A deviated septum is a common condition that causes breathing difficulties and other related symptoms. The nasal septum is the thin wall of bone and cartilage that separates the two nostrils.

“When the septum is straight, it can allow plenty of air to move through the nose,” explains otolaryngologist Samuel Pate, MD. “When there is a deviation or curvature, to one side or the other, it leads to an obstruction or restriction of airflow, and people can't breathe well through their nose.”

A deviated septum can be a result of:

• A condition present at birth
• Trauma or injury to the nose
• Natural development during growth

Signs and symptoms

While some individuals may have a deviated septum without experiencing any noticeable symptoms, others may face a range of issues, including:

1. Nasal congestion: Persistent stuffiness or congestion, particularly on one side of the nose, is a common symptom of a deviated septum.

2. Difficulty breathing: Reduced airflow through one or both nostrils can make breathing challenging, especially during physical activities or while sleeping.

3.  Inadequate treatment of sinus disorders: A deviated septum can restrict topical medication’s access to the sinuses and inhibit the improvement of sinus disorders.

4. Snoring and sleep apnea: The narrowing of the nasal passage due to a deviated septum can contribute to snoring and sleep apnea, a sleep disorder characterized by breathing interruptions during sleep.

5. Frequent nosebleeds: While not as common as other symptoms, nosebleeds may be caused by chronic dryness of a deviated septum.

Septoplasty: The solution to a deviated septum

Septoplasty is an outpatient surgical procedure performed by an otolaryngologist, commonly known as an ear, nose and throat, or ENT, specialist. The only way to correct a deviated septum is through surgery to straighten out the septum, according to Dr. Pate.

“The reason for surgery is to correct nasal airflow issues,” he says. “Patients will say, ‘I can’t breathe through my nose, or I’m easily fatigued during exercise, or I don’t tolerate my CPAP,’ and it’s because they can’t get sufficient airflow through their nose.”

For successful outcomes, it is important that patients are thoroughly evaluated by an experienced ENT specialist. Sometimes, other issues contribute to airflow restriction; if these go unaddressed, the septoplasty will not be as effective.

“You want to make sure that you’re getting the best evaluation by someone who really knows what they are doing,” Dr. Pate says. “In our group, you’re going to get that every time, and you’ll have the best chance at a great outcome.

About septoplasty

1. Pre-operative assessment: Before undergoing septoplasty, an ENT specialist will thoroughly exam the nasal passages, either by direct visualization or endoscopy.

2. Surgery: During the outpatient procedure, the surgeon will make an incision inside the nose to access the deviated septum. They will then reposition or remove excess bone and cartilage to straighten the septum, allowing for improved airflow. The procedure takes around 45 to 90 minutes.

3. Recovery: Following septoplasty, patients may experience mild swelling, congestion and nasal drainage. Most individuals can resume normal activities within 7 to 10 days.

4. Risks and complications: As with any surgical procedure, septoplasty carries some risks, such as bleeding, infection or a recurrence of the deviation, persistent hole in the septum. However, these complications are rare and can be minimized with proper care and adherence to post-operative instructions.

Nebraska Medicine ENT doctors are amongst the most skilled in the region and perform a high volume of surgeries, ranging from simple to highly complex. Nebraska Medicine is ranked by U.S. News & World Report as one of the 50 top-scoring ENT hospitals nationally.