What is a septal deviation and do you need to fix it?

The nasal septum (septum) is the wall of cartilage and bone that divides the two sides of the nose. I tell patients it's the inside part of your nose that keeps you from picking both sides of your nose at the same time. My wife gets annoyed when I say that, but my patients nod their understanding every time.

Anatomy wise, the wiggly part you can feel in the front is cartilage. In the back the septum is made of bone. The septum is quite large. It's about as large as the palm of your hand. It's not just the part you can feel in the front. It goes all the way back between your cheeks sinuses and your eyes.

The septum should be straight. However, some patients have a deviated septum from birth or the septum deviates as it is growing to adult size. Of course, trauma can cause a septal deviation as well.

Here is a CT scan example of a severe left-sided septal deviation.

Signs and symptoms of a deviated septum

The most common symptom of a deviated septum is difficulty breathing through one or both nostrils. Other symptoms include frequent sinus infections, snoring, nosebleeds, facial pain, and sometimes even migraines. The severity of symptoms usually vary with the degree of the deviation. In general mild septal deviations cause mild symptoms and severe septal deviations cause severe symptoms.

How do we diagnose a deviated septum?

Deviations in the front of the nose can be seen with a flashlight and nasal speculum. Deviations farther back in the nose may require evaluation with a nasal endoscope or CT scan. Most primary care doctors or allergists can diagnose deviations in the front. The ones in the back often require you to see an ENT doctor for evaluation.

How do you fix a deviated septum?

Septal deviations can be treated surgically by performing a septoplasty. An upcoming newsletter will focus on septoplasty.

Not all septal deviations need fixing. Sometimes there's associated swelling in the nose that medications can treat. Decreasing the associated swelling can decrease nasal congestion and in some cases eliminate the need for a septoplasty.

Risks of not treating a deviated septum

The only risks of not treating a deviated septum are continued and sometimes worsening symptoms.

Till Next Week,
Dr. Atkins, Follow me on Twitter.

P.S.

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