Deviated Septum: Diagnosis, Causes and Treatments

Defining a Deviated Septum

The cartilage wall dividing the left nostril from the right nostril is commonly known as the septum. Although the ideal resting place for the septum is exactly at the center, in a sizeable portion of the population, the septum is found to be slightly off-center. This slight imbalance in the septum’s position makes one nasal passage a little larger than the other. Physically a deviated septum is not overtly visible, and in most cases this does not cause any problems, but for some people this issue can culminate in severe health issues. 

Causes of a Deviated Septum
Some patients develop the condition spontaneously, whereas for others an injury to the nasal region can cause the deviation. Injuries received during accidents such as high impact contact sports are common sources for a misaligned septum.  

Signs and Symptoms 
A deviated septum can aggravate certain medical conditions. The following list will help you determine if you suffer from this issue: 

• A common symptom is difficulty in breathing as the deviation hinders the smooth flow of air through the nasal passages. Breathing problems could be augmented especially if you’re suffering from colds and allergies.
• A disproportionate septum increases your susceptibility to sinus infections and could make you vulnerable to frequent infections.
• Due to the insufficient or altered flow of air through the nostrils, a misaligned septum can dry out nasal membranes which increases the possibility of nosebleeds.
• Sleep apnea and sounds emanating during sleep such as snoring, and loud breathing can also originate from a deviated septum, even though most commonly other factors are also present

Diagnosis
If you are experiencing discomfort, pain, bleeding or are having problems breathing, contact a medical professional. A trained doctor will be able to give you an accurate diagnosis and may provide you with medications that are designed to alleviate the symptoms. In severe cases which cannot be treated with prescription medication, surgery could be the best option.

Preventive Measures
The best way to safeguard yourself from this condition is to adopt precautions which minimise injury to your nose. Simple measures such as wearing headgear, seat belts can help to a certain degree.

Treatments and Surgical Procedures

Prescription medication often provides relief for patients, there are also a number of at home treatments you can incorporate into your life:

• Humidifiers/vaporisers introduce moisture into the air which helps lubricate the nasal membrane which would then clear nasal passages, as well as prevent the membranes from drying out.
• Irrigating the nasal passage by running salt water through the nostrils flushes out the mucus and prevents infections.
• Nasal strips work to lift up the side of the nostrils which allow the air to flow with greater ease. The strips also assist in diminishing snoring.

Fixing a deviated septum
Surgery offers a permanent solution to this condition, and offers long term relief, thereby enhancing the overall quality of your health. The surgery which realigns a deviated septum is known as septoplasty. Simultaneously the surgeon could also operate on your external nose, this dual procedure is known as septorhinoplasty or rhinoseptoplasty. Surgery offers a permanent solution to this condition, and offers long term relief, thereby enhancing the overall quality of your health.

What kind of surgery can I opt for?
You can opt for rhinoplasty offered in conjunction with septoplasty focused on correcting the deviation in the septum. This joint surgical procedure will rectify the internal structure of the nose, and will also perform aesthetic corrections to the nose, if required.

How is the operation performed?
A fairly common procedure, normally the time frame for the surgery ranges between 45-90 minutes. General anaesthetic is administered as per discussion with your surgeon. The surgeon will start by creating an incision to the side of your nose to access the nasal cavity. The mucus lining covering the septum is lifted, and the surgeon then reshapes both cartilage and bone. After the realignment process is completed the mucus lining will be re-positioned. Segments of obstructive tissue can be removed, and for turbinates which are thicker, radiofrequency reduction may be used to decrease their size. Spreader grafts, which are tiny bands of cartilage used to strengthen and reinforce the septum, can also be used by the surgeon.

What can I expect after the surgery?
Packing or nasal stents will be placed inside the nostril to stem bleeding, causing patients to temporarily breathe through their mouths. Nasal packing is removed after a day or two and the nasal stents are removed one week after surgery. Once the anesthesia has worn off, you are permitted to return to your home on the same day, or stay overnight for observation.

What steps and post-surgery safety precautions should I follow at home?
You may be prescribed pain medications. Drugs that thin the blood should be avoided. Limit physical activity, refrain from exerting yourself, it is crucial to give your body time to recuperate. Vigorous exercises such as lifting weights, running, contact sports should be avoided for at least a few weeks post-surgery. Sleep with your head elevated at a higher angle than your body. Do not wear sunglasses or prescription glasses during the healing period. For the first few weeks do not blow your nose vigorously, restrict facial movements, and ensure that you get adequate sleep and nourishment. Do not drink alcohol or smoke during the initial recovery period. What is the average recovery time frame? You can expect the superficial incision wounds to heal quickly. The bone and cartilage will take up to 6 weeks and the nasal swelling may take over a year to subside completely.

What are the costs for fixing a Deviated Septum?

Dr Rodrigo\’s main interest is Rhinoplasty and Septoplasty treatment, which is only available in combination with rhinoplasty. An ENT surgeon will be able to offer only internal surgery and septoplasty and will be able to inform the costs. It also depends on the expertise of the surgeon, and the complexity of the operation. Septoplasty qualifies for rebates from Medicare, and private health insurance companies, but make sure you consult before committing. I hope that this blog has been useful and gives you more information about deviated septums, the diagnosis, causes and treatments. Have more questions? Don’t hesitate to reach out to me, and book an appointment.

Dr Rodrigo is a Plastic and Reconstructive Surgeon in Melbourne. He is interested in Aesthetic Surgery, Rhinoplasty and Facial Surgery.

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