A wall of cartilage divides the nose into 2 separate chambers. It’s called the nasal septum. A deviated septum is when this wall is shifted away from the midline. This may cause congestion, problems with breathing, or nasal discharge.
The most common symptom from a deviated septum is trouble breathing through the nose. The symptoms are often worse on one side. In some cases, normal sinus drainage is affected. This can result in repeated sinus infections.
You may be born with a deviated septum. Or, it can result from injury, or damage from past treatments.
Other people normally can’t tell you have a deviated septum. Trouble breathing through the nose, or one side of the nose, is the most common symptom. You may also have stuffiness, congestion, or a feeling of fullness. A deviated septum can also impair normal drainage from the sinuses. This can lead to recurrent sinus infections.
Your healthcare provider will take a health history and do a physical exam. He or she will ask questions about any previous injury, and symptoms. The physical exam may include a nasal speculum, otoscope, or nasal endoscopy. If needed, a CT scan of the nose may be done.
Depending on the severity of your symptoms, surgery may be advised. Septoplasty is a reconstructive surgery done to correct a deviated nasal septum. The procedure is done through the nostrils. During the procedure, parts of the septum may be removed, or readjusted and reinserted into the nose.
Septoplasty may be done with the traditional open surgery from inside the nose. When open surgery is done, small scars are made on the base of the nose. They are usually not noticeable. Scarring is not visible when internal surgery is done. Depending on the severity of the deviation, septoplasty may be done in:
- A surgeon's office
- An outpatient surgery center
- A hospital as an outpatient
- A hospital as an inpatient
The surgeon will let you know when you can get back to normal activities. Many people recover within a few days and are able to return to school or sedentary work in a week or so.
After surgery, you may have a splint on the nose to help hold its new shape. You may also have nasal packs or soft splints in the nostrils to stabilize the septum.
Short-term side effects of surgery may include:
- Face will feel puffy
- Nose may ache
- Dull headache
- Swelling around the eyes
- Bruising around the eyes
- Small amount of bleeding in first few days
- Small ruptured blood vessels may appear as tiny red spots on the skin's surface
Healing is a slow process. You may have some swelling for months, especially in the tip of the nose. Final results of nasal surgery may not be clear for a year or more.
As with any surgery, there can be complications. People vary greatly in their anatomy and ability to heal. The outcome is never fully predictable. Complications include:
- Nosebleed and/or blood clot
- Perforation (hole) in the septum
- Reaction to the anesthesia
- The septum is cartilage that divides the nose into 2 separate chambers. A deviated septum is when the septum is shifted away from the midline.
- The most common symptom is trouble breathing through the nose.
- You may be born with a deviated septum. Or, it may be caused by an injury, or damage from previous treatments.
- Reconstructive plastic surgery may be done to correct a deviated septum.
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
January 16, 2018
Clinical presentation, diagnosis, and treatment of nasal obstruction. UpToDate, Postoperative Management in the Prevention of Complications After Septoplasty: A Systematic Review. Quinn J. The Laryngoscope. 2013;123:1328-33., Assessment the long-term effects of septoplasty surgery on olfactory function. Kilicaslan A. Acta Oto-Laryngologica. 2016., Septoplasty can Change the Shape of the Nose. Saharia P. Indian Journal of Otolaryngology and Head & Neck Surgery. 2013;65:s220-s225., Fact Sheet: Deviated Septum. American Academy of Otolaryngology - Head and Neck Surgery
Freeborn, Donna, PhD, CNM, FNP,Kacker, Ashutosh, MD