Deviated Septum

A deviated septum occurs when the internal dividing wall between the right and left sides of the nose–the nasal septum–shifts away from the midline.  When the septum is crooked, it causes obstruction of the nasal airways and makes breathing difficult.

What is the Function of the Septum?

The septum is comprised of bone and cartilage and is surrounded on each side by a mucosal lining.  This mucosal lining covers and protects the cartilage and bone, and helps to keep the inside of the nose moist.  The septum also allows for the direct transit of the air that we breathe in through our nostrils to go directly into the lungs.

What Causes a Deviated Septum?

A deviated septum is usually genetic or random, but may also be the result of injury or trauma to the nose.

What are Symptoms of a Deviated Septum?

Nasal congestion is the most common symptom associated with a deviated septum, and this congestion is usually worse on one side, and sometimes occurs on the side opposite the bend.  Other symptoms include difficulty breathing, recurrent or repeated sinus infections, frequent nosebleeds, facial pain, headaches, loud breathing, snoring and mild sleep apnea. For some patients, the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.

How is a Deviated Septum Diagnosed?

As part of your initial assessment, your ENT (ear, nose, and throat) doctor will ask you about your symptoms and if you have ever incurred trauma to your nose or if you have ever had previous nasal surgery.  Your doctor will then examine the general appearance of your nose, including the position of your nasal septum, using a lighted small endoscope to inspect the nasal cavity from the front all the way to the adenoid area in the nasopharynx.  For some patients, CT scans and allergy testing may also be ordered. If the deviated septum is causing troublesome nosebleeds or recurrent sinus infections, surgery may be the recommended treatment. Surgery would also be recommended if the deviation is determined to be a significant causative factor of your nasal obstruction.

What is a Nasal Obstruction?

A nasal obstruction refers to some blockage of the nose or nasal cavity.  There are many things that can cause a nasal obstruction. Allergies, for some patients, can lead to swelling of the nasal and sinus lining, which causes congestion and blockage.  For other patients, the blockage may be due to a simple anatomical obstruction, such as an enlarged nasal turbinate, a polyp in the nasal passage, or a deviated septum.

Are There Any Non-Surgical Treatment Options Available?

There are a couple of non-surgical options available for patients to help alleviate symptoms associated with a deviated septum.  These include Allergy Treatments and Medications:

  • Allergy Treatments can help to decrease the swelling of the lining of the septum and surrounding tissue, thereby decreasing nasal congestion.
  • Medications can also be used to ease symptoms.  Your doctor may prescribe one or more of the following, depending on the severity of your symptoms:
    • Antihistamines
    • Decongestants
    • Nasal Antihistamine Sprays
    • Nasal Steroid Sprays

Note, however, that these options do not correct the septal deviation.

What is the Recommended Treatment for a Deviated Septum?

A septoplasty is the preferred surgical treatment to correct a deviated septum and improve breathing. It is a minor, minimally-invasive, outpatient procedure. The procedure can frequently be done in the office under local anesthesia with oral sedation. The procedure is performed entirely through the nostrils where the surgeon makes a small incision in the septum and then removes the excess bone or cartilage required to even out the breathing space of the nostrils.

Who is a Candidate for a Septoplasty?

A septoplasty procedure is often recommended for patients who:

  • Have a persistent nasal obstruction where the deviated septum is determined to have played a significant role in the symptoms;
  • Have symptoms of nasal blockage and congestion; and
  • Have not responded to medical therapy (prescribed and over-the-counter medications).

For these patients, a septoplasty can have a major, positive impact on nasal breathing, congestion, and quality of life.

Septoplasty FAQs

This procedure can be done using a local or a general anesthetic and is usually done on an outpatient basis.

After surgery, you may have drainage of some mucus and blood from your nose. This is a normal part of the healing process.

The RFA procedure can be done as an in-office procedure under local anesthesia. The SMR and Out-Fracture procedures are normally done in an ambulatory surgery center or in a hospital operating room under general anesthesia.

Many surgeons perform turbinate surgery without nasal packing. If nasal packing is used, it is inserted to prevent excessive postoperative bleeding. Talk to your surgeon about his/her standard practice.

Generally, turbinate reduction surgery takes 15-20 minutes, but that can vary from patient to patient. Of course, the time is extended when any other procedures are added on (i.e., sinus surgery, septoplasty, etc.).

Time off for recovery usually depends on the type of procedure performed as well as the type of anesthesia used. Recovery time for patients undergoing an RFA typically involves less time off of work–usually a day or two–because these procedures are performed under local anesthesia. For patients who have nasal and sinus procedures performed under general anesthesia, they may need to take 3-4 days off of work. During this time, patients are advised to refrain from heavy lifting or vigorous activity for 1-2 weeks.

No, turbinate reduction surgery does not affect the external appearance of the nose or face.

Neither sutures nor stitches are required for inferior turbinate reduction surgery.

Patients can expect to have some discomfort after surgery including fatigue, nasal stuffiness, and mild nasal drainage. The stuffiness typically results from swelling after the procedure and typically starts to improve after the first week. Most patients find that any post-operative discomfort can easily be managed with regular or extra-strength Tylenol.

There may be some post-operative bleeding after turbinate surgery, as the turbinates have a strong blood supply. For this reason, your doctor may advise you to use topical vasoconstrictor sprays such as Afrin or Oxymetazoline to control post-operative bleeding. If you experience any persistent or significant bleeding post-surgery, contact your doctor right away.

Yes, other procedures can be performed at the same time as a turbinate reduction. When other components contribute to nasal congestion, such as a deviated septum, sinus polyps, enlarged adenoids, or a sinus blockage, these components can be addressed at the same time as turbinate surgery Your doctor will discuss such options with you when developing your treatment plan.

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If you are having nasal symptoms and think you may have a deviated septum

Contact ENT of Parker at (303) 840-9690 to schedule a consultation for evaluation, diagnosis, and treatment.