The nasal septum is a flexible, cartilaginous structure inside your nose that is covered with skin and separates your nostrils into two sections.

Although the ideal nasal septum is exactly midline, it is estimated that 80 percent of all septums are off-center to some degree. When your septum becomes significantly deviated, it shifts away from the midline to the extent that it can cause difficulty breathing through the nose. The condition is usually not noticeable unless the deviation is marked, which generally occurs from injury or trauma.

Deviated septums may also be confused with other nasal-airway obstructions or conditions, such as reactive edema (swelling) in infected areas, allergies, or other anatomic abnormalities. It may also be a combination of many conditions or obstructions.

Common Causes

Many congenital septum disorders are caused by genetic connective-tissue problems. Conditions such as Marfan syndrome, homocystinuria, and Ehlers-Danlos syndrome are associated with deviated septums, as is compression of the nose during childbirth. Most frequently, however, deviated septums are caused by impact trauma to the face, such as a broken nose.

Symptoms

The most common symptoms of a deviated septum are nasal congestion and difficulty breathing. Symptoms tend to be worse on one side and can interfere with drainage of the sinuses. If an individual experiences chronic sinus infections and has difficulty breathing through one side of the nose, they might have a deviated septum. An individual with a deviated septum may also experience:

  • Nosebleeds
  • Facial pain
  • Headache
  • Postnasal drip
  • Loud breathing and snoring during sleep

Treatment Options

If your deviated septum interferes with your ability to live comfortably and function normally, surgery may be recommended. Your doctor or specialist will examine your nose, including the position of your septum, to determine the best course of action. Additional testing may be required in some circumstances.

If surgery is recommended, a procedure called a septoplasty will be performed. It’s performed entirely through the nostrils, which results in little bruising or visible external trauma. In some cases, a rhinoplasty — altering the appearance of the nose — may be included as part of this procedure if your doctor or surgeon feels that it would help you breathe more easily (or for cosmetic benefit, if you desire). During the operation, your septum will be adjusted to clear the nasal passages, but sections of it may be removed entirely. The operation usually takes between one and two hours, depending on how deviated your septum is, and nasal packing will be inserted to prevent excessive bleeding. You’ll be able to return home a few hours after surgery.

If a deviated septum was the cause of your chronic sinusitis, you should no longer have issues after the operation. If your operation included a rhinoplasty, swelling and bruising are common for up to two weeks after the procedure.