Main
- A deviated septum narrows one half of the nose, so the air meets resistance right at the entrance.
- Causes: nasal trauma, congenital features, uneven tissue growth, consequences of operations in the nasal area.
- Symptoms: difficulty breathing, snoring, frequent colds, dryness and nosebleeds, headaches, reduced sense of smell.
- Diagnosis: examination by an ENT doctor and rhinoscopy, if necessary nasal endoscopy and computed tomography of the sinuses.
- Management: in the absence of complaints, observation is sufficient; with persistent breathing problems, surgical correction of the septum is discussed.
What is a deviated nasal septum
A deviated nasal septum is a change in the shape of the cartilaginous and bony part of the septum that divides the nose into two halves. Because of this, one half of the nose may become narrower, and breathing through it becomes difficult.
What happens in the body
The nasal septum divides the nose into two halves, and how freely air passes depends on its shape. When the cartilaginous or bony part of the septum deviates to one side, the passage of one half of the nose narrows. Air meets resistance right at the entrance, and the person begins to breathe through the more open half. Over time, this load is distributed unevenly, and the mucosa on the narrowed side works under different conditions. A deviated nasal septum is often noticeable by the habit of breathing through the mouth or by a feeling of congestion without a runny nose. The shape of the septum does not straighten out on its own, but it also does not always interfere enough to require intervention. If breathing through the nose has become noticeably more difficult, it is reasonable to discuss this with a doctor rather than wait for the condition to change on its own.
What causes it to develop
- Nasal injury: a blow or a fall displaces the cartilage and bone, and the septum heals in a changed position.
- Congenital structural features: an uneven shape of the septum is laid down even before birth and becomes apparent as the child grows.
- Uneven growth of the tissues of the septum: bone and cartilage grow at different rates, causing the septum to deviate to one side.
- Consequences of previous operations in the nasal area: after intervention, tissues do not always heal symmetrically, and the shape of the septum changes.
- A combination of several causes: an injury against the background of a congenital feature produces a more pronounced deviation than each factor on its own.
Who encounters this more often
A deviated nasal septum occurs in people of different ages, but it is more noticeable in those who have had a nasal injury. In children and adolescents, the septum is still forming, so uneven tissue growth affects its shape especially strongly. In adults, congenital features are often compounded by the consequences of old blows that the person no longer remembers. Men sustain nasal injuries more often, so in them the deviation is detected more regularly during examination. In people whose work involves the risk of falls or collisions, the likelihood of such damage is higher. Difficulty breathing through one half of the nose is a reason not to compare yourself with others, but to see a doctor. The specialist will assess the shape of the septum and say whether it requires attention in a particular case.
What symptoms can there be?
A deviated nasal septum does not always make itself known, but more often it manifests as difficulty breathing through the nose. Knowing its signs helps to understand when this condition requires a planned visit to a doctor and when urgent help is needed.
How it is noticed at the very beginning
A deviated nasal septum often announces itself through difficulty breathing through one or both halves of the nose. A person gets used to breathing through the mouth and puts it down to tiredness or a cold. At night, snoring and noisy breathing appear, making sleep restless. During the day, frequent colds and a feeling of congestion without an obvious cause are added to this. Gradually the sense of smell decreases, and dryness or nosebleeds occur in the nose. Headaches and pressure in the area of the nose also often accompany this condition. If such signs recur regularly, it is worth seeing an ENT doctor for an examination.
Signs that occur most often
- Difficulty breathing: air passes less well through one or both halves of the nose, and this is noticeable at rest and during exertion.
- Snoring and noisy breathing: at night breathing becomes loud, sleep is interrupted, and in the morning the person feels worn out.
- Frequent colds: congestion and discharge return again and again, although there is no obvious cold.
- Dryness and bleeding: the mucous membrane dries out, crusts appear, and sometimes blood from the nose.
- Headaches: a pressing sensation in the area of the nose and head intensifies towards the evening or when the weather changes.
- Decreased sense of smell: smells are felt more weakly, food seems less aromatic, this affects appetite.
When to seek help urgently
Examinations and tests
Examination for a deviated nasal septum begins with an ENT doctor's assessment and is refined using instrumental methods. Below is a list of what is actually used in practice and what information each method provides.
How the examination begins
The first appointment with an ENT doctor begins with questions about how long nasal breathing has been difficult and on which side. The doctor then examines the nose with instruments and assesses the patency of each half of the nose separately. During rhinoscopy, the shape of the septum, its deviation from the midline and the areas where air flows less well are visible. The doctor pays attention to the condition of the mucosa, the presence of swelling and other changes that also interfere with breathing. If the examination does not provide a complete picture, additional investigations are prescribed to clarify the structure of the septum and rule out other causes of difficult breathing. This sequence is needed because similar sensations are caused by different conditions, and further management depends on the cause. Therefore, it is worth coming to the appointment with the results of previous examinations, if you have them.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries from previous examinations: the ENT doctor's notes on the condition of the nose and earlier conclusions help to see how the situation has changed over time.
- Endoscopy and tomography results: images and descriptions give the doctor a ready picture of the structure of the septum and sinuses, if the examinations have already been carried out.
- Allergist's conclusions: information about the allergens tested and their results shows whether the congestion is related to a reaction to something.
- Your own observations: notes on when breathing is more difficult and when it is easier help to describe the condition more accurately at the appointment.
- A list of the medicines you take: a list of what you use regularly is needed so that the doctor can take this into account when assessing the condition of the mucosa.
- Questions for the doctor: questions written down in advance about the causes of difficult breathing and further steps save time and make the appointment more productive.
Which doctor should I see?
The section explains which doctor to consult for a deviated nasal septum, what happens at the first appointment and what areas the care consists of. It is stated separately which part of the result depends on the regularity of follow-up with a specialist.
Which specialist manages this condition
A deviated nasal septum is managed by an ENT doctor, since it is they who assess the structure of the nasal cavity and how it affects breathing. At the first appointment, the doctor examines the nose from the inside, clarifies the complaints and finds out whether the deviation makes breathing difficult or causes other problems. If the deformity does not create difficulties, the specialist may not prescribe treatment and may suggest simply monitoring it. If symptoms are pronounced, the ENT doctor selects therapy to reduce mucosal swelling and congestion. When breathing is persistently impaired and does not improve for a long time, the doctor discusses with the patient the possibility of surgical correction of the septum. If there is no specialist nearby, it is worth starting with an appointment with an ENT doctor at the polyclinic at the place of residence. This approach helps not to postpone assessment of the condition and to understand in advance whether any intervention is needed at all.
What the treatment consists of
- Monitoring in the absence of complaints: if the deviation does not interfere with breathing and does not cause other problems, it is enough to see the doctor periodically.
- Selection of therapy by the doctor: if symptoms are pronounced, the specialist selects treatment to reduce mucosal swelling and nasal congestion.
- Nasal irrigation with saline solutions: this measure helps to moisturise the mucosa and eases nasal breathing in everyday life.
- Surgical correction of the septum: surgery is discussed for persistent breathing impairment, when other measures do not give the desired effect.
- Regular examinations by an ENT doctor: repeat appointments allow assessment of whether the condition is changing and whether the chosen approach remains appropriate.
What depends on the patient themselves
The regularity of follow-up with an ENT doctor largely determines how promptly changes in the condition can be noticed. If a person comes for examinations as agreed, the specialist sees whether mucosal swelling is decreasing and whether congestion persists. In persistent breathing impairment, it is repeat appointments that show that conservative measures are not helping and that it is time to discuss surgery. A patient who postpones visits risks missing the moment when the problem could still have been corrected more simply. Following the doctor's recommendations on nasal irrigation and mucosal care also affects how one feels between appointments. Notes on when and how congestion manifests help the doctor assess the dynamics more accurately at the next examination. A reasonable conclusion: keep to the agreed schedule of visits, even if the complaints seem familiar and do not interfere with life.
What helps prevent an exacerbation?
A deviated nasal septum does not always require intervention, but flare-ups largely depend on the person's own everyday decisions. Regular monitoring and sensible habits help you encounter congestion, a runny nose and other unpleasant manifestations less often.
What to change in your habits
A deviated nasal septum makes the nose more vulnerable to injuries and congestion, so habits directly affect how you feel. During sports, you should protect your face from blows, because even a minor injury can worsen the deviation. The habit of treating a runny nose to the end prevents mucus from stagnating in the deviated areas and turning into sinusitis. Controlling allergies is important because swelling of the mucosa against the background of a deviation is felt more strongly and lasts longer. If you constantly breathe through your mouth, the mucosa dries out, crusts and discomfort appear, and over time a secondary infection sets in. Giving up smoking noticeably reduces irritation of the mucosa and decreases the frequency of inflammation in the nasal cavity. It is worth discussing with an ENT doctor in advance how to protect the nose when swimming, doing martial arts and other contact sports.
What to keep under control
- Frequency of congestion: how many days a week the nose breathes freely, because persistent difficulty breathing indicates an unfavourable course.
- Nature of the runny nose: clear discharge is usually linked to allergies, while thick and yellow discharge requires a doctor's attention.
- Allergic reactions: seasonal itching, sneezing and watery eyes are important to notice and discuss with a doctor in good time.
- Headache and pressure: heaviness in the area of the bridge of the nose and forehead often signals congestion in the paranasal sinuses.
- Night-time breathing: snoring, awakenings and dry mouth in the morning reflect how freely the nose works at rest.
- Visits to an ENT doctor: routine check-ups with chronic symptoms help to notice changes in time and adjust monitoring.
How often to see a doctor
A regular examination by an ENT doctor is needed even when the nose breathes freely and nothing bothers you. A deviated nasal septum can go unnoticed for years and then manifest against the background of a cold or allergy. The doctor assesses how breathing, the condition of the mucosa and the paranasal sinuses change, and notices changes earlier than the person themselves. With chronic congestion, frequent runny noses and snoring, monitoring becomes especially important. Routine visits help not to miss the onset of sinusitis and other complications. If new symptoms appear, you should not put off the visit until the next check-up. Such monitoring does not replace the prescribed treatment, but it helps to notice in time that the situation is changing.
What is worth remembering
A deviated nasal septum is a feature a person can live with for years without suspecting it. Understanding that it is neither a sentence nor a reason to panic helps to make sense of the topic.
Key takeaways
A deviated nasal septum does not always require intervention: in many people it exists as an anatomical feature and does not manifest itself in any way. It is usually noticed when persistent congestion, frequent nosebleeds or difficulty breathing on one side appear. A deviated nasal septum can be congenital, or it can be the result of an injury sustained in childhood or in adulthood. It is impossible to distinguish one cause from another on your own, and attempts to treat it without an examination only delay the necessary step. The degree of deviation of the nasal septum is assessed by a doctor based on the results of an examination and additional tests. One should not put up with constant discomfort, attributing it to a cold or an allergy — a deviated nasal septum may be behind it. If nasal breathing has been difficult for a long time, it is reasonable to discuss the situation with a specialist and decide together what to do next.
