The nasal septum is the wall separating the left and right nostrils from each other. A deviated nasal septum occurs when the nasal septum is not centered between the two nostrils. A well-centered septum allows equal airflow through each nostril.

A deviated septum may cause no symptoms at all. In severe cases, however, airflow through one or both nostrils may be blocked. Nostril blockage may cause chronic stuffiness (nasal congestion) and a tendency to get sinus infections.

Causes

Causes include:

• Present at birth; arose during fetal development (5% of cases)

• Birth injury to the nose

• A blow to the nose, often during an accident or while playing sports

Risk Factors

A risk factor is something that increases your chance of getting a disease, condition, or injury.

Risk factors include:

• Contact sports, especially karate or football without appropriate protective headgear

• Trauma is the most common risk factor or etiologic factor

Symptoms

Symptoms include:

• Stuffy nose (one or both sides)

• Sinus infections

• Nosebleeds

• Breathing noisily during sleep

• Facial pain or headache

• Postnasal drip

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will carefully examine the nasal passages using a nasal speculum to hold the nose open.

Treatment

Most people with a deviated septum don't require treatment. In severe cases, surgery may be recommended. Surgery on the septum alone is called septoplasty. Septoplasty relieves nasal blockage by centering the septum between the two nostrils.

Sometimes surgery to reshape the nose (rhinoplasty) is performed at the same time. The two procedures together are called septorhinoplasty. Children who need surgery usually wait until they've stopped growing, around age 16. Since many insurance companies regard septorhinoplasty as cosmetic surgery, be sure to confirm that your surgical costs will be covered before scheduling treatment.

Prevention

To help prevent a deviated septum:

• Wear seat belts in automobiles and airplanes.

• Wear appropriate protective headgear when playing sports.

RESOURCES:

American Academy of Otolaryngology–Head and Neck Surgery
http://www.entnet.org

HealthFinder, US Department of Health and Human Services
http://www.healthfinder.gov

References:

Merck Manual of Diagnosis and Therapy, 17th ed. Merck and Company; 1999.

American Academy of Otolaryngology–Head and Neck Surgery website. Available at: http://www.entnet.org.