Nasal Septum Deviation

The nose consists of two separate parts: an outer, felt and elevated part called the pyramid of the nose, and an inner part consisting of two nasal cavities. The inner part communicates with the outer part through the nostrils and is separated by a thin tissue of bony cartilage called the nasal septum. As a rule, this abutment is rigidly vertically aligned, while in some people the nasal septum is curved. Because of this curvature, the flow of air through one of the nostrils is greatly reduced, and sometimes there is no passage at all and this condition is called nasal congestion.

A deviated septum does not cause any discomfort in many cases, but in some cases it leads to frequent nosebleeds, sleep disturbance, respiratory disorders…etc. It can be caused by very many symptoms. Diagnosis is usually based on a careful physical examination. If symptoms are intolerable, it is necessary to resort to septoplasty, which is an operation to treat a curved nasal septum.

What is a deviated nasal septum?

A deviated nasal septum is a disorder that occurs when the osteochondral plate between the two nasal cavities moves to the right or left.

In many people, this deviation narrows the canal of the affected nostril and reduces the flow of air through it. If this narrowing is so severe that it creates a real barrier to the passage of air, it is called pathological nasal congestion (or nasal obstruction). Deformities caused by a deviated nasal septum are permanent.

Why does deviation occur?

The nasal septum may deviate due to childbirth or a blow to the nose. Aging also plays a big role.

Deviated nasal septum at birth

A deviated nasal septum that is present from birth may be the result of an event that occurred during the fetus’s development in the womb (an unpredictable event) or the result of a problem during childbirth (difficulty giving birth). In these cases, the deviation is generally not obvious and problematic; However, this may be the case throughout life due to old age or one or more recurrent traumas.

Septal deviation due to trauma

In most cases, a deviated nasal septum is caused by a blow that occurs during childhood or adolescence. In children or teens, the most common causes are accidental falls or collisions with other children while playing with them.

when you are an adult; The most common causes are injuries when playing sports (especially in contact sports such as football, boxing, etc.), domestic injuries, and traffic accidents (especially when seat belts are worn).

Deviated nasal septum and aging

The normal aging process affects the anatomy of the nasal cavities, making a deviated septum worse and, in some cases, problematic. Aging leads to resorting to surgery even though there is no trauma or similar event in a person’s youthful age.

Symptoms of deviation and its complications

In most cases, a bend in the middle part of the nose does not cause any symptoms that patients do not even know they have. But they can cause various inconveniences to other people, some of which are very annoying:

  • Obstruction of one or both nostrils. The deviated septum may be so pronounced that the patient has difficulty breathing. This possibility may affect one or both gills. Often, the problem is aggravated with the appearance of a cold or allergy, as they further block the way for the passage of air.

  • Nose bleeding. The inner tissue of the nasal passages (mucous membrane) dries up due to septal abnormalities, which increases the incidence of nosebleeds.

  • Breathing disorders during sleep. Babies and children especially suffer from it. In most cases, the presence of a deformation of the nasal septum and inflammation of the tissues lining the nasal cavities are often the result.

  • Awareness of the nasal cycle. Nasal circulation is a physiological process in humans and other animals in which the nasal cavities are alternately blocked and decongested. In other words, the two nostrils are never opened at the same time, and the open side is sometimes the right side and sometimes the left side. One of the features of this process is that it is completely imperceptible. However, when you suffer from a deviated nasal septum, you can understand how the nasal circulation works.


When a septal deviation occurs, it includes one or more of the following complications:

  • Dry mouth

  • Feeling of pressure in one of the nasal passages

  • Sleeping problems

a condition called dry mouth(or xerostomia); Caused by continuous mouth breathing of a patient who cannot breathe effectively through his nose. The sleep disturbance is caused by nasal breathing disorder: the patient cannot find a suitable position in the bed that will comfort him in order to sleep.

When should you see a doctor?

It is recommended that you consult your doctor when you develop persistent sinus infections, have frequent nosebleeds, or when nasal congestion does not improve with different decongestant sprays and medications.

Diagnosis of a deviated nasal septum

To diagnose a deviated septum, the patient should be subjected to a thorough physical examination and asked to describe all the symptoms he feels. During the examination, the doctor uses a very strong light and a special instrument called a rhinoscope that can open the nostrils well. It is also very common to see the nasal cavities before and after decongestant treatment so that we can understand what the interior tissues of the nose look like. In some special cases, the nose is examined endoscopically, that is, using a small camera inside the nose.

Nasal septal deviation treatment

When a deviated septum causes unbearable discomfort, the only way to correct it is a surgical procedure known as septoplasty.

While waiting for surgery, the patient often takes some drug treatments such as nasal decongestants, antihistamines, etc. This will relieve symptoms and allow at least temporary relief.

Surgical intervention: septoplasty

During septoplasty, the surgeon makes an entry from the nasal cavities and reshapes the curved septum.

In some cases, when the deviation is very significant, a decision is made to perform a more in-depth operation, where the septal curvature is first removed and then repositioned in the appropriate area after correcting separately.

The operation can be performed under general anesthesia or local anesthesia, depending on the following patient characteristics (age, sensitivity to anesthetic drugs, etc.) and the experience of the surgeon performing the operation. Septoplasty usually includes excellent results.

Important note: septoplasty does not solve the problem of allergy symptoms such as itchy nose. Allergic symptoms occur independently of a deviated nasal septum. Patients with allergic rhinitis will continue to have allergy symptoms even after septoplasty if appropriate medications are not used.

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