While playing his usual weekly game of pick up softball, Dan slid into home plate and was inadvertently whacked in the nose by the catcher. Initially, he suffered some bleeding and a blackened eye. But, over the next few months, he started to notice a bit of difficulty breathing through his right nostril. At first, he ignored it.
Over time, though, he noticed a persistent stuffiness in his nose. Finally, Dan made an appointment with his doctor who, after a brief physical exam, discovered that Dan had a deviated septum.
A septum is any wall that divides two cavities. In the nose, the septum runs down the center of the nose and divides the nose into two separate chambers. The septum itself is made up of two parts. Toward the far back of the nose, the septum is hard bone. At the middle and towards the tip, it is made of cartilage—a tough, semi-flexible material.
Virtually no one has a perfectly straight or centered septum, and a slight deviation one way or the other is not usually problematic. If, however, the septum protrudes too far to one side or the other, it can interfere with the movement of air into and out of, as well as the draining of mucus from, the nasal cavity. While a deviated septum can be the result of genetics, it can also be caused by trauma, such as a blow to the nose from an accident or while playing sports.
Symptoms of a deviated septum include the following:
Although normally invisible from the exterior, diagnosis of a deviated septum can easily be determined by a brief examination of the interior of the nose by an ear, nose, and throat specialist (otolaryngologist). Recommended treatment will depend on the severity of the symptoms. Possible treatments include the following:
When the symptoms are minor (intermittent stuffy nose, minor snoring), treatment usually consists of antihistamines, nasal decongestants, and cortisone-containing nasal sprays. These medications can help to clear mucus and prevent congestion from building up in the nasal cavity.
When symptoms become persistent and/or difficult to deal with, such as with chronic sinusitis, breathing problems, or extreme snoring, your doctor may recommend surgery to correct the deviated septum.
Surgery to correct a deviated septum is called septoplasty. As a rule, it is generally not done until after the age 18, when cartilage growth is complete.
During septoplasty, the doctor pushes back the lining of the septum and cuts away the portion of the cartilage that is protruding into the nostril. After the cartilage is removed, the lining is moved back into place. Tiny splints may be placed inside the nose to keep the septum in place while it heals.
Before deciding on surgery to correct a deviated septum, talk to your doctor about the possible severity of your symptoms, as well as the possibility of surgical complications.
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Otolaryngology—Head and Neck Surgery
Alberta Health and Wellness
Acute sinusitis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 7, 2014. Accessed March 25. 2014.
Chronic rhinosinusitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 8, 2013. Accessed March 25. 2014.
Fact sheet: deviated septum. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/deviatedSeptum.cfm. Accessed March 25, 2014.
Rhinoplasty overview. American Rhinologic Society website. Available at: http://care.american-rhinologic.org/rhinoplasty_overview. Updated July 2011. Accessed March 25, 2014.
Septal deviation and perforation. Merck Manual of Diagnosis and Therapy website. Available at: http://www.merckmanuals.com/professional/ear_nose_and_throat_disorders/nose_and_paranasal_sinus_disorders/septal_deviation_and_perforation.html. Updated October 2013. Accessed March 25, 2014.
Last reviewed April 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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