Nose
Deviated Septum — Internal Nasal Curvature
The nasal septum is the wall of cartilage and bone that separates the two nasal passages. A deviated septum occurs when this wall bends or sits off-centre, potentially narrowing the space available for airflow.
Some degree of asymmetry is common and may cause no problems. Treatment is considered when the deviation contributes to troublesome symptoms.
How Does a Deviated Septum Develop?
A deviation may be present from birth, develop as the nose grows or follow an injury. Not everyone recalls a specific accident.
The appearance of the outside of the nose does not reliably show the position of the septum. Internal narrowing and external crookedness need to be assessed separately, although they can occur together.
What Symptoms Can Occur?
Possible symptoms include:
- Difficulty breathing through one or both nostrils.
- Persistent blockage that is more noticeable on one side.
- Mouth breathing, particularly during sleep.
- Noisy breathing at night.
- Recurrent nosebleeds associated with dryness.
Symptoms may become more noticeable during a cold or allergy flare-up because swelling further reduces the available space.
Not every nasal symptom is caused by the septum. Enlarged turbinates, allergies, polyps and nasal valve narrowing may also contribute.
How Is It Assessed?
Assessment begins with a discussion of breathing difficulties, sleep-related symptoms, previous injuries and any treatments already tried.
The clinician examines the inside and outside of the nose, including the septum, turbinates and nasal valves. Nasal endoscopy may provide a more detailed view when needed. Imaging is not routinely necessary for an isolated septal deviation but may be considered for associated disease.
Can Medication Help?
Medication cannot straighten cartilage or bone. However, treating associated swelling or allergies may improve airflow enough that surgery is unnecessary.
Depending on the findings, treatment may include saline preparations, corticosteroid nasal sprays or allergy medication. A deviation that causes no symptoms generally needs no treatment.
When Is Septoplasty Considered?
Septoplasty may be considered when the deviation is a significant cause of persistent obstruction and appropriate treatment of contributing inflammation has not provided sufficient relief.
During surgery, the surgeon reshapes or repositions selected areas of cartilage and bone while preserving support for the nose. Turbinate treatment may be considered when enlargement also contributes to blockage.
Is Septoplasty the Same as Rhinoplasty?
Septoplasty primarily addresses the internal partition to improve nasal airflow. Rhinoplasty changes the shape or supporting structure of the nose and may address appearance, function or both.
When internal and external structural problems coexist, a combined septorhinoplasty may be appropriate. Septoplasty alone is not intended as a cosmetic reshaping procedure, although an unintended change in nasal shape is a possible risk.
What Should You Know About Recovery?
Temporary swelling and congestion are expected after surgery, so breathing improvement may develop gradually. Follow-up and individual instructions guide nasal care and the return to normal activities.
Risks include bleeding, infection, a hole in the septum and persistent obstruction. Results vary, particularly when more than one condition affects breathing.
Discuss Your Symptoms
Contact the clinic to arrange an assessment and discuss whether your symptoms relate to septal deviation, another cause or a combination of factors.
This information provides general guidance and does not replace an individual medical assessment.
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