Deviated Septum

Deviated septum is a shift of the nasal septum away from the midline. The nasal septum is a wall that divides the nasal cavity into halves. Normally, the nasal septum is straight and is located exactly in the middle of the nasal cavity. In many people, it is bent towards the left or right. Symptoms occur when there is a severe shift from the midline. Difficulty in breathing through the nose is the most common symptom. The crooked septum can block the drainage of the air-filled spaces within the bones of the face (sinuses) causing repeated sinus infection. Surgery can be done to correct the deviation. Surgery is usually not recommended in minors as the septum grows till 18 years of age.

SYMPTOMS

People with mild deviation of the nasal septum usually do not have any symptoms. Symptoms develop when the deviation is severe. The common symptoms are:

  • Blockage in one or both sides of the nose.

  • Nasal congestion or stuffy nose.

  • Frequent nosebleeds.

  • Frequent sinus infection.

  • Headache.

  • Facial pain.

  • Excess collection of mucus at the back of the throat or nose (postnasal drip).

  • Noisy breathing while sleeping.

Some people with mild deviation have symptoms only when they get common cold. The deviated septum causes frequent inflammation of the sinuses (sinusitis) by blocking the sinus.

DIAGNOSIS

  • During the first visit, your caregiver will ask about your symptoms.

  • Your caregiver will examine the appearance of your nose.

  • You will be asked about any previous injury that may have caused damage to your nose.

  • You will be asked about any previous nose surgeries.

  • Your caregiver will check the position of your nasal septum.

  • Your caregiver may use a flashlight and a device used to widen your nostril (nasal speculum).

  • Your caregiver may suggest other tests, such as a computerized X-ray scan (CT or CAT scan), if needed.

TREATMENT

Mild deviation of the septum does not need any treatment. Your caregiver may advise a surgery to correct the deviated septum (septoplasty), if the deviation is severe. This surgery is done through your nose. No bruising will be visible outside. Your caregiver may instruct you to stop taking aspirin and other blood thinning medicines. Listen to your caregiver regarding those medicines. You will be given local or general anesthesia. Your surgeon will remove or adjust the septum and place it in the correct position. The entire procedure takes about 1 to 2 hours. You will be given a nasal pack to control the bleeding. The patient typically keeps the nasal pack in until the first follow-up visit after surgery. Hospital admission is not needed for this. Your surgeon might also do a sinus surgery along with this surgery, if needed. Sinus surgery entails opening the ostia (openings) of the sinuses to allow better drainage. Once deviated septum has been fixed, larger openings allow for better drainage. This leads to decreased incidence in sinus infections.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's advice after surgery.

  • Do not blow your nose.

  • Do not hold your breath.

  • Use ice packs to reduce pain.

  • For a few days, tighten your muscles while bearing down during bowel movement.

  • If bleeding occurs that exceeds nasal packing, and it does not stop with gentle pressure, call your caregiver.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.