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Septal Deviation – Causes, Symptoms and Treatment

A septal deviation is a crooked or displaced nasal septum that can cause breathing difficulties. It may be present from birth or result from injury.

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Things worth knowing about "Septal Deviation"

A septal deviation is a crooked or displaced nasal septum that can cause breathing difficulties. It may be present from birth or result from injury.

What Is a Septal Deviation?

A septal deviation refers to a displacement or curvature of the nasal septum – the wall of bone and cartilage that divides the nasal cavity into left and right passages. When the septum is deviated, it is shifted to one side rather than running straight down the centre of the nose. This is one of the most common anatomical variations and affects a large proportion of the population to varying degrees.

Causes

A deviated septum can result from several causes:

Congenital: Some people are born with a slightly deviated septum, which may become more pronounced as the body grows.
Injury or trauma: A broken nose or facial injury can displace the nasal septum.
Uneven growth: During development, the septum may grow unevenly, leading to a deviation over time.

Symptoms

Many individuals with a deviated septum experience no symptoms. In more severe cases, the following symptoms may occur:

Nasal congestion on one or both sides
Difficulty breathing through the nose, especially at night
Frequent sinus infections (sinusitis)
Snoring and disrupted sleep
Mouth breathing due to reduced nasal airflow
Nosebleeds caused by dry nasal membranes
Headaches or facial pressure

Diagnosis

A deviated septum is typically diagnosed by an ear, nose and throat (ENT) specialist. Common diagnostic methods include:

Rhinoscopy: Direct examination of the nasal cavity using a nasal speculum or endoscope.
Rhinomanometry: Measurement of airflow resistance in the nose to assess breathing function.
CT or MRI scan: Imaging techniques used in complex cases or as preparation for surgery.

Treatment

Conservative Treatment

For mild symptoms, non-surgical approaches may help reduce discomfort:

Decongestant nasal sprays (for short-term use only)
Nasal corticosteroid sprays to reduce mucosal swelling
Saline nasal rinses to moisturise and cleanse the nasal passages

Surgical Treatment – Septoplasty

For significant deviations causing persistent symptoms, surgical correction is often recommended. The procedure is called septoplasty (or septorhinoplasty if the external shape of the nose is also corrected). During surgery, the deviated cartilage and bone are straightened to improve airflow. The procedure is typically performed under general anaesthesia and is considered a routine operation with good outcomes.

When to See a Doctor

Medical evaluation is recommended if you experience persistent blockage on one or both sides of the nose, recurrent sinus infections, sleep disturbances due to snoring or mouth breathing, or a general reduction in quality of life related to nasal breathing.

References

American Academy of Otolaryngology – Head and Neck Surgery. Clinical Practice Guideline: Nasal Valve Compromise and Septal Deviation (2023).
Konstantinidis I. et al. – Septal deviation and its effects on nasal aerodynamics and airflow. PubMed, 2014.
Bhatt JM, Bhattacharyya N. – Nasal septal deviation: epidemiology and comorbidities. Otolaryngology – Head and Neck Surgery, 2022.

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