Deviated Septum

The nasal septum is the wall of cartilage and bone that divides the nose into two passages. A deviated septum is one that is bent or shifted to one side, narrowing one or both passages. Some degree of bend is present in most adults and causes no trouble.

It matters only when it blocks breathing or contributes to sinus problems or nosebleeds. Sprays can shrink the swollen lining around it but cannot straighten it. When symptoms justify it, the fix is a septoplasty, an operation done through the nostrils.

Symptoms

• Blocked nose, usually worse on one side
• Blockage that switches sides or worsens when lying down
• Mouth breathing, dry mouth and snoring
• Recurrent nosebleeds from the side where airflow dries the lining
• Facial pressure or repeated sinus infections
• Noisy breathing during sleep
• A visibly crooked nose after an injury in some people

Causes and risk factors

Many deviations arise during growth, as the septum outgrows the space available, or from pressure on the nose during birth. The rest follow injury, from sport, falls, road accidents or fights, sometimes years before symptoms are noticed. The blockage is often a combination of the bent septum, enlarged turbinates on the opposite side, and swelling from allergy. A weak nasal valve, where the sidewall collapses inwards on breathing in, can mimic or add to it.

How it is diagnosed

• Nasal examination: A look inside with a light and speculum before and after a decongestant spray shows how much of the blockage is structural and how much is swollen lining.
• Nasal endoscopy: A thin camera examines the back of the septum, the turbinates and sinus openings, and excludes polyps or a growth.
• CT scan of the sinuses: Requested when sinus disease is suspected or surgery on the sinuses is planned alongside. Not needed for every deviated septum.
• Airflow measurement: Rhinomanometry or peak nasal flow is used in some centres to document obstruction objectively.

Treatment options

• Steroid nasal spray and saline rinses: A trial of 6 to 8 weeks reduces lining swelling. If breathing becomes acceptable, surgery can be avoided.
• Allergy treatment: Antihistamines and allergen measures where allergy is contributing to the blockage.
• Septoplasty: Through an incision inside the nose, bent cartilage and bone are reshaped, repositioned or removed. It takes 45 to 90 minutes, usually under general anaesthetic, with no external cuts or bruising.
• Turbinate reduction: Often added to septoplasty to shrink enlarged turbinates using radiofrequency or partial trimming.
• Septorhinoplasty: Chosen when the outside of the nose is also crooked or the valve needs support, as the septum and the external shape are dealt with together.

When it is urgent

A deviated septum is not urgent. After a blow to the nose, though, get same-day local assessment if both sides become completely blocked with increasing pain, as a blood collection in the septum needs drainage within hours to protect the cartilage. A nosebleed that does not stop after 20 minutes of firm pressure, or clear watery fluid dripping from the nose after head injury, also needs emergency care.

Travelling to Türkiye for treatment

Septoplasty is a planned, short operation that suits travel well. Expect a day case or one night in hospital and 5 to 7 days in the city so that splints can be removed and the nose checked before you fly. Bring any CT scans. Breathing continues to improve for several weeks as swelling settles. If the problem is mainly allergy, an operation abroad will disappoint, so the assessment before booking matters.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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