A deviated septum
DEFINITION
A deviated septum occurs when the thin wall (nasal septum) between your nostrils is displaced to one side. In many people, the nasal septum is displaced — or deviated — making one nasal passage smaller.
When a deviated septum is severe, it can block one side of your nose and reduce airflow, causing difficulty breathing. The additional exposure of a deviated septum to the drying effect of airflow through the nose may sometimes contribute to crusting or bleeding in certain individuals.
Nasal obstruction can occur from a deviated nasal septum, from swelling of the tissues lining the nose, or from both. Treatment of nasal obstruction may include medications to reduce the swelling or adhesive strips that may help open the nasal passages. To correct a deviated septum, surgery is necessary.
CAUSES
A deviated septum occurs when your nasal septum — the thin wall that separates your right and left nasal passages — is displaced to one side.
A deviated septum can be caused by:
- A condition present at birth. In some cases, a deviated septum occurs during fetal development and is apparent at birth.
- Injury to the nose. A deviated septum can also be the result of an injury that causes the nasal septum to be moved out of position. In infants, such an injury may occur during childbirth. In children and adults, a wide array of accidents may lead to a nose injury and deviated septum — from tripping on a step to colliding with another person on the sidewalk. Trauma to the nose most commonly occurs during contact sports, active play or roughhousing, or automobile accidents.
The normal aging process may affect nasal structures, worsening a deviated septum over time. Also, changes in the amount of swelling of nasal tissues, because of developing rhinitis or rhinosinusitis, can accentuate the narrowing of a nasal passage from a deviated septum, resulting in nasal obstruction.
SYMPTOMS
Most septal deformities result in no symptoms, and you may not even know you have a deviated septum. Some septal deformities, however, may cause the following signs and symptoms:
- Obstruction of one or both nostrils. This obstruction can make it difficult to breathe through the nostril or nostrils. This may be more noticeable when you have a cold (upper respiratory tract infection) or allergies that can cause your nasal passages to swell and narrow.
- Nosebleeds. The surface of your nasal septum may become dry, increasing your risk of nosebleeds.
- Facial pain. Though there is some debate about the possible nasal causes of facial pain, a severe deviated septum that impacts the inside nasal wall, when on the same side as one-sided facial pain, is sometimes considered a possible cause.
- Noisy breathing during sleep. This can occur in infants and young children with a deviated septum or with swelling of the intranasal tissues.
- Awareness of the nasal cycle. It is normal for the nose to alternate being obstructed on one side, then changing to being obstructed on the other. This is called the nasal cycle. The nasal cycle is a normal phenomenon, but being aware of the nasal cycle is unusual and can be an indication that there is an abnormal amount of nasal obstruction.
- Preference for sleeping on a particular side. Some people may prefer to sleep on a particular side in order to optimize breathing through the nose at night. This can be due to a deviated septum that narrows one nasal passage.
When to see a doctor
See your doctor if you experience:
- A blocked nostril (or nostrils) that doesn’t respond to treatment
- Frequent nosebleeds
- Recurring sinus infections
