The septum is the cartilage in the nose that separates the nostrils. Typically, it sits at the center and divides the nostrils evenly. However, in some people, this isn’t the case. Many people have an uneven septum, which makes one nostril larger than the other.
Severe unevenness is known as a deviated septum. It can cause health complications such as a blocked nostril or difficulty breathing.
An uneven septum is very common. According to the American Academy of Otolaryngology - Head and Neck Surgery, 80 percent of all septums are deviated to some degree. A deviated septum requires medical attention only if it causes other health issues or negatively impacts quality of life.
A deviated septum can be congenital. This means that a person was born with it. It can also occur as a result of an injury to the nose. People often get these injuries from contact sports, fighting, or car accidents. A deviated septum can also worsen with age.
Most people with a deviated septum have only a minor deviation. Symptoms are unlikely in these cases. Still, possible symptoms include:
- difficulty breathing, especially through the nose
- having one side of the nose that’s easier to breathe through
- sinus infections
- dryness in one nostril
- snoring or loud breathing during sleep
- nasal congestion or pressure
Severe deviation can be accompanied by facial pain. You should see your doctor if you frequently have nosebleeds or sinus infections. You should also see a doctor if breathing difficulty is affecting your quality of life.
To diagnose a deviated septum, your doctor first examines your nostrils with a nasal speculum. The doctor checks the septum’s placement and how it impacts the size of the nostrils. The doctor will also ask questions about sleep, snoring, sinus problems, and difficulty breathing.
For most cases, treatment is not necessary. For a severely deviated septum, surgery is the common treatment option. Due to the costs, risks, or other factors, some people with a deviated septum choose not to undergo surgery. Other treatment options are available. They don’t resolve a deviated septum, but they can lessen the symptoms that accompany it.
To help with symptoms, treatment focuses on correcting that issue. Common treatments for symptoms include:
- nasal steroid sprays
- nasal strips
If your symptoms do not improve with medication or other treatment attempts, your doctor may suggest a reconstructive surgery called septoplasty.
Preparation: To prepare, you should avoid taking medications such as aspirin or ibuprofen for two weeks before and after the surgery. These drugs may increase your risk of bleeding. You should also stop smoking, as it can interfere with healing.
Procedure: Septoplasty takes about 90 minutes and is performed under anesthesia. You may receive local or general anesthesia depending on the surgeon and your specific case. During the procedure, a surgeon cuts the septum and takes out excess cartilage or bone. This straightens the septum and your nasal passage. Silicone splints may be inserted in each nostril to support the septum. Then the incision wound is closed with sutures.
Complications: You’ll be monitored immediately after the surgery for complications, and you’ll likely be able to go home the same day. Septoplasty is generally a safe procedure for most people who can go under anesthesia. The risks that remain include:
- changing of nose shape
- persistence in problems even after the surgery
- excessive bleeding
- decreased sense of smell
- temporary numbness in upper gums and teeth
- septal hematoma (mass of blood)
Cost: Septoplasty may be covered by your insurance. Without insurance, it can cost between $6,000 and $30,000.
During recovery from septoplasty, your doctor may give you medication. Taking it can reduce your risk of post-op infection or it can help manage pain or discomfort. It’s important to take all the medications your doctor prescribes.
You also want to avoid disrupting your nose while healing. The septum becomes relatively stable by three to six months after the surgery. Some changes can still happen up to a year later. To prevent this, avoid bumping your septum as much as possible.
After the procedure, you can aid healing by following these tips:
- Don’t blow your nose.
- Elevate your head when you’re sleeping.
- Avoid strenuous exercise, including cardio.
- Wear clothes that fasten in the front instead of pulling over your head.
If left untreated, a severely deviated septum can cause complications. A common complication is the obstruction of one or both nostrils. This can cause:
- chronic sinus problems
- loud breathing during sleep
- disrupted sleep
- only being able to sleep on one side
Other complications include:
- facial pain
- dry mouth
- disturbed sleep
- pressure or congestion in the nasal passages
A deviated septum may not cause any issues and may not require treatment. In some cases, a deviated septum can lead to other complications. These include sleep apnea, snoring, congestion, difficulty breathing, infections, or nosebleeds. Severe cases may call for surgery. If you have a deviated septum that may need treatment, discuss your options with your doctor.