What is a deviated septum, anyway?

Michael Beasley, MD

Head and Neck Surgery, Otolaryngology

A deviated septum, when the thin wall between your nasal passages is crooked, is one of the most common nasal conditions. In fact, almost all adults have at least a mildly deviated septum. Most don’t require medical attention, but some adults and children may need surgery to correct the deviation in the case of uncomfortable symptoms that cause difficulty to their everyday lives.

Head and neck surgeon Michael Beasley, MD, answered some common questions about deviated septums, how they’re diagnosed and how they’re treated.

What are the symptoms of a deviated septum?

“Many people believe that if you have a septal deviation, that it will be visible to you by looking in the mirror, but this isn’t true, and it isn’t one of the symptoms we’re usually looking for,” said Dr. Beasley.

The most common symptoms of a deviated septum include:

• Difficulty breathing through the nose
• Nosebleeds
• Nasal crusting
• Whistling heard when breathing through the nose

These symptoms come from the fact that a crooked septum can potentially partially or fully block one or both nasal passages, making the basic act of breathing uncomfortable or even difficult.

How is a deviated septum diagnosed?

Diagnosis usually comes during a visit to the ENT office after a referral. The doctor may perform an anterior rhinoscopy and rigid nasal endoscopy. These procedures involve using an otoscope and light source (rhinoscopy) or a thin tube with small camera attached (nasal endoscopy) to examine the interior of the nose and evaluate your airways.

In some cases, a CT scan may be needed for additional imaging, especially if you also have sinus issues.

How do you fix a deviated septum?

“Over time, conditions like a septal deviation or perforation tend to become larger, so we usually recommend closing the perforations through surgery,” said Dr. Beasley. “For some people, surgery isn’t the right choice, and we do have additional options using implant materials to help lessen those uncomfortable symptoms.”

If you’re dealing with discomfort or difficulty breathing through the nose or the other common symptoms of a deviated septum, it’s worth seeing an ear, nose and throat doctor to look into what might be causing the problem and available treatments.

Does fixing a deviated septum change the shape of the nose?

“Depending on patient desires and surgical technique, correction of a deviated septum can also be performed at the same time as changing the shape of the nose,” said Dr. Beasley. “This surgery is more frequently referred to as septorhinoplasty and is frequently performed for both cosmetic and functional reasons to change the external appearance of the nose.”