When does a deviated nasal septum become a problem? – Causes and treatment options

A deviated nasal septum may not cause any significant discomfort in many people. However, when the deviation significantly narrows one of the nasal passages, it can lead to symptoms such as difficulty breathing, nasal congestion and sleep problems. Experts say that whether treatment is needed is determined not simply by how crooked the septum appears, but by how much it affects a person’s breathing and daily life.

The nasal septum is a structure made of bone and cartilage that divides the nasal cavity into right and left sides. When the septum deviates to one side, one of the nasal passages may become narrower. If the deviation is mild, a person may not notice it at all. The problem mainly arises when airflow becomes significantly restricted.

When does a deviated septum cause problems?

A deviated nasal septum becomes particularly significant when breathing through one or both nostrils becomes difficult. Persistent nasal congestion, especially when it is more pronounced on one side, is considered one of the main symptoms.

Some people experience difficulty breathing through the nose at night, which can lead to mouth breathing and snoring. Narrow nasal passages can also affect sleep quality. In addition, dryness of the mucous membrane caused by airflow through the nose can lead to recurrent nosebleeds.

A deviated nasal septum should not always be considered a direct cause of headaches or sinus problems. Nasal congestion can also be caused by allergies, rhinitis, sinusitis and other structural problems inside the nose. Therefore, attributing long-term nasal congestion solely to a deviated septum is not the correct approach.

What causes a deviated septum?

A deviated nasal septum can be congenital. In some cases, the septum gradually shifts to one side during the development of the nose.

Another major cause is trauma to the nose. Injuries sustained during sports, falls, road traffic accidents and other physical trauma can change the position of the nasal septum. In some cases, even when a previous injury is not remembered, breathing problems that develop later may be related to the structure of the nasal septum.

As people age, changes in the structures of the nose can also make an existing deviation more noticeable. At the same time, colds, allergies and inflammation inside the nose can cause swelling of the mucous membrane, further narrowing an already restricted passage.

How is it diagnosed?

The first step in diagnosing a deviated nasal septum is an examination by an ear, nose and throat (ENT) specialist. The doctor examines the nasal cavity to assess the position of the septum and determine the extent to which the nasal passages are narrowed.

If necessary, nasal endoscopy may be performed. This examination allows the deeper parts of the nasal cavity to be viewed and helps determine whether breathing difficulties are caused solely by the deviated septum or whether other problems are also involved. Computed tomography (CT) is not necessary in every case and is generally considered as an additional examination when a physical examination does not fully explain the cause of the problem.

How is it treated?

If a deviated nasal septum does not cause any symptoms, specific treatment is usually not necessary. Treatment is mainly considered when breathing difficulties and other troublesome symptoms persist.

If nasal congestion is caused by allergies or inflammation inside the nose, a doctor may prescribe appropriate medication. Nasal sprays and other medications can reduce swelling of the mucous membrane and improve breathing. However, these treatments do not straighten a deviated septum; they only help reduce associated swelling and other symptoms.

The main surgical method used to change the anatomical structure of the septum itself is septoplasty. During this procedure, the nasal septum is straightened and repositioned to improve airflow. Scientific studies also show that septoplasty can help improve symptoms and quality of life in appropriate patients with nasal obstruction related to a deviated septum.

In some patients, enlargement of other tissues inside the nose alongside a deviated septum can also restrict airflow. In such cases, the treatment plan is determined based not only on the condition of the septum but also on the overall structure of the nasal passages.

The key issue is not the degree of deviation, but the problems it causes

Having a crooked nasal septum does not automatically mean that a person has a disease or needs surgery. The key issue is how significantly the deviation affects breathing function.

If persistent nasal congestion, particularly difficulty breathing through one side, recurrent nosebleeds, nighttime breathing problems or disrupted sleep occur, consulting an ENT specialist is recommended. This is because the same symptoms can also be caused by allergies, rhinitis, sinus problems and other nasal conditions.

Thus, a deviated nasal septum should not be assessed solely on appearance. If the deviation causes no symptoms, treatment may not be necessary. When it affects everyday functions such as breathing and sleep, the underlying cause should be accurately determined and the appropriate treatment selected following a medical examination.

Aysel Matlab