Deviated Nasal Septum: A crooked problem

A shifted nasal cartilage affects not just your looks but also your breathing

Woman having nose block

Apart from serving an important function, the nose gives a face its character. But a condition like deviated nasal septum [DNS] threatens to distort the shape of the nose and with it, our appearance. Not to mention, the physical problems one can face due to it. Although it sounds serious, DNS is simply a shift in the structure [called the septum] that divides our nostrils. The septum is made partly of cartilage and partly of bone. Apart from acting as a partition between the nostrils, it maintains normal airflow, filters the air and helps in temperature control of inhaled air.

A deviated septum can obstruct breathing and is one of the commonest reason for people to visit an ENT specialist. The degree of the shift could be mild or severe—and, at times, can even deform the shape of the nose.

What causes Deviated Nasal Septum?

A person can be born with a deviated septum, which might get dislodged due to some pressure in the uterus or at the time of delivery.

In later life, it may occur due to an injury, assault or accident. It is common in people who play contact sports and hence seen more commonly in men than women.

What are the symptoms?

Although the main symptom is difficulty in breathing, symptoms can vary from being mild to severe depending upon the degree of deviation. Mild DNS, however, doesn’t lead to significant difference in appearance.

Depending on the severity of the deviation, you may have one or more of these symptoms:

  • Discharge and bleeding from the nose
  • Altered sense of smell
  • Excessive sneezing and irritation in the nose
  • Discharge from the nose, cough and change in voice
  • Sinusitis and nasal polyps
  • Snoring and sleep apnoea
  • Chronic facial pain and headaches.

The symptoms aggravate in case of an accompanying sinus infection, nasal allergy or exposure to extreme cold environment.

How is it diagnosed?

Some tests that are used to diagnose a DNS include:

  • Rhinoscopy, which is an inspection of the nose with a thin tube-like instrument that has a lens attached to its end.
  • Conventional radiography such as X-ray.
  • CT imaging, which is a standard diagnostic tool.
  • Diagnostic Nasal Endoscopy [DNE].

A simple nasal examination may not be sufficient to evaluate the type and degree of respiratory impairment caused by DNS. For that a CT scan is required.

How is DNS treated?

Since the sinuses open in the nasal cavity, a deviated nasal septum can block the outflow of discharges from them, causing mucus to collect. And this can lead to bacterial infection of the sinuses.

Persistent nasal blockage forces you to breathe through the mouth, which can cause sore throat, mouth odour and tooth decay.

In cases of sinusitis caused by DNS, removing the obstruction and draining the sinuses is all that is necessary to facilitate ventilation.

But mostly, treatment involves managing symptoms. The aim is to prevent complications or worsening of the symptoms. Since most people suffer from mild DNS, they respond well to non-surgical forms of therapy like anti-histamine, anti-allergy, decongestant preparations, and allergy desensitisation. However, if the symptoms do not show signs of improvement, surgery could be the way out.

Surgery involves septoplasty, a procedure that is performed entirely through the nostril. The significantly deviated portions of the septum are removed or repositioned and remodelled.


A version of this article first appeared in the April 2012 issue of Complete Wellbeing.

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Ravikiran Vernekar
Dr Ravikiran M Vernekar is a full-time consultant in the department of ENT and Head & Neck surgery at Dr L H Hiranandani Hospital, Mumbai. He has a high success rate in treating patients with headache, especially sinus headache and allergic conditions of nose.

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