Nasal septal deviation

The nasal septum is the thin vertical wall that separates the right and left nasal airways.  It is made of flexible cartilage and thin bone, and plays a key role in supporting the external nose.

How do I know if I have a deviated septum?

It is actually very common to have a nasal septum that is not perfectly straight.  However a more severe septal deviation can make the nasal airway narrower, usually on one side more than the other.

Severe septal deviations can be caused by nasal injuries; often minor nasal injuries that occurred in childhood while the nose was still growing.  Sometimes there is no apparent cause.

What should I do if I think my septum is deviated? 

If you have difficulty breathing through your nose, it is important to be examined by a specialist.  There are many causes for nasal congestion, and it is important to be diagnosed accurately before assuming the nasal septum is the cause.  Some patients should trial medical treatments before considering surgery.

How is a septal deviation corrected?

There are three main ways that a septal deviation is corrected.  It is important that the most suitable approach is chosen by the surgeon to give the highest chance of a successful correction whilst minimising the risks:

  1. Endonasal septoplasty.  This is the most common approach and is the operation usually referred to as simply a "septoplasty".  It is performed using a small incision just inside one of the nostrils.

  2. Endoscopic septoplasty:  Deviations further back in the nose can be corrected easily using an endoscopic (keyhole) approach and fine instruments.  This is often performed in combination with other procedures such as endoscopic sinus surgery.

  3. Open approach functional septo(rhino)plasty:  This operation involves exposing the entire cartilage/bone skeleton via a small incision across the skin between the nostrils.  It is similar to a septorhinoplasty performed for cosmetic reasons, but the main aim in this case is improving the nasal airway.  This procedure is necessary when the deviation of the septum is too complex or severe to be corrected via an endonasal or endoscopic approach.