Nasal septum deviation is a physical disorder of the nose, involving a displacement of the

nasal septum The nasal septum () separates the left and right airways of the Human nose, nasal cavity, dividing the two nostrils. It is Depression (kinesiology), depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal s ...

. Some displacement is common, affecting 80% of people, mostly without their knowledge.

Signs and symptoms

The

is the bone and

cartilage Cartilage is a resilient and smooth type of connective tissue. Semi-transparent and non-porous, it is usually covered by a tough and fibrous membrane called perichondrium. In tetrapods, it covers and protects the ends of long bones at the joints ...

in the nose that separates the

nasal cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nas ...

into the two

nostril A nostril (or naris , : nares ) is either of the two orifices of the nose. They enable the entry and exit of air and other gasses through the nasal cavities. In birds and mammals, they contain branched bones or cartilages called turbinates ...

s. The cartilage is called the quadrangular cartilage and the bones comprising the septum include the maxillary crest,

vomer The vomer (; ) is one of the unpaired facial bones of the skull. It is located in the midsagittal line, and articulates with the sphenoid, the ethmoid, the left and right palatine bones, and the left and right maxillary bones. The vomer forms ...

, and the perpendicular plate of the ethmoid. Normally, the septum lies centrally, and thus the nasal passages are symmetrical. A deviated septum is an abnormal condition in which the top of the cartilaginous ridge leans to the left or the right, causing obstruction of the affected nasal passage. It is common for nasal septa to depart from the exact centerline; the septum is only considered deviated if the shift is substantial or causes problems. By itself, a deviated septum can go undetected for years and thus be without any need for correction. Symptoms of a deviated septum include infections of the sinus and

sleep apnea Sleep apnea (sleep apnoea or sleep apnœa in British English) is a sleep-related breathing disorder in which repetitive Apnea, pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor vent ...

snoring Snoring is an abnormal breath sound caused by partially obstructed, turbulent airflow and vibration of tissues in the upper respiratory tract (e.g., uvula, soft palate, base of tongue) which occurs during sleep. It usually happens during in ...

, repetitive

sneezing A sneeze (also known as sternutation) is a semi-autonomous, convulsive expulsion of air from the lungs through the nose and mouth, usually caused by foreign particles irritating the nasal mucosa. A sneeze expels air forcibly from the mouth a ...

, facial pain,

nosebleed A nosebleed, also known as epistaxis, is an instance of bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significa ...

mouth breathing Mouth breathing, medically known as chronic oral ventilation, is long-term breathing through the mouth. It often is caused by an obstruction to breathing through the nose, the innate breathing organ in the human body. However, by the early 20 ...

, difficulty with

breathing Breathing (spiration or ventilation) is the rhythmical process of moving air into ( inhalation) and out of ( exhalation) the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxy ...

, mild to severe loss of the ability to smell, and possibly headaches. Only more severe cases of a deviated septum will cause symptoms of difficulty breathing and require treatment.

Causes

It is most frequently caused by impact trauma, such as by a blow to the face. It can also be a

congenital disorder A birth defect is an abnormal condition that is present at childbirth, birth, regardless of its cause. Birth defects may result in disability, disabilities that may be physical disability, physical, intellectual disability, intellectual, or dev ...

, caused by compression of the nose during childbirth. Deviated septum is associated with genetic connective tissue disorders such as

Marfan syndrome Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with dolichostenomelia, long arms, legs, Arachnodactyly, fingers, and toes. They also typically ha ...

, homocystinuria and

Ehlers–Danlos syndrome Ehlers–Danlos syndromes (EDS) is a group of 14 genetic connective-tissue disorders. Symptoms often include loose joints, joint pain, stretchy velvety skin, and abnormal scar formation. These may be noticed at birth or in early childhood. Co ...

Diagnosis

Nasal septum deviation is the most common cause of nasal obstruction. A history of trauma to the nose is often present including trauma from the process of birth or microfractures. A medical professional, such as an

otorhinolaryngologist Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspecialty within medicine that deals with the surgical an ...

(ears, nose, and throat doctor), typically makes the diagnosis after taking a thorough history from the affected person and performing a physical examination. Imaging of the nose is sometimes used to aid in making the diagnosis as well.

Treatment

Medical therapy with nasal sprays including

decongestants A decongestant, or nasal decongestant, is a type of pharmaceutical drug that is used to relieve nasal congestion in the upper respiratory tract. The active ingredient in most decongestants is either pseudoephedrine or phenylephrine (the latter of ...

antihistamines Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provides r ...

, or nasal

corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are invo ...

sprays is typically tried first before considering a surgical approach to correct nasal septum deviation. Medication temporarily relieves symptoms, but does not correct the underlying condition. Non-medical relief can also be obtained using nasal strips. A minor surgical procedure known as

septoplasty Septoplasty (, "septum" + , "to shape"), or alternatively submucous septal resection and septal reconstruction, is a corrective surgical procedure done to straighten a deviated nasal septum – the nasal septum being the partition between the tw ...

can cure symptoms related to septal deviations. The surgery lasts roughly one hour and does not result in any cosmetic alteration or external scars. Nasal congestion, pain, drainage or swelling may occur within the first few days after the surgery. Recovery from the procedure may take anywhere from two days to four weeks to heal completely. Septal bones never regrow. If symptoms reappear they are not related to deviations. Reappearance of symptoms may be due to

mucosal A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...

metaplasia Metaplasia () is the transformation of a cell type to another cell type. The change from one type of cell to another may be part of a normal maturation process, or caused by some sort of abnormal stimulus. In simplistic terms, it is as if the ...

of the nose. There are times also when the surgery also may be unsuccessful, leading to a continuation of the symptoms. A randomised controlled trial found that people who had septoplasty had a greater improvement in their symptoms and quality of life after 6 months than people who managed their nasal airway obstruction with nasal sprays.

Complications of septoplasty

*Adhesions and synechiae between septal mucosa and lateral nasal wall *Dropped nasal tip due to resection of the caudal margin *External nasal deformity *Incomplete correction with persistent nasal symptoms *

Nasal septum perforation A nasal septum perforation is a medical condition in which the nasal septum, the bony/cartilaginous wall dividing the nasal cavities, develops a hole or fissure. This may be brought on directly, as in the case of nasal piercings, or indirect ...

due to bilateral trauma of the mucoperichondrial flaps opposite each other. * Saddle nose due to over-resection of the dorsal wall of the septal cartilage *Scarring inside the nose and nose bleeding *Septal

hematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillaries. A hematoma is ...

and septal

abscess An abscess is a collection of pus that has built up within the tissue of the body, usually caused by bacterial infection. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pre ...

Notable examples

Jennifer Aniston Jennifer Joanna Aniston (born February 11, 1969) is an American actress. She rose to international fame for her role as Rachel Green on the television sitcom ''Friends'' from 1994 to 2004, which earned her Primetime Emmy, Golden Globe, and Scr ...

Ashley Tisdale Ashley Michelle Tisdale (born July 2, 1985) is an American actress and singer. During her childhood, she was featured in over 100 advertisements and had minor roles on-screen and in theatre. She achieved mainstream success as Maddie Fitzpatric ...

* Josh Hutcherson *

Cameron Diaz Cameron Michelle Diaz (born August 30, 1972) is an American actress. Prolific in both comedy and drama, Cameron Diaz filmography, her films have grossed over $3 billion in the U.S. box-office. Her output of romantic comedies in the late 1990s a ...

Ed Miliband Edward Samuel Miliband (born 24 December 1969) is a British politician who has served as Secretary of State for Energy Security and Net Zero since July 2024. He has been Member of Parliament (United Kingdom), Member of Parliament (MP) for D ...

References

External links

Injuries {{DEFAULTSORT:Nasal Septum Deviation Nose disorders Otorhinolaryngology Rhinology