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Septum is a thin, somewhat flexible lining made up of bony cartilage that separates the two nostrils in a human nose. In some people, the septum isn't quite in the middle of the two nostrils. This condition is known as a deviated nasal septum (DNS) or nasal septum deviation.

A nasal septum deviation can make it difficult for the person to breathe freely. A study done as far back as 1978 observed that more than a third of the world's population has been living with this condition.

The left and right nasal passages in a person's nose are usually of the same size—when a deviated septum makes one nostril too small, it can restrict airflow.

Some people are born with a crooked or off-centre septum, while others may develop DNS later in life due to some sort of an injury or accident. Research shows people who are born with a deviated septum most often have a smooth "C" or "S" shaped nose with a bend in the anterior septum. In people who develop DNS due to an injury or accident, the deviation tends to be more angular and may even point to a dislocation.

In most cases, people tend to ignore this condition as it doesn't cause a disruption in their daily lives, but it is known to cause difficulty breathing, congestion, sinusitis, postnasal drip, nosebleeds or even sleeping problems and headaches in moderate to severe cases. The condition is treatable through conservative or surgical interventions.

Here's everything you wanted to know about a deviated septum:

  1. Nasal septum deviation symptoms
  2. Nasal septum deviation causes
  3. Prevention of nasal septum deviation
  4. Diagnosis of nasal septum deviation
  5. Nasal septum deviation treatment
  6. Nasal septum deviation complications
  7. Doctors for Nasal Septum Deviation

Nasal septum deviation symptoms

Difficulty while breathing through the nose is the most noticeable symptom when one has a deviated septum, especially when it is significantly crooked or tilted to one side of the nose. Here are some of the symptoms of a nasal septum deviation:

  • Difficulty breathing through one or both nostrils: One half of the nose always feels blocked, making it difficult to breathe through the nose—this is more noticeable when the person has a common cold or allergies.
  • Nosebleeds: The membranes in the nose dry up as air doesn't pass through the nostrils as efficiently, leading to nosebleeds.
  • Repeated sinus infections: Clogged airways and nasal passages are some of the leading causes of sinus infections and sinusitis.
  • Loud breathing through the mouth and snoring: Difficulty breathing is also a common reason behind sleeping difficulties as well as sleep apnea among people.
  • Headaches: The pressure built up in the head due to the lack of oxygen also leads to headaches.

Nasal septum deviation causes

As mentioned earlier, many people do not even realise that they have been living with a nasal septum deviation unless blocked sinuses or allergies trigger breathing difficulties that lead them to get it checked by a doctor. However, some of the leading causes of deviated septums among people are:

  • Congenital: People are known to be born with this defect, or a deviated septum develops during childhood.
  • Injury: Sudden injury to the face or directly to the nose has also been known to cause nasal septum deviations among many people. Boxers are known to suffer from broken noses even during training, and some have also been known to surgically remove the cartilage to avoid injuries during professional bouts.

Prevention of nasal septum deviation

A nasal septum deviation, if it hasn't developed at birth or during childhood, can be prevented by taking precautions for the face. A direct injury or blow to the face can damage the nose and the nasal septum, thus wearing helmets while playing contact sports or while riding a motorcycle, or wearing a seatbelt while driving are some precautions one can take.

Diagnosis of nasal septum deviation

If you have been having difficulty breathing for a while and it gets aggravated due to seasonal changes, allergies or blocked sinuses, it is a good idea to get it checked by a doctor who can diagnose any underlying problem. Deviated septums are quite noticeable in most cases, but may also need a doctor to check both the nostrils with a nasal speculum, an instrument specially designed to widen the nostril to be able to look further inside.

The doctor would follow up their examination with some questions regarding the symptoms you have been facing as well as your medical history with regards to sleeping troubles, snoring and sinus problems, besides the breathing difficulties you have been experiencing.

Nasal septum deviation treatment

Many people continue to lead normal lives despite having a deviated septum—treatment is usually not required in these cases. For all other patients of DNS, the severity of the nasal septum deviation determines the course of action and subsequent treatment.

There are several other treatment options available to help alleviate the symptoms that emerge due to the presence of a deviated septum:

  • Decongestants: There are several medicines that can help reduce the swelling in the nasal tissues—swelling in these tissues can add to the breathing difficulties. These decongestants can help keep the airways in the nostrils open on both sides, helping a patient to breathe better. Nasal sprays or pills are often prescribed to deal with stuffy noses or blocked sinuses, but the downside is that prolonged use of these medications may cause dependency. Symptoms are also known to worsen if one stops using these decongestants suddenly.
  • Nasal steroid sprays: Nasal sprays containing corticosteroids are helpful in reducing the swelling in the nasal passages and draining out the mucus, leading to improved breathing. However, these must be used only under the strict instructions of a doctor.
  • Antihistamines: These medications are useful to prevent symptoms arising out of allergies such as a stuffy or runny nose, or even non-allergic symptoms due to a common cold. However, these medications are also known to have side effects such as drowsiness, which is why it is important to not drive or operate heavy machinery after consuming them.
  • Nasal strips: These over-the-counter nasal strips are tiny elastic strips that one puts over the flare of their nostrils—they have adhesive on one side to keep them in place. The bands begin to straighten back to their original shape, thus lifting the sides of the nose up and opening the airways. They are particularly useful for those suffering from sleeping difficulties.
  • Septoplasty: Septoplasty is a kind of surgery that is usually prescribed by the doctor if none of the above-mentioned treatment methods works. It is a surgical procedure to straighten the nasal septum and reposition it to the centre of the nose. The level of improvement, however, is dependent on the severity of the deviation in the first place. This procedure can help erase problems such as blocked airways, but other problems such as sinusitis, allergies or other nasal problems that are not there because of your deviated septum cannot be cured.

Nasal septum deviation complications

There are some complications associated with having a nasal septum deviation. They include:

  • Sleep disorders: Difficulty sleeping is one of the common side effects of living with a deviated septum, as it affects the airflow while sleeping, resulting in disrupted sleeping patterns. Not being able to breathe comfortably through the night can lead to affected sleep, and it is a common sign of sleep apnea as well.
  • Pressure: Congestion in the nasal passages leads to a feeling of pressure in the face and head, leading to headaches and general discomfort.
  • Dry mouth: A common fallout of not being able to breathe comfortably through your nose is breathing through the mouth, which results in a dry mouth.

There are complications associated with surgical procedures to correct a nasal septum deviation as well. While on most occasions surgeries go well, there can be some risks that remain, including a change in the shape of the nose, excessive bleeding from the nose, lowered or reduced sense of smell or even septal hematoma, besides the problem arising out of a deviated septum returning despite the surgery.

Dr. Chintan Nishar

Dr. Chintan Nishar

कान, नाक और गले सम्बन्धी विकारों का विज्ञान

Dr. K. K. Handa

Dr. K. K. Handa

कान, नाक और गले सम्बन्धी विकारों का विज्ञान

Dr. Aru Chhabra Handa

Dr. Aru Chhabra Handa

कान, नाक और गले सम्बन्धी विकारों का विज्ञान

References

  1. Health Harvard Publishing: Harvard Medical School [Internet]. Harvard University, Cambridge. Massachusetts. USA; Deviated Septum.
  2. ENT Health: American Academy of Otolaryngology-Head and Neck Surgery. [Internet] Alexandria, Virginia, USA. Deviated Septum
  3. Cleveland Clinic Foundation. [Internet] Cleveland, Ohio, USA. Is Your Nose Working Against You? 5 Signs of a Deviated Septum.
  4. Gray LP. Deviated Nasal Septum. Incidence and Etiology. The Annals of Otology, Rhinology and Laryngology Supplement. 1978 May-Jun; 87(3, 50):3-20.
  5. Reeti R and Kundu R. Deviated Nasal Septum In A Population Of Eastern India Presenting With Sinonasal Complaints - A Radiological Study. Journal of Evidence Based Medicine and Healthcare. 2018 May; 5(19): 1503-1506.

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