16924 Deviated Septum

Overview

A deviated septum means the thin wall between your nostrils (the septum) is crooked or off-center. It can make one nasal passage smaller and cause breathing difficulties or other symptoms. This wall is made of bone and cartilage, and when it is not straight, it can affect how air moves through your nose.

Yes, this is very common. Many people have some degree of septal deviation, though not everyone has symptoms that affect their daily life.

It can affect people of any age. Some are born with it, and others develop it after a nose injury. It is often first noticed in adulthood, but children can have symptoms too.

Symptoms

Common symptoms

• Difficulty breathing through one or both nostrils
• Stuffy nose that does not go away
• Frequent nosebleeds
• Recurrent sinus infections
• Snoring or loud breathing during sleep
• Facial pain or headaches
• Postnasal drip (mucus running down the back of your throat)

Symptoms in children

• Noisy breathing through the nose
• Mouth breathing, especially at night
• Trouble sleeping or restless sleep
• Frequent colds or sinus congestion

Symptoms in older adults

• Dry mouth from breathing through the mouth
• Worsening sleep apnea symptoms
• Fatigue from poor sleep
• More noticeable nasal blockage due to aging changes in the nose

Causes

Main causes

• It can be present at birth, during growth in the womb.
• An injury to the nose, such as from a fall, sports collision, or car accident.
• Aging can make a previous deviation more noticeable as nasal tissues change.

Risk factors

• Playing contact sports, such as football or rugby
• Previous nose or facial injuries
• A family history of nasal structural problems, though this is not always the case

When to see a doctor

See a doctor urgently if:

• After any significant injury to the nose, especially if it changes shape
• If you have severe pain or swelling around your nose or eyes
• If you have a high fever with symptoms of a sinus infection

Book a routine appointment if:

• If you have ongoing trouble breathing through your nose
• If you have repeated sinus infections or nosebleeds
• If snoring or mouth breathing is affecting your sleep or energy

Diagnosis

A doctor can usually diagnose a deviated septum by asking about your symptoms and looking inside your nose. They may use a small light and a tool called an otoscope or a thin flexible camera called an endoscope.

Tests that may be done

• Physical exam of the nose and face
• Nasal endoscopy – a thin tube with a light and camera is placed in the nose
• A CT scan is sometimes used if the diagnosis is unclear or if more detail is needed

What to expect at your appointment

The exam is usually quick and does not require special preparation. The doctor will look at both sides of your nose and may ask you to breathe in and out. It is not painful, though you may feel a little pressure or tickling during an endoscopy.

Treatment

Treatment depends on how much the deviated septum affects your breathing and life. Many people need only self-care and simple measures. If symptoms are severe, medicines or surgery may help. Every treatment plan should be discussed with your doctor.

Self-care at home

• Use a saline nasal rinse or spray to keep the nose moist and clear
• Use a humidifier in your home to add moisture to the air
• Inhale steam from a warm shower to ease congestion
• Sleep with your head slightly raised to improve airflow
• Avoid known nasal irritants such as smoke and strong fumes

Medical treatments

Doctors may suggest short-term use of decongestants or nasal steroid sprays to reduce congestion and inflammation. Antihistamines can help if allergies are also present. These treatments control symptoms but do not fix the position of the septum. Always ask your doctor or pharmacist which options are right for you.

When is surgery considered?

Surgery called septoplasty may be recommended if a deviated septum causes severe symptoms that do not improve with medicine or self-care, such as repeated sinus infections, serious sleep apnea, or trouble breathing that affects daily life. Surgery aims to straighten the septum to improve airflow.

Living with this condition

You can manage many symptoms with simple habits. Keeping your nose moist, staying hydrated, and avoiding irritants can make a big difference. If surgery is an option, it is usually done only when symptoms are truly bothersome.

Lifestyle tips

• Use a saline nasal rinse regularly if your nose feels dry or congested
• Wear a protective mask or helmet during contact sports to prevent injury
• Keep your home dust-free and avoid allergens that can worsen congestion
• Avoid smoking and second-hand smoke

Diet and exercise

A healthy diet and regular exercise support your overall health. Exercise may help you breathe deeper and sleep better, but it will not change the shape of your septum. Gentler activities like walking or swimming are often easier if you feel congested.

Mental health and emotional wellbeing

Breathing problems and poor sleep can leave you feeling tired, frustrated, or low. It is normal to feel this way. If you feel anxious or depressed, talk to your doctor. If you ever have thoughts of harming yourself, reach out for crisis support right away.

Prevention

A deviated septum is often not preventable, but you can reduce the chance of a nose injury by wearing seatbelts, using appropriate protective gear during sports, and avoiding risky behaviors that can lead to facial trauma.

Vaccines

Staying up to date on flu and pneumonia vaccines can help prevent respiratory infections that might make nasal symptoms worse.

Screening programmes

There is no routine screening for a deviated septum. It is usually found when you see a doctor about symptoms.

Complications

If left untreated

• Recurrent sinus infections that do not fully clear
• Frequent nosebleeds
• Sleep apnea, a condition where breathing pauses during sleep
• Chronic mouth breathing, which can cause dry mouth and dental issues
• Difficulty breathing during exercise or physical activity

Long-term outlook

With the right care, most people feel better. Many do not need any treatment, and for those who do, simple measures or surgery can greatly improve breathing and quality of life. Even when surgery is needed, it is a common and usually safe procedure, though not everyone ends up with a perfectly straight septum. Recovery takes time, but the outlook is very positive.

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