Deviated Septum

What is a deviated septum?

A deviated septum is when the bone and cartilage that divides your nasal cavity is off-center. Your nasal septum separates the right and left sides of your nasal cavity. It’s why you have two nostrils.

Up to 80% of the general population has nasal septum deviation. Some people don’t even realize they have a deviated septum because they don’t have symptoms. But for some, a deviated septum can cause breathing concerns, headaches and other issues.

What are the symptoms of a deviated nasal septum?

People with a severely deviated septum may notice a change in the shape of their nose.

Other deviated septum symptoms may include:

• Difficulty breathing out of one or both nostrils.
• Headaches.
• Facial pain.
• Nasal congestion.
• Noisy breathing (stridor).
• Nosebleeds.
• Chronic sinusitis (inflammation of your sinuses).
• Snoring.
• Sleep apnea.

How to tell if you have a deviated septum

Lean your head back and look into a mirror. (You can also take a picture of the underside of your nose.) If your nostrils are uneven, or if they’re two different sizes, you might have a deviated septum.

You might also be able to tell by taking the deviated septum self-test:

1. Using your finger, hold one of your nostrils closed.
2. Breathe in and notice the airflow. Be mindful about how easy or difficult it is to breathe through that nostril.
3. Now, hold your other nostril closed and repeat the exercise.
4. If you have difficulty breathing through one or both nostrils, you could have a deviated septum.

This test can be a helpful self-test tool. But the only surefire way to know if you have a deviated septum is to get a diagnosis from a healthcare provider.

What causes a deviated septum?

An injury, like a broken nose, can cause a deviated septum. Other causes include:

• Playing contact sports.
• Car accidents.
• Falls.
• Fights and other physical altercations.

Some people are born with nasal septum deviation. For example, difficult births or connective tissue disease can cause it.

A deviated septum can also be a result of normal development. As your nose grows, your septum also grows and can sometimes lean toward one side. This is the most common deviated septum cause.

What are the complications of nasal septum deviation?

Minor nasal septum deviation may not cause any complications at all. But if you have a severely deviated septum, you may develop complications, including:

• Chronic sinus issues.
• Sleep apnea.
• Snoring or loud breathing during sleep.
• Nasal congestion.
• Nosebleeds.
• Dry mouth (xerostomia).

How do healthcare providers diagnose nasal septum deviation?

A healthcare provider will examine your nose using a nasal speculum. This handheld instrument gently spreads your nostrils open so your provider can see the inside of your nose. They’ll look at your septum to see if it affects the size of your nasal passages.

Your provider will also ask about your symptoms. They may ask questions like:

• What symptoms do you have?
• How long have you experienced these symptoms?
• Do you have difficulty breathing?
• Do you have disrupted sleep?
• Do you snore during sleep?
• Do you have a history of sinus issues or nasal congestion?

How do healthcare providers treat a deviated septum?

It depends on the severity of your condition. Most people don’t need deviated septum treatment because they have little to no symptoms. You can treat mild symptoms with medication. But if a deviated nasal septum keeps you from breathing properly, you might need surgery.

Medications

Mild septal deviation may cause occasional symptoms. You can treat these symptoms with over-the-counter (OTC) medications, including:

• Nasal decongestants. (You shouldn’t use nasal decongestant sprays for more than three days in a row. It could cause rebound congestion.)
• Nasal steroid sprays.
• Antihistamines.

Septoplasty

The most common deviated septum treatment is septoplasty. If you have breathing problems, frequent sinus infections or other bothersome symptoms, a septoplasty may be an option for you.

During a septoplasty, a surgeon reshapes your septum. This may involve adding or removing bone and cartilage.

Typically, septoplasty is an outpatient procedure. It takes between 30 and 90 minutes to complete.

Can I prevent nasal septum deviation?

Some people are born with a deviated septum. Others may develop a deviated septum during development in childhood. You can’t prevent nasal septum deviation in these cases.

If you don’t already have a deviated septum, there are ways to reduce your risk:

• Wear protective gear (like a midface mask and helmet) when playing contact sports.
• Always wear your seatbelt.

What can I expect if I have a deviated septum?

In many cases, having a deviated septum doesn’t affect your quality of life. If you have mild symptoms, then you may be able to manage them with over-the-counter medications.

Severe cases may require surgery. If you have difficulty breathing, chronic nosebleeds or persistent nasal congestion, ask your healthcare provider if surgery is an option.

When should I see a healthcare provider?

Talk to a healthcare provider if your symptoms interfere with breathing, disrupt your sleep or have a negative impact on other aspects of your life.

When should I go to the emergency room?

If you think you have a broken nose, you should go to your nearest emergency room (ER) for care. If you have a broken nasal septum, they can treat it right away.

Can you feel a deviated septum with your finger?

In most cases, you can’t tell if you have a deviated septum just by feeling it. But people with severe nasal deviation might be able to tell that their septum is off-center.

Is it worth fixing a deviated septum?

Only you can decide what’s best for yourself. If your deviated septum isn’t causing breathing issues, sleep apnea or other worrisome symptoms, you probably don’t need to do anything. But if your condition has a negative impact on your quality of life, surgery could be a good option.

Generally, deviated septum surgery has good success rates, up to 85%. But about 15% of people who have this type of treatment don’t notice a significant improvement in their symptoms.

Can you push a deviated septum back into place?

You shouldn’t try to push your septum back into place under any circumstances. If a traumatic event — such as a car crash or fight — causes a broken nose or deviated septum, you should head to your nearest emergency room right away.

Can a deviated septum cause sleep apnea?

Yes, a deviated septum can block the airflow through your nasal passages, resulting in snoring and sleep apnea.

A note from Cleveland Clinic

Most people have a deviated septum, but those with little to no symptoms may not even know it. Having a deviated septum doesn’t mean there’s something wrong with you. You probably don’t need treatment unless it interferes with your quality of life. But if you develop symptoms like chronic nasal congestion, nosebleeds, sleep apnea or difficulty breathing, tell your healthcare provider. They can determine if you have a deviated septum and recommend appropriate treatment.