Deviated Septum: Symptoms, Treatment and When Septoplasty May Help

If one side of your nose always feels more blocked than the other, you struggle to breathe comfortably through your nose or you've simply assumed that poor nasal breathing is normal for you, a deviated septum could be contributing to the problem.

Septal deviation is common, but not everyone who has one requires treatment. The important question is whether the shape of your septum is actually affecting nasal function and your quality of life.

Mr Karan Jolly is a Consultant ENT Surgeon specialising in rhinology and nasal surgery, providing specialist assessment for patients experiencing nasal obstruction and breathing difficulties.

What is a deviated septum?

The nasal septum is the wall of cartilage and bone separating the left and right sides of the nose.

Ideally, it sits relatively centrally. In many people, however, it bends or deviates towards one side.

Some people are born with septal deviation, while others develop it following trauma or injury to the nose.

A mildly deviated septum may cause no problems at all. More significant deviation can narrow one or both nasal passages and restrict airflow.

What are the symptoms of a deviated septum?

Symptoms can include:

• difficulty breathing through the nose

• one nostril feeling consistently more blocked

• nasal congestion

• mouth breathing

• difficulty exercising comfortably

• disturbed sleep

• snoring

• recurrent nosebleeds in some patients

Some people don't realise how restricted their breathing has become because they have experienced it for many years.

Why does my blocked side sometimes change?

The nose naturally goes through something called the nasal cycle, where the tissues inside each side of the nose alternately swell and reduce in size.

Most people don't notice this.

When the nasal passage is already narrowed by septal deviation, however, the normal nasal cycle can make obstruction considerably more noticeable.

Other factors such as allergies or enlarged turbinates can also exist alongside a deviated septum, which is why identifying the complete cause of nasal obstruction matters.

How is a deviated septum diagnosed?

Diagnosis involves more than simply looking at the outside of the nose.

A specialist assessment may include:

• discussion of your breathing symptoms

• examination inside the nose

• nasal endoscopy where appropriate

• assessment of the turbinates and other potential causes of obstruction

The aim is to establish whether the septum is genuinely responsible for your symptoms and whether other factors are contributing.

Can a deviated septum be treated without surgery?

Medication cannot physically straighten a deviated septum.

However, this doesn't mean everyone with septal deviation needs an operation.

If inflammation or allergies are contributing to nasal obstruction, treatments such as nasal steroid sprays or allergy management may significantly improve breathing.

Where structural narrowing caused by the septum remains the principal problem despite appropriate medical management, surgery may be considered.

What is septoplasty?

Septoplasty is an operation designed to improve nasal airflow by straightening the internal nasal septum.

The procedure is generally performed through the nostrils, meaning there are usually no visible external scars.

During surgery, the deviated areas of cartilage and bone are carefully removed while maintaining the support and function of the nose.

The primary purpose of septoplasty is functional: to improve breathing.

Is septoplasty the same as rhinoplasty?

No.

Septoplasty primarily addresses the internal septum to improve nasal function.

Rhinoplasty changes the external shape or structure of the nose.

In some patients, both internal and external structural issues contribute to breathing problems. A combined septorhinoplasty may then be considered to address both function and nasal structure.

A specialist assessment can establish which approach, if any, is appropriate.

What is recovery from septoplasty like?

Patients can usually expect nasal congestion and swelling during the early stages of recovery.

Breathing may initially feel more restricted because of this swelling before gradually improving as the nose heals.

The exact recovery period varies, and patients receive individual guidance about returning to work, exercise and other activities following surgery.

When should I see a specialist?

Consider seeking specialist advice if:

• you've struggled to breathe through your nose for several months or years

• one side is consistently blocked

• nasal obstruction affects sleep or exercise

• you've previously injured your nose

• medical treatments haven't improved your breathing

It is important not to assume that septal deviation is responsible without assessment.

Nasal polyps, enlarged turbinates, allergies and chronic sinus disease can produce similar symptoms.

Frequently asked questions

Does everyone have a slightly deviated septum?

Some degree of asymmetry is very common and often causes no symptoms. Treatment is generally only considered when septal deviation contributes to functional problems such as significant nasal obstruction.

Can a deviated septum get worse?

The septum doesn't usually progressively bend without a reason, although symptoms can become more noticeable because of inflammation, allergies, injury or other changes within the nose.

Will septoplasty change the appearance of my nose?

Septoplasty is primarily an internal functional operation and isn't intended to cosmetically reshape the nose. Where external structural changes are also required, septorhinoplasty may be discussed.

Is septoplasty painful?

Patients commonly experience congestion, pressure and discomfort during the initial recovery period. Your surgeon will discuss pain management and what to expect following the procedure.

How do I know whether I need septoplasty?

The decision should be based on your symptoms, examination and whether other appropriate treatments have helped. A specialist assessment can determine whether structural septal deviation is the main cause of your breathing difficulties.

Breathe more comfortably

If persistent nasal obstruction is affecting your sleep, exercise or everyday life, understanding the cause is the first step.

Book a consultation with Mr Karan Jolly for specialist assessment of nasal obstruction, septal deviation and other nose and sinus conditions.