What is a deviated septum?

A deviated septum means the nasal septum (the thin wall of bone and cartilage that divides the inside of your nose into two sides) is crooked. This can make one side narrower than the other.

You may have a mild or severe deviation, depending on how much the wall is bent.

What are the symptoms of a deviated septum?

Most people have no symptoms and may not know they have a deviated septum.

If you have a severe deviated septum, the most common symptom is difficulty breathing through the nose. This is usually worse on one side.

Some people may also have:

• a blocked nose — either on one side or switching between nostrils
• nosebleeds
• frequent sinus infections
• headaches or facial pain
• snoring and noisy breathing during sleep
• trouble falling or staying asleep
• obstructive sleep apnoea (OSA)

What causes a deviated septum?

Some people are born with a septum that isn't straight. This is common and usually happens as the nose forms before birth.

You may develop a deviated septum after an injury to your nose including from a:

• car accident
• sporting or other accident
• fall

When should I see my doctor?

See your doctor if you think you have a deviated septum and it's causing problems. You should also see your doctor if your symptoms don't go away after treatment.

How is a deviated septum diagnosed?

Your doctor will ask about your symptoms and examine your nose. They may use a special light and tool to look inside your nose.

Sometimes, your doctor might use a nasal endoscope. This is a long, thin tube with a light and camera to look further inside your nose. This is usually done by a specialist called an ear, nose and throat (ENT) doctor.

Your doctor will also check for other causes of a blocked nose, such as:

• allergies
• infections
• nasal polyps
• overuse of nasal sprays
• a nasal tumour

How is a deviated septum treated?

Mild deviations often don't need treatment. More severe deviations may need surgery if they cause symptoms that don't get better with medicines.

Medicines

Medicines can help ease symptoms such as a blocked or runny nose. They won't change the shape of your septum.

Medicines may include:

• antihistamine nasal sprays (for allergy-related symptoms)
• corticosteroid nasal sprays (to reduce inflammation)
• saline nasal sprays or nasal douche (to clear mucus and allergens)

Surgery

If your deviated septum is causing ongoing symptoms, you may need surgery called a septoplasty, to straighten the septum.

Sometimes, rhinoplasty surgery may be done at the same time. This is done to reshape your nose if the deviation affects your nose's structure or appearance.

Surgery is usually safe, but it can have risks, such as bleeding, infection or numbness.

Living with a deviated septum

Many people with a deviated septum don't have any problems. If your nose feels blocked or stuffy a lot of the time, it can affect your sleep, your energy and how well you feel during the day.

Here are some tips for managing your symptoms:

• Talk to your doctor about nasal sprays or a nasal rinse to help clear your nose.
• Avoid things that trigger symptoms, such as cigarette smoke, strong smells or pet dander.
• Raise your head when sleeping to help with night-time stuffiness.

What are the complications of a deviated septum

A deviated septum can lead to several complications, especially if it is severe or leads to ongoing symptoms. These complications can affect your:

• physical health
• sleep
• mental wellbeing

Complications may include:

• sinus problems — a deviated septum can lead to more frequent or longer-lasting sinus infections (sinusitis)
• reduced sense of smell — this can happen if air doesn't flow properly through your nose
• psychological effects — ongoing nasal blockage and poor sleep may lead to anxiety, depression and a lower quality of life

Sometimes, a deviated septum is associated with high blood pressure.

Can a deviated septum be prevented?

A deviated septum can't always be prevented. Many people are born with a slightly crooked septum or it may develop as their nose grows.

Sometimes, a deviated septum happens after an injury. Wear protective gear, such as helmets or face guards to help lower your risk of nose injuries.

Resources and support

• The Austin Hospital has a patient information sheet about surgery for deviated septum (septoplasty).
• ENT Victoria also has a patient information sheet about septoplasty surgery for deviated septum.
• The Australian Government Department of Health, Disability and Ageing offers information about the costs and fees for septoplasty surgery.
• Allergy and Anaphylaxis Australia has information about long-lasting sinus infections (chronic rhinosinusitis).

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.