A deviated septum is a common nasal condition where the thin wall (septum) that divides the two nostrils becomes bent or crooked. In an ideal scenario, the septum is centrally positioned, allowing balanced airflow between both nasal passages. However, when the septum deviates, it leans to one side, obstructing airflow through one or both nostrils. Difficulty in breathing stands out as a hallmark symptom of a deviated septum, although some individuals may remain asymptomatic.
Deviated septums are nearly ubiquitous, with nearly everyone possessing some degree of septal deviation. It can either be a congenital condition, present from birth, or develop later in life due to trauma or injury to the face, such as a broken nose. The severity of symptoms determines the course of treatment, ranging from conservative measures like saline sprays to surgical intervention aimed at straightening and repositioning the septum to enhance airflow.
Symptoms of a Deviated Septum
Symptoms of a deviated septum can vary widely from person to person. While some individuals with mild deviations may remain asymptomatic, others with more pronounced deviations may experience:
1. Difficulty Breathing: Impaired airflow through one or both nostrils is a common symptom.
2. Nasal Congestion: Chronic stuffiness or congestion in the nasal passages.
3. Nosebleeds: Frequent occurrences of nosebleeds.
4. Sinusitis: Recurrent sinus infections may develop due to impaired drainage.
5. Sleep-Related Symptoms: Loud breathing or snoring during sleep can be indicative of a deviated septum.
Causes of a Deviated Septum
A deviated septum can result from trauma or injury to the nose, which can bend or distort the septum. A broken nose, for instance, is a common cause of a deviated septum. However, some individuals may have a deviated septum without any history of facial trauma, suggesting a genetic predisposition similar to other facial features like eye shape and color. This means that the shape and position of the nasal septum can be determined by genetic inheritance. In some cases, a deviated septum may develop during fetal development or as a result of trauma during childbirth.
Risk Factors
Several factors can increase the risk of developing a deviated septum, including:
1. Contact Sports: Engaging in contact sports increases the risk of facial trauma, which can lead to a deviated septum.
2. Seatbelt Usage: Not wearing a seatbelt in a motor vehicle can result in facial injuries during accidents.
3. Family History: Having a family history of a deviated septum, particularly in the absence of trauma or facial injury, can elevate the risk.
Diagnosis
Healthcare providers, typically ear, nose, and throat specialists (otolaryngologists or ENTs), can usually diagnose a deviated septum through a thorough nasal examination using a bright light and nasal speculum. The nasal speculum helps in gently separating the nostrils to visually assess the nasal passageways for any visible deviation.
In some instances, diagnostic procedures may be necessary to confirm the diagnosis, including:
1. Nasal Endoscopy: A flexible tube with a light (endoscope) is inserted into the nostrils to provide a detailed view of the nasal passages, assessing the extent and location of deviation and its impact on airflow.
2. Computed Tomography (CT) Scan: CT scans offer detailed images of nasal structures, aiding in evaluating the severity of deviation and identifying other nasal or sinus issues like nasal polyps.
Treatments for a Deviated Septum
The treatment approach for a deviated septum aims to alleviate symptoms and enhance nasal airflow, making breathing easier. The choice of treatment depends on the severity of symptoms.
Non-Surgical Treatments
For individuals with mild septal deviations, initial treatment may focus on relieving nasal congestion. Non-surgical options include:
1. Antihistamines: Over-the-counter antihistamine medications, like Zyrtec or Allegra, can be beneficial for those with allergies exacerbating nasal congestion.
2. Corticosteroid Nasal Spray: Prescription nasal sprays reduce inflammation and swelling in the nasal passages, providing temporary relief from congestion.
3. Nasal Saline Irrigation: Rinsing the nasal passages with a saltwater solution or using saline nasal sprays can clear mucus, reducing congestion.
Surgery
Septoplasty is the gold standard surgical procedure for moderate to severely deviated septums. During septoplasty, the cartilage and bone components of the septum may be reshaped or adjusted, and, if necessary, sections may be removed and repositioned to ensure the septum’s proper alignment and both nasal airways remain open. Septoplasty has proven highly effective, with up to 85% of patients experiencing symptom reduction post-surgery.
Prevention
Preventing a deviated septum may not always be possible, especially if it is congenital or due to accidental traumatic injuries. However, measures to reduce the risk of nasal trauma that can lead to a deviated septum include:
1. Protective Gear: When participating in contact sports, wearing protective gear such as helmets and face guards can reduce the risk of facial injuries.
2. Seatbelt Usage: Wearing seatbelts when traveling in a motor vehicle can prevent injuries to the face during accidents.
3. Avoid High-Risk Activities: Limiting participation in activities with a high risk of facial injury, such as wrestling or boxing.
Complications
While most individuals with a mild deviated septum do not require treatment and can manage symptoms with medications, severe deviations left untreated can lead to complications such as:
1. Chronic Sinusitis: Disruption of normal sinus drainage due to a deviated septum can result in recurrent or chronic inflammation and sinus infections.
2. Nasal Obstruction: Misalignment of the septum may lead to persistent nasal congestion and obstruction, making breathing through the nose difficult.
3. Sleep Apnea: A deviated septum can contribute to sleep apnea due to reduced airflow through nasal passages during sleep.
4. Headaches and Facial Pain: Chronic headaches or facial pain may arise from persistent nasal congestion and pressure caused by a deviated septum.
Living with a Deviated Septum
Symptoms of a mildly deviated septum can often be managed with conservative treatments like antihistamines or corticosteroid nasal sprays. If the air in your living space is dry, using air humidifiers can help moisturize the air, prevent nasal dryness, and alleviate stuffiness. Surgery, specifically septoplasty, can provide long-term relief for individuals experiencing symptoms that significantly impact their quality of life, such as chronic headaches or sinus infections.
It’s important to work closely with your healthcare provider to determine the most suitable treatment plan for your specific situation. With the appropriate treatment, most individuals with a deviated septum can breathe comfortably and normally.
Frequently Asked Questions
Does a Deviated Septum Get Worse with Age?
Aging can bring changes to nasal tissues, including increased dryness, narrowing of nasal passages, and heightened postnasal drip. These natural changes may exacerbate symptoms of a deviated septum for some individuals.
What Happens if You Don’t Fix a Deviated Septum?
While many people with a deviated septum do not require treatment and can manage their symptoms with medications, severe untreated deviations can lead to persistent issues such as chronic nasal congestion, recurring sinus infections, sleep-disordered breathing, headaches, and facial pain.
What Is the Success Rate of Deviated Septum Surgery?
Septoplasty, the surgical correction of a deviated septum, has a high success rate. Studies show that the procedure can improve nasal airflow, reduce congestion, and alleviate associated symptoms in up to 85% of patients.
How Painful Is Deviated Septum Surgery?
Septoplasty is performed under anesthesia, so patients do not experience pain during the procedure. Mild discomfort and nasal congestion are common during the initial recovery period, which can be managed with prescribed pain relief medications.