What Is a Deviated Septum?

A deviated septum means that the cartilage and bone that divides the nostrils and the right and left sides of the nasal airway is essentially crooked. Small deviations typically don't cause noticeable symptoms and can be left untreated. But if the deviation is bad enough, it may cause difficulties breathing, nosebleeds, a stuffy nose, and loud breathing that may prompt someone to have the issue evaluated and corrected.

A healthcare provider can usually diagnose a deviated septum upon examination. If severe enough, you may be offered a surgery called a septoplasty to straighten out the septum.

Deviated Septum Symptoms

Difficulty breathing is usually the first and most noticeable symptom of a deviated septum. Other common symptoms include :

• Nasal congestion and stuffiness
• Nosebleeds
• Frequent sinus infections
• Post-nasal drip
• Trouble sleeping
• Sleep apnea

Due to the normal aging process of the cartilage within the nose, a deviated septum may worsen over time. Health conditions such as allergic rhinitis or chronic sinusitis and excessive weight can also worsen the nasal blockage caused by a deviated septum.

Causes

Research suggests that up to 80% of the population has a deviated septum. Oftentimes, the deviated septum is present from birth due to a genetic or congenital factor. In these cases, a high-arched palate may be present as well.

Trauma from childbirth can also contribute to a deviated septum. One may also occur as a result of trauma later in life, such as a broken nose from a sports or car accident. 

Diagnosis

A deviated septum is best diagnosed by an ear, nose, throat (ENT) specialist. This can usually be done fairly easily by examining your septum with a bright light and a nasal speculum.

Sometimes, other tests—such as a nasal endoscopy (a procedure in which a practitioner inserts a thin, flexible tube deep into your nose) or a computed tomography (CT) scan—may be performed.

These tests can help your healthcare provider evaluate for various nasal and sinus conditions that may be accompanying your deviated septum. Examples that are commonly seen include:

• Sinus infection and accompanying swelling; swollen mucous membranes
• Enlargement of the tonsils or adenoids
• Congestion in the nose
• Turbinate hypertrophy from allergies

Treatment

If your symptoms are severe and/or if breathing problems like snoring or sleep apnea occur, your healthcare provider may recommend a septoplasty to fix your deviated septum. However, if you are under age 18, your practitioner may suggest waiting to have the procedure done, as your face is still growing and developing.

A septoplasty entails surgically breaking the cartilage that makes up the nasal septum and repositioning it back in the midline so that the airways on each side are opened up. While a minor deviation may still exist after the surgery, breathing and snoring problems are usually cured.

Septoplasty procedures are generally well-tolerated; however, they still carry risks. This is why it's important to have a thoughtful discussion with your healthcare provider about whether surgery is right for you.

The main risks of surgery are a septal perforation and potential saddle nose deformity, in which the bridge of the nose collapses.

Other risks of surgery include:

• Excessive bleeding
• Complications from anesthesia
• Numbness of the upper teeth and nose
• Infection

Very rarely, a cerebrospinal fluid leak may occur.

If you do decide to proceed with surgery, the good news is that most septoplasty procedures are performed in a surgical center (rather than a hospital), which means you can go home the same day.

A Word From Verywell

If you are experiencing nasal symptoms, like stuffiness or difficulty breathing through one nostril, be sure to make an appointment with your primary care doctor or an ENT specialist. While a deviated septum may be present, there are many other potential causes for your symptoms.