deviated septum

A deviated septum occurs when the thin wall (nasal septum) between the nasal passages shifts to one side. In many people, the nasal septum is displaced – or deviated – making one of the nostrils smaller.

If the septum is severely deviated, it may block one side of the nose and reduce airflow, causing difficulty breathing. Sometimes people may have crusting or bleeding due to the drying of a deviated septum caused by airflow through the nose.

Nasal obstruction or congestion may result from a deviated nasal septum, swelling of the tissues lining the nose, or both.

Treatment for a stuffy nose may include medication to reduce swelling. To correct a deviated nasal septum, you’ll need surgery.



Most cases of a deviated septum cause no symptoms, and you may not even know you have it. However, some deformities of the nasal septum may cause the following signs and symptoms:

  • Blockage of one or both nostrils. This blockage can cause difficulty breathing from one or both nostrils. You may notice this more when you have a cold or allergies that can cause congestion and narrowing of the nasal passages.

Nosebleeds. The surface of your nasal septum may become dry. Which increases the risk of nosebleeds.

Facial pain. There is some disagreement about possible nasal causes of facial pain. A possible cause of one-sided facial pain may be a severely deviated septum, in which the surfaces inside the nose come into contact, creating pressure.

Loud breathing during sleep. A deviated nasal septum or tissue congestion inside the nose can be one of several causes of noisy breathing during sleep.

  • Awareness of the nasal cycle. The nose alternates between blockage on one side, then blockage moving to the other side. This is called a nasal cycle. It is unusual to feel its presence, and it can indicate a blockage in the nose.

Preferring to sleep on a certain side. Some people may prefer to sleep on their side to improve nasal breathing at night if a nasal passage is narrowed.


When do you see a doctor?

Visit a doctor if you experience the following:

  • Blockage in one or both nostrils with no response to treatment
  • Recurring nosebleeds

Recurring sinus infections



A severely deviated septum, which causes nasal obstruction, can lead to:

Dry mouth as a result of chronic mouth breathing

A feeling of pressure or congestion in the nasal passages.

Disturbed sleep, due to the inability to breathe comfortably through your nose at night


During the visit, the doctor will first ask about any symptoms you may have.

To examine the inside of the nose, the doctor will use a bright light and sometimes an instrument designed to widen the nostrils. Sometimes, the doctor will examine the back of the nose with a speculum with a long tube attached to a bright light at the end. The doctor may also examine the nasal tissues before and after using a decongestant spray.

Based on this examination, the doctor will be able to diagnose a deviated septum and determine the severity of the condition.

If the doctor is not an ear, nose and throat specialist and you need treatment, he or she may refer you to a specialist for further consultation and treatment.



Dealing with symptoms

The initial treatment for a deviated septum can focus on relieving its symptoms. Your doctor may prescribe:

  • Decongestants. Decongestants are medications that reduce swelling of nasal tissue. This helps keep the airways on both sides of the nose open. Decongestants are available as pills or nasal sprays. However, nasal sprays should be used with caution, as frequent and continuous use may cause dependence on them and worsen symptoms after they are discontinued.

Oral decongestants have a stimulant effect and may lead to irritability, as well as an increase in blood pressure and a rapid heartbeat.

  • Antihistamines. Antihistamines are medications that help prevent allergy symptoms, including stuffy or runny nose. It can also sometimes help with nonallergic conditions, such as those associated with the common cold. Some antihistamines cause drowsiness and can affect your ability to perform tasks that require physical coordination, such as driving.
  • Nasal steroid sprays. Prescription corticosteroid nasal sprays can reduce swelling in the nasal passages and help drain nasal secretions. It usually takes 1 to 3 weeks for this type of spray to reach its maximum effect; Therefore, it is important to follow your doctor’s instructions regarding their use.

Medications only treat swollen mucous membranes, but they do not correct a deviated septum.


Surgical repair

If you’re still experiencing symptoms despite medical treatment, you may have surgery to correct a deviated nasal septum (septoplasty).

During septoplasty, the nasal septum is usually straightened and repositioned in the middle of the nose. This may require the surgeon to cut and remove parts of the nasal septum before repositioning it.

The level of improvement that can be expected from the surgery depends on the degree of the deviated septum. Symptoms caused by a deviated septum, especially nasal obstruction, can disappear completely. However, any other nasal or sinus condition that affects the tissues that line your nose, such as allergies, can’t be treated with surgery alone.


Reshape your nose

In some cases, nose reshaping surgery (rhinoplasty) is performed at the same time as the septoplasty procedure. Rhinoplasty involves modifying the bone and cartilage of your nose to change its shape, size, or both.