Contents:

Nasal congestion is often associated with a cold or allergies. However, if it persists for a long time and is more pronounced on one side, a deviated nasal septum may be the cause. At the same time, this deformity does not always cause symptoms or require treatment.

In this article, we will discuss the different types of septal deformity, why it occurs, and how it manifests. We will also explain how diagnosis is performed and when the septum needs to be straightened.

What types of nasal septum deviation are there?

The nasal septum can change shape along its entire length or only in one area. In some cases, it curves smoothly to one side; in others, it has several bends, a ridge, or a spur. The shape and location of the deformity determine which part of the nasal passage is narrowed.

According to Nasal Septal Deviation: A Comprehensive Narrative Review, the deviation most commonly has a C- or S-shaped form, while after trauma it is often irregular, with sharp bends.

The main types of nasal septal deviation are classified by shape:

  • C-shaped deviation — the septum curves to one side and may narrow one nasal passage;
  • S-shaped deviation — different areas of the septum curve in opposite directions, so narrowing may occur on both sides;
  • ridge-like deviation — an elongated projection forms on the septum;
  • spur-like deviation — a localized pointed projection forms and sometimes comes into contact with the lateral wall of the nasal cavity.

Some patients have a combination of several variants, such as an S-shaped bend and a spur. By location, the deformity may be anterior, posterior, or involve several parts of the nasal septum.

Doctors at «Oxford Medical» note that an internal deformity does not always change the external shape of the nose. Even if it looks straight, a deviated area may narrow the nasal passage.

Causes of nasal septum deviation

The main causes include:

  • congenital characteristics — the septum develops unevenly before birth or becomes deformed as a result of birth trauma;
  • uneven growth of nasal structures — during growth, the cartilaginous and bony parts may shift relative to the midline;
  • injuries — blows, falls, nasal fractures, sports injuries, or road traffic accidents.

After a fracture, a displaced nasal septum may heal in an incorrect position. At the same time, the external shape of the nose sometimes remains almost unchanged, while the deformity inside the nasal cavity persists and makes breathing difficult.

Symptoms of nasal septum deviation

Symptoms of nasal septum deviation

A minor deviation often causes no noticeable symptoms. According to Cleveland Clinic, approximately 8 out of 10 people have a septum that is slightly displaced from the center, but many have no symptoms. Complaints occur when the deformed area significantly narrows the nasal passage or swelling of the mucous membrane further obstructs airflow during a cold or an allergy flare-up.

Possible symptoms include:

  • persistent nasal congestion that is usually more pronounced on one side;
  • difficulty breathing through one or both nostrils;
  • a habit of breathing through the mouth, especially during sleep or physical activity;
  • noisy breathing during sleep and snoring;
  • dryness of the mucous membrane, crusting, and frequent nosebleeds;
  • a reduced sense of smell;
  • restless sleep and frequent awakenings due to a lack of air.

The intensity of symptoms may vary. During a cold or an allergy, the mucous membrane swells, so the nasal passage becomes even narrower and breathing becomes more difficult. After the swelling subsides, the condition improves, but the sensation of congestion on one side may persist.

Doctors at «Oxford Medical» recommend consulting an otolaryngologist if congestion persists for a long time, interferes with sleep, or occurs after an injury. Similar complaints may occur with chronic rhinitis, allergies, polyps, and enlarged nasal turbinates, so the exact cause can only be established based on examination and diagnostic findings.

A crooked nasal septum: possible consequences

When the deviation significantly narrows the nasal passages, a person begins to breathe through the mouth more often, and sleep becomes less restful. Prolonged impairment of nasal breathing may cause dry mouth, nosebleeds, daytime fatigue, and contribute to inflammation of the paranasal sinuses. However, a minor deformity without symptoms usually does not lead to such consequences or affect daily well-being.

Possible consequences of prolonged impairment of nasal breathing:

Consequence Why it may occur
Dry mouth and throat discomfort Due to difficulty breathing through the nose, a person breathes through the mouth more often, especially at night.
Impaired sleep quality Congestion may worsen snoring, cause frequent awakenings, and lead to a feeling of tiredness after sleep.
Recurrent nosebleeds The mucous membrane may dry out and develop crusts in the area of the deviation. Bleeding occurs when these crusts are damaged.
Inflammation of the paranasal sinuses The sinuses connect to the nasal cavity through small openings. If the deviation impairs their ventilation and mucus drainage, it may increase the risk of inflammation. Under these conditions, maxillary sinusitis — inflammation of the maxillary sinuses — may develop or recur more frequently.
Daytime fatigue and reduced concentration These complaints may result from restless sleep and frequent nighttime awakenings.

Nasal septum deviation is not the only cause of snoring, nosebleeds, or recurrent sinusitis. These problems may also be associated with other conditions affecting the nose and nasopharynx.

Doctors at «Oxford Medical» warn that if snoring is accompanied by pauses in breathing during sleep, sudden awakenings, or pronounced daytime sleepiness, medical attention is required. Before starting snoring treatment, it is important to undergo an examination to determine its cause and rule out obstructive sleep apnea.

Nasal septum deviation in a child

A child cannot always explain that it is difficult to breathe through the nose, especially if the problem has existed for a long time. Therefore, parents need to pay attention to how the child breathes during the day, while sleeping, and during active play.

Signs of impaired nasal breathing may include:

  • mouth breathing during the day;
  • sleeping with the mouth open;
  • persistent congestion on one side;
  • rapid fatigue during running and active play.

These signs may occur not only with a deviated septum but also with enlarged adenoids or allergic rhinitis.

Doctors at «Oxford Medical» explain that a child’s nasal septum and other nasal structures continue to grow, so even a noticeable deviation does not always require surgery. If the child breathes freely and has no complaints, the doctor may recommend observation.

How to straighten the nasal septum

How to straighten the nasal septum

First, the otolaryngologist asks about the patient’s complaints, examines the nasal cavity, and assesses how much the deviation narrows the nasal passages. For a detailed examination of the septum, rhinoscopy or an endoscopic examination may be performed. Additional diagnostic tests are prescribed when indicated, for example, if a paranasal sinus condition is suspected or after an injury.

The examination findings are compared with the patient’s complaints because the shape of the nasal septum does not always indicate how much it interferes with breathing. In addition, persistent congestion may be caused by allergic rhinitis, polyps, or enlarged nasal turbinates. If the doctor identifies these changes, they may need to be treated first. When an internal deviation is combined with a change in the external shape of the nose, the patient may also need a consultation with a plastic surgeon.

If the examination confirms that the septal deformity significantly impairs breathing, the doctor may recommend septoplasty. The operation is performed for persistent symptoms that affect sleep and daily well-being. If the deviation does not cause complaints, surgical treatment is usually unnecessary.

Septoplasty is an operation to correct deformed areas of the nasal septum. The operation is performed through the nasal passages: the doctor repositions the deviated areas of cartilage and bone or partially removes them to improve airflow. External incisions are usually not made.

Doctors at «Oxford Medical» explain that there is no way to straighten the nasal septum at home. Exercises, massage, and pressure cannot change the position of the cartilage or bone. Nasal medications also do not correct the deformity, but they may reduce swelling of the mucous membrane and temporarily make breathing easier.

Nasal septum deviation does not always need to be corrected. What matters is not only its shape but also whether the deformity interferes with normal breathing and affects sleep and well-being. This can be determined after an examination and the necessary diagnostic tests.

If congestion persists for a long time, is more pronounced on one side, or occurs after an injury, consult an otolaryngologist at «Oxford Medical». You can book a consultation using the online appointment form on the website or by calling the contact center.

The information in this article is provided for informational purposes and is not intended as instructions for self-diagnosis or treatment. If symptoms of a condition occur, consult a doctor.

Sources:

U.S. National Library of Medicine

The BMJ

American Academy of Otolaryngology