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What is a deviated septum?
The septum is the thin wall between your nasal passages. It is supposed to run straight down the center of the nose. When it deviates, or has moved to one side, it can block that side of the nose and reduce airflow. The septum can be deviated at birth, or it can become deviated from an injury. Most people have at least a slightly deviated septum. However, a significantly deviated septum can cause difficulty breathing, recurrent rhinitis, or sinusitis.
What are the signs of a deviated septum?
Signs of a deviated septum include:
- Nasal obstruction
- Noisy sleep breathing
- Facial pain
How is a deviated septum treated?
In some cases, a deviated septum can be treated with medicine, including decongestants, antihistamines, or nasal steroid sprays. In others, a surgical procedue called a septoplasty may be necessary.
The septoplasty procedure
During a septoplasty, the surgeon goes through the nostril to make an incision in the lining of the septum. They would then trim or straighten the cartilage. It may also be necessary to make cuts in the nasal bones to reposition them. After the septum is straightened, small splints may be inserted. Local or general anesthesia is used. In some cases, septoplasties are performed along with other sinus or nasal procedures.
The procedure should take about 60 minutes, with a recovery of up to several weeks. Post-op swelling or discoloration is rare unless there are unusual complications. The nasal tissues should stabilize 3-6 months after surgery, although it can take up to a year.
Turbinate surgery is often performed at the same time as septoplasty. Turbinates are shelves of tissue that project into each nasal passage. They can become excessively enlarged due to a deviated septum, underlying allergies, or other causes. Surgery can reduce enlarged turbinates back to a more normal size.
WHAT ARE THE POTENTIAL BENEFITS?
The primary benefit is improved breathing through the nose. In fact, septoplasty, with or without turbinate surgery, significantly reduces nasal obstruction in more than 85% of cases. Obviously, improvement cannot be guaranteed in every case.
Nasal surgery is less likely to help with headaches, nasal drainage, and sinus infections. While these symptoms may improve, the main goal is better nasal breathing.
In regards to snoring, nasal surgery is beneficial in only 20% of cases. Snoring and sleep apnea are usually due to throat obstruction, not nasal obstruction. As such, throat surgery and palatal procedures are more effective snoring treatments.
WHAT ARE THE RISKS?
Risks include, but are not limited to, the following:
- a hole in the septum (i.e., septal perforation), which could cause a whistling noise, nasal crusting, or recurrent nosebleeds.
- a decrease in the sense of smell, which would also affect taste.
- temporary or permanent numbness of the front teeth.
- excessive bleeding during surgery or recovery which, on rare occasions, could require a blood transfusion.
- infection, which could be localized within the nose or spread to the rest of the body.
- a change in the external appearance of the nose due to a loss of nasal support structures.
- anesthetic complications, both minor and life-threatening.
Fortunately, nasal surgery is commonly performed by ENT physicians and these complications occur in less than 2% of cases.
recovery and restrictions from deviated septum surgery
After deviated septum surgery, patients should avoid strenuous activities, such as aerobics or other activities that could cause a blood pressure elevation. They may experience some congestion, but they should not blow their noses. They should instead use nasal spray to manage any congestion. They should also elevate their heads when sleeping, and they should wear clothes that fasten in the front instead of those that are pulled over the head.