Deviated Septum: Symptoms and Treatment Options
What Is a Deviated Septum?
A deviated septum occurs when your nasal septum is off-centre, causing one nostril to be smaller than the other. It can block one side of your nose causing nasal congestion, sinus infections, and nosebleeds. In Singapore, 15% of the population have a deviated septum, either at birth or due to injury. Many people with a deviated septum show no symptoms, so it’s possible you could have it without even knowing – for peace of mind, we recommend getting checked by an ENT specialist.
Role of Cartilage in Septum Deviations
The septum is made up of bone and cartilage. The four-sided part of the cartilage the front part of the septum, is what holds the shape and structure of the nose together. When this cartilage is misaligned or deformed it can cause a deviated septum. A deviation is when the septum is twisted to one side and one nasal passage is smaller than the other. This can block airflow and cause symptoms such as difficulty breathing, nasal congestion and frequent nosebleeds.
Deviated Septum Symptoms
A deviated septum can cause various uncomfortable symptoms that affect your daily life. Understanding these symptoms can help you recognise when it’s time to seek medical attention for better breathing and overall health.
- Breathing: Difficulty in breathing through one or both nostrils may indicate deviated septum. This can make it hard to get enough air especially during physical activities.
- Nasal Congestion (obstruction of one or both nostrils): Feeling like your nose is always congested, especially when you have allergies or a cold that can cause swelling and narrowing of your nasal passages. This congestion can switch between nostrils, making it difficult to find relief.
- Frequent Nosebleeds: You may notice you have nosebleeds more often than usual. This is because air is not flowing and dries out your nasal passages.
- Noisy Breathing: Loud or noisy breathing when you sleep may be a sign of a deviated septum, which can cause discomfort and disturbed sleep.
- Headaches: Common symptom associated with a deviated septum. The misalignment can cause uneven airflow through the nasal passages, leading to increased pressure and frequent headaches. These headaches can vary in intensity and may be accompanied by sinus pain, especially around the forehead, eyes, and nose.
- Sleep Apnea: Serious condition where breathing repeatedly stops and starts during sleep. A deviated septum can contribute to sleep apnea by causing partial or complete blockage of the nasal passages. This can lead to interrupted sleep, excessive daytime sleepiness, and other health complications. If you experience symptoms of sleep apnea, such as loud snoring, choking sounds during sleep, or extreme fatigue during the day, it’s important to seek medical evaluation.
- Snoring: Obstruction in the nasal passages can cause turbulent airflow, leading to vibrations in the tissues of the throat and nose. This often results in loud and disruptive snoring, which can affect the quality of your sleep and that of those around you.
- Facial Pain or Pressure: A severe deviation can cause facial pain around your nose and eyes. This can be constant or come and go.
- Mouth Breathing: When you breathe through your mouth often, especially when you sleep. This can cause dry mouth and sore throat.
- Allergies and Sinus Infections: More frequent and severe allergies and infections can also be expected with deviated septum. The blockage can prevent your sinuses from draining properly.
Deviated Septum Complications
- Breathing Issues: You may have difficulty breathing through one or both nostrils, especially noticeable when you have a cold or allergies.
- Nasal Congestion: Nasal congestion is common and it’s worse on one side, which can lead to other problems like reduced airflow.
- Frequent Infections: A deviated septum increases your risk of sinus infections, as this can block the sinus openings and mucus buildup.
- Sleep Apnea: You may suffer from obstructive sleep apnea, a condition where your breathing stops and starts during sleep. It’s a serious condition and needs medical attention.
- Snoring: Snoring can become louder and more frequent due to the blocked nasal passage, disrupting both your sleep and your partner’s.
- Nosebleeds: The altered airflow can dry out the nasal membranes and make them prone to bleeding. Frequent nosebleeds is a sign to watch out for.
- Headaches: Pressure from the blocked nasal passages can cause headaches. You may feel pain around your nose, eyes, and forehead.
Deviated Septum Treatments
Treating a deviated septum can be with medications or surgery, depending on the severity and symptoms. Here are the common treatment options and what you need to know about each.
Septoplasty
Septoplasty is a common surgical procedure that corrects a deviated septum, straightening it to improve breathing.
Cartilage plays a big role in this procedure as the surgeon trims, repositions or removes parts of the quadrangular cartilage to correct the deviation and straighten the septum.
Recovery time is short, most patients can go back to normal activities in a week. Septoplasty can improve your breathing and overall quality of life.
Septorhinoplasty
Septorhinoplasty is a combination of septoplasty and rhinoplasty, addressing the septum and the appearance of the nose. This can correct breathing issues while enhancing the look of your nose.
This procedure involves reshaping the nasal bones and cartilage. The surgeon may reshape or augment the cartilage which is key to getting the shape and function.
Discuss your aesthetic and functional goals with your surgeon to get favourable results.
Submucosal Resection
Submucosal resection is another surgical option for deviated septum. This procedure involves removing parts of the bone or cartilage under the mucous membrane (the inner lining of organs like the nose) of the nasal passages. Cartilage in this procedure is important as the surgeon removes the cartilage causing the obstruction to improve airflow.
Recovery time is short, but some temporary discomfort or nasal congestion may occur. Always follow your doctor’s post-op instructions to get optimal healing.
Turbinate Outfracture
Turbinate outfracture is a procedure to further improve nasal airflow by addressing the turbinates—bony structures inside your nose.
In this procedure, the turbinates are repositioned and reduced in size to reduce the obstruction. While this procedure is mainly bone, it complements the cartilage adjustments done during septoplasty to maximise breathing improvement.
Post-op, you may experience some swelling and discomfort, but this will subside in a few days. Consult with your surgeon for personalised advice and care.
Decongestants
Decongestants can reduce swelling in the nasal tissue and make breathing easier. These can be taken orally or as a nasal spray.
Oral decongestants are effective but can cause side effects like increased heart rate and insomnia.
Nasal spray decongestants, on the other hand, are good for short-term relief, but prolonged use can cause rebound congestion and make symptoms worse. Always consult your doctor before using these for the long term.
Nasal Steroid Sprays
Nasal steroid sprays reduce inflammation inside the nostrils. These sprays contain corticosteroids that decrease swelling and allow more airflow through the nasal passages.
Commonly prescribed nasal corticosteroids are fluticasone ( these relieves runny or stuffy nose) and mometasone (alleviates itching and redness). Both are safe for long term use and can improve breathing problems caused by deviated septum. Use them as per your doctor’s instructions to get effective symptom management.
Antihistamines
Antihistamines are used to treat allergy symptoms that may worsen deviated septum issues. These can reduce runny nose, sneezing, and nasal congestion.
Newer antihistamines, like cetirizine or loratadine, are less likely to cause drowsiness compared to older ones. Always follow your doctor’s instructions for dosage and frequency to minimise side effects and effectively manage your symptoms.
Decongestants
Decongestants can reduce swelling in the nasal tissue and make breathing easier. These can be taken orally or as a nasal spray.
Oral decongestants are effective but can cause side effects like increased heart rate and insomnia.
Nasal spray decongestants, on the other hand, are good for short-term relief, but prolonged use can cause rebound congestion and make symptoms worse. Always consult your doctor before using these for the long term.
Nasal Steroid Sprays
Nasal steroid sprays reduce inflammation inside the nostrils. These sprays contain corticosteroids that decrease swelling and allow more airflow through the nasal passages.
Commonly prescribed nasal corticosteroids are fluticasone ( these relieves runny or stuffy nose) and mometasone (alleviates itching and redness). Both are safe for long term use and can improve breathing problems caused by deviated septum. Use them as per your doctor’s instructions to get effective symptom management.
How Is a Deviated Septum Diagnosed?
Medical History
Physical Examination
Endoscopy
Imaging tests
Breathing Tests
Deviated Septum Self Test
To see if you have a deviated septum, lean back and look in the mirror, or take a picture of the underside of your nose. If your nostrils are uneven or different sizes, that’s a deviated septum.
You can also try this easy self-test:
- Close one nostril with your finger.
- Breathe in and observe the airflow. How easy or hard is it to breathe through that nostril?
- Now, close the other nostril and repeat.
If you can’t breathe through one or both nostrils, you may have a deviated septum. This self-test is helpful but the only way to know for sure is to get a diagnosis from a doctor. Contact the Nuffield ENT team now.
Deviated Septum Causes
- Present at Birth:
- Some people are born with a deviated septum, a condition that occurs during fetal development (when the fetus is growing inside the womb).
- This may not be a problem immediately but can become a problem as you age.
- Injury or Trauma:
- Accidents or impacts, like those from contact sports or car accidents, can cause trauma to the nose and lead to a deviated septum.
- Even minor injuries, such as a bump or falls, especially in children, can cause displacement of the nasal septum.
- Nasal Surgery:
- Nasal surgery can inadvertently cause the septum to shift.
- Inform your doctor about any past nasal surgery to help them manage any complications.
- Natural Ageing Process:
- Ageing can cause gradual changes in the structure of your nose.
- These changes can cause or worsen a deviated septum over time.
Deviated Septum Treatment Procedure
Before the Procedure
Before septoplasty, you will need to have a medical evaluation. Your doctor will examine your nasal passages and may request imaging tests like a CT scan.
Discuss your medical history with your doctor, including allergies and any medications you’re taking.
Your doctor will advise you to stop taking certain medications, like aspirin or blood thinners, and to avoid smoking to help with healing.
Fasting the night before surgery is required if general anaesthesia is used.
During the Procedure
During septoplasty, you will be given either local or general anaesthesia. General anaesthesia will keep you asleep and pain-free during the surgery.
The surgeon will make an incision inside your nose to access the septum. They will then reposition or remove parts of cartilage and bone to straighten it.
The procedure takes about 30-90 minutes and is usually an outpatient procedure, so you can go home the same day.
Your nose may be packed with splints to help maintain its shape as it heals.
After the Procedure
After surgery, you may experience some swelling and bruising around your nose.
Your doctor will discuss pain management and you may prescribe medications to control discomfort and prevent infection.
To reduce swelling,elevate your head and apply cold compresses.
While full recovery takes up to 3 months, you can return to normal activities in a week or two.
Avoid strenuous activities and don’t blow your nose to promote healing.
Follow up appointments will help monitor your recovery and ensure everything is healing as expected.
When Is Deviated Septum Surgery Needed?
Symptoms That Indicate Surgery
- Breathing Difficulty: If you can’t breathe through one or both nostrils, it’s time for surgery.
- Chronic Nasal Congestion: Surgery is needed if your nose is always blocked and doesn’t respond to medication.
- Frequent Nosebleeds: Recurring nosebleeds is a sign of severe septal deviation.
- Sinus Infections: If you have frequent sinus infections, surgery may be recommended to improve nasal airflow.
Quality of Life
- Sleep: A deviated septum can cause or worsen sleep apnoea, leading to poor sleep quality and daytime fatigue.
- Headaches: Chronic headaches and facial pain due to nasal obstruction may be relieved by septoplasty.
Medical Evaluation
Conservative Management
- Medications: Decongestants, antihistamines, and nasal sprays.
- Nasal Strips: These can temporarily improve airflow.
Advantages of Surgery
- Better Breathing: Septoplasty can improve your ability to breathe through your nose.
- Better Sleep: Many patients experience improved sleep quality after the surgery.
- Fewer Infections: A straighter septum means fewer sinus infections.
Stage 4 (Moderate to Severe)
Deviated Septum Treatment Benefits
- Better Breathing: Treatment fixes the septum (or the wall inside your nose that separates your two nostrils), so both nostrils can breathe and reduces chronic nasal congestion, making breathing easier..
- Better Sleep: Fixing the septum can reduce or eliminate snoring and sleep apnea helping you sleep better.
- Fewer Sinus Infections: Proper airflow reduces the risk of sinus infections by improving sinus drainage. It also lessens mucus buildup so bacteria can’t grow and infections don’t recur.
- Fewer Nosebleeds: Healthier nasal passages reduce the risk of frequent nosebleeds from dry nasal tissues (or when the inside of your nose feels dry and irritated), and balanced airflow stops the irritation.
- Better Quality of Life: Treatment can reduce pressure headaches, improve your sense of smell and taste, and make physical activities easier without breathing difficulties.
- Long-term Cost Savings: Treating a deviated septum can reduce doctor visits and medications for sinus infections and other related issues, which lowers the amount you have to pay.
- Aesthetic Benefits: Septorhinoplasty (the procedure done to fix a deviated septum) can shape and improve the appearance of the nose for both functional and cosmetic benefits, and boost self esteem.
Deviated Septum Surgery Risks
As with any procedures, there may be risks related to deviated septum surgery, find out what they are through the list below.
- Infection: As with any surgery, there’s a risk of infection, but this can be treated with antibiotics.
- Bleeding: You may experience bleeding more than usual. This is usually minor but should be monitored.
- Numbness: Temporary numbness around your nose, upper lip, or front teeth is possible, but this typically goes away within a few weeks.
- Scarring: Internal nasal scarring can occur, potentially affecting the shape of your nose or cause blockage.
- Reduced sense of smell: Some individuals may notice temporary loss of smell.
- Septal perforation: A rare complication where a hole can develop in the septum, possibly requiring additional surgery.
- Anaesthesia risks: As with any procedure under anaesthesia, there’s a small risk of adverse reactions.
- Pain and swelling: After surgery, you may feel pain and swelling around your nose and face, but this is usually temporary.
- Incomplete correction: In some cases, the surgery may not fully correct the issue, and another procedure may be necessary.
- Nasal obstruction: Scar tissue or swelling can cause nasal passage blockage after surgery.
Deviated Septum Treatment Cost in Singapore
The cost of treating a deviated septum, typically through septoplasty, starts at SGD 6,500 in Singapore.
This does not include initial consultation or follow up appointments.
Consultation Fees:
- Initial Consultation: SGD 150 – SGD 300
- Follow up Visits: SGD 80 – SGD 150
Included in the Surgery Cost:
- General Anaesthesia
- Hospital Stay
- Surgeon’s Fees
Are There Subsidies for Deviated Septum Treatment in Singapore?
You may be wondering if financial aid is available for deviated septum treatment in Singapore. This is a common concern, and it’s important to ensure you can get the treatment you need without a financial burden.
We have numerous payment methods available for your disposal.
- Instalment payments with certain banks (call us to check)
- All major credit cards (Visa / MasterCard / Amex)
- Child Development Account (CDA) Baby Bonus
- Cash
- NETS
- Bank Transfer
Medisave is a big help. You can use your Medisave to pay for part of the cost of septoplasty. This is especially helpful if the procedure is medically necessary. There may be additional financial aid for those who qualify under the Community Health Assist Scheme (CHAS). CHAS provides more subsidies for lower to middle income Singaporeans.
Private insurance can also assist with costs. Check with your insurer to see what coverage they have for septoplasty. Some private health insurance plans may cover part of the cost, so you won’t have to pay as much.
Septoplasty vs Rhinoplasty
- Purpose: Septoplasty corrects a deviated septum to improve breathing and symptoms, while Rhinoplasty reshapes the nose for cosmetic or functional purposes.
- Primary Goal: The primary purpose of septoplasty is to improve breathing and alleviate symptoms such as nasal blockage. Rhinoplasty, on the other hand, seeks to improve both the appearance and function of the nose.
- Surgical Area: Septoplasty focuses on the septum, the wall between the nasal passages, while Rhinoplasty addresses the external structure of the nose, including bone and cartilage.
- Common Symptoms Treated: Common symptoms treated with septoplasty include nasal blockage, breathing issues, and recurrent nosebleeds. Rhinoplasty treats cosmetic concerns, nose abnormalities, and, in some cases, breathing problems.
- Procedure: Septoplasty involves moving or removing sections of the septum to increase air flow. Rhinoplasty is the process of modifying the bone and cartilage of the nose to create the desired shape.
- Recovery Time: Recovery time for both surgeries is normally 1-2 weeks. However, Rhinoplasty may take 6-12 months to get full results.
- Anaesthesia: Anaesthesia options include general or local anaesthesia for septoplasty and general anaesthesia for rhinoplasty.
- Visible Changes: Septoplasty creates internal modifications that are not visible from the outside, while Rhinoplasty alters the nose’s shape and appearance.
- Insurance Coverage: Insurance covers septoplasty if medically necessary, but not rhinoplasty unless for functional advantages.
Why Nuffield ENT for Deviated Septum Treatment?
Expert ENT Surgeons:
At Nuffield ENT, you will be seen by experienced ENT specialists such as Dr Vyas Prasad, who has trained in the full variety of children’s ENT conditions including airway obstruction, sleep apnoea, and Dr Rebecca Heywood, who has 25 years of medical experience. With both having many years of experience in managing complex ENT cases, rest assured you are under good care.
Comprehensive Diagnostics and Treatments:
Personalised Care Plans:
Your treatment at Nuffield ENT will be tailored to your individual needs. The team will take the time to understand your symptoms and medical history and customise the approach to give you top-rated results.
Modern Facilities:
Accessible Location:
Patient-Centric Approach:
Nuffield ENT is all about you. The friendly and caring staff will do everything to make your experience as seamless and stress free as possible. You will find a warm environment where your concerns will be heard and addressed.
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When to See an ENT Specialist
If you think you have a deviated septum, you should know when to see a doctor or healthcare provider.
Persistent Symptoms
- Breathing through one or both nostrils
- Frequent nosebleeds
- Recurrent sinus infections
- Snoring or sleep disturbances
Daily Life
- Trouble during exercise
- Difficulty sleeping due to breathing problems
- Problems with your sense of smell or taste
Physical Examination
- Nasal speculum: To look inside your nose
- Endoscope: To closely examine the nasal passages
Specialist Referral
- The self-test shows a major issue.
- You have persistent symptoms despite treatment.
Preparation for Appointment
Physical Examination
- Nasal speculum: To look inside your nose
- Endoscope: To closely examine the nasal passages
Deviated Septum Prevention
- Avoid Nasal Trauma: Wear helmets or protective gear during sports or physical activities to protect your nose.
- Good Nasal Hygiene: Keep your nasal passages moist and clean to prevent infections or inflammation that can affect the nasal septum.
- Safe Practices: Avoid inserting objects into your nose, as this can damage or displace the septum.
- Manage Allergies: Address nasal allergies or chronic sinusitis with proper treatment and minimise inflammation that can affect the septum.
- Early Intervention: If you have difficulty breathing or notice irregular nasal airflow, consult a healthcare provider immediately to prevent worsening.
- Healthy Lifestyle: Maintain a balanced diet, exercise regularly, and avoid smoking. Overall health supports better nasal health and helps prevent complications.
- Educate and Inform: Understanding the risks and causes of deviated septum can help you take proactive steps for prevention.
FAQs
Many people have a deviated septum without even knowing it. often showing no symptoms. This condition occurs when the septum is off-centre, and up to 100% of people may have some degree of deviation.
Symptoms include:
- Obstruction of one or both nostrils
- Breathing difficulty
- Sinus infections
- Nosebleeds
When To Get Help
If you’re having trouble breathing or having frequent nasal problems, see a healthcare provider. They will assess your symptoms and diagnose if the deviation is severe enough to need treatment.
Yes, a deviated septum can cause headaches by putting pressure on sensitive nasal tissues and blocking airflow. It may also lead to sinus infections, resulting in headaches and nasal congestion. Consult an ENT specialist if you suspect your headaches are related to a deviated septum for proper diagnosis and treatment.
As you age, a deviated septum may become more prominent, worsening symptoms like congestion and breathing difficulties due to narrowing nasal passages. Managing these symptoms can also become harder, especially with allergies or sinus infections. Watch for increased congestion, frequent nosebleeds, and difficulty breathing. Consult a doctor for relief.
Medical References
Alghamdi, Fahad S., et al. “Nasal Septal Deviation: A Comprehensive Narrative Review.” Curēus, Nov. 2022, doi:10.7759/cureus.31317.
Jin, Hong Ryul, et al. “Common Sites, Etiology, and Solutions of Persistent Septal Deviation in Revision Septoplasty.” Clinical and Experimental Otorhinolaryngology, vol. 11, no. 4, Dec. 2018, pp. 288–92, doi:10.21053/ceo.2017.01788.
Van Egmond, M. M. H. T. Septoplasty for Nasal Obstruction Due to a Deviated Nasal Septum in Adults: A Systematic Review. 1 Jan. 2018, www.rhinologyjournal.com/Abstract.php?id=1806.