an appointment with one of our expert physicians at Alamo ENT for an evaluation.