Overview and Facts about Deviated Nasal Septum
The nasal septum is the wall that divides the nose in half. It is made of cartilage and bone. A deviated septum is when that wall is crooked or off-center.
When the front or anterior portion of the septum is deviated, it can make one of the nasal passages appear smaller or asymmetric.
A deviated septum can be diagnosed by examining the nose or using a special camera called an endoscope to look deeper into the nose by a specialist, known as an otolaryngologist (ENT).
Signs and Symptoms of Deviated Nasal Septum
Approximately 7 out of 10 people may have a mild or moderately deviated septum. A minority of patients have a severe deviation or a deviation in just the right spot that may cause bothersome symptoms.
Symptoms and signs of a deviated septum may include:
-
Difficulty breathing through the nose, especially one side more than the other
-
Nasal congestion or pressure
-
Post-nasal drip
-
Mild nosebleed
-
Snoring or noisy breathing during sleep
-
Dry mouth
-
Headaches
-
Inability to tolerate CPAP device
Symptoms of sensorineural hearing loss include:
-
Noises seeming too loud or too quiet
-
Difficulty following a conversation when two or more people are speaking at the same time
-
Problems listening in environments with background noise
-
The sense that others’ speech is slurred or mumbled
-
Ringing in the ears (tinnitus)
Symptoms of mixed hearing loss include a combination of conductive and sensorineural hearing loss symptoms.
Causes and Risk Factors of Deviated Nasal Septum
A deviated septum may occur during fetal development or may be the result of a facial or nasal injury.
Tests and Diagnosis of Deviated Nasal Septum
A physician will perform an exam using various instruments, such as a nasal speculum, which is a handheld device used to widen the nostrils to gently view the inside nasal passages.
The specialist may also use a fiber-optic nasal endoscope to get a detailed view of the nasal passages, to evaluate the position of the septum, and to rule out any other structural issues, sinus issues or or other abnormalities.
The physician will also ensure that the cause of nasal stuffiness is not related to allergies, nasal polyps, large adenoids or any other issue that can affect nasal breathing.
Imaging such as a CT scan of the sinuses is considered if the physician would like to evaluate additional nasal structures.
Treatment and Care of Deviated Nasal Septum
Patients without symptoms from a deviated septum do not require treatment. For those with symptoms, patients are usually first offered a nasal steroid spray and nasal saline rinses.
It is important that the patient be educated on the correct method of use of these sprays. If the symptoms are persistent and bothersome, an elective surgery under general anesthesia may be recommended.
Surgery is usually an outpatient procedure (exceptions include patients with sleep apnea or serious medical conditions requiring an inpatient stay).
The surgery performed is called a septoplasty and involves incisions usually on the inside of the nose, with straightening and/or removing of crooked cartilage and or bone. Often times, an additional structure known at the inferior turbinates, is also reduced.
A septoplasty surgery is one of the most common surgeries performed by otolaryngologists. If Loyola's specialists feel this is the cause of your congestion, a surgery may significantly improve your nasal breathing.
