By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Nasal septum is the wall / bridge in your nasal cavity which divides the cavity into right and left halves. It is partly made up of bone and partly by the cartilages. Nasal septum is usually straight but not as a rule. In some people it is deviated more to the left or to the right. A slight tilt is most often normal and does not produce any symptoms in many people.
Displacement of the wall between the nasal passages to one side more than the other is called deviated septum. This makes one nasal passage smaller than the other.
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Impact of deviation of septum
Difficulty in breathing – When this is severe the deviated septum can cause difficulty in breathing by causing block on one side of the nose.
Formation of crusts or bleeding – When this deviated septum gets constantly dried due to its exposure to the air flowing through the nasal passages, crusting or bleeding from the nose occurs.
Nasal congestion / obstruction – Nose blockage is caused by deviated septum. This also happens due to swelling of tissues lining the nose. Both these conditions also can coexist.
Fact – About 80% septums are deviated to some degree (American Academy of Otolaryngology – Head and Neck Surgery). Treatment for DNS shall be considered only if it causes health issues or impacts quality of life in a negative way.
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Most deformities of septum are asymptomatic. Certain septal deformities present following symptoms –
Obstruction and difficulty in breathing through the nose – can occur in one or both nostrils. This is often found during episodes of cold / upper respiratory tract infections or allergies which cause swelling and narrowing of nasal passages.
One sided breathing – the person can breathe on one side and not on the side towards which the septum has been displaced
Nasal congestion or pressure
Bleeding from the nose – When the nasal septum becomes dry the risk of bleeding from nose increases.
Facial pain – severe DNS can cause one sided facial pain but not as a rule.
Snoring / Noisy breathing
Obstruction on either side of the nose taking place alternatively is normal and is called nasal cycle. Being aware of this cycle is not typical. It can indicate nasal obstruction.
Sleeping on a particular side – one having DNS may prefer sleeping on a particular side. It helps in optimizing breathing through the nose especially when one passage is narrowed or blocked.
Dryness – may be found in one nostril / nasal passage
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Right time to consult doctor
Severe blockage in the nostrils and not responding to the treatment
Recurring infections of sinuses
Frequent nose bleeding
Breathing difficulty interfering with quality of life
Causes of deviated septum
At birth – In some conditions, a deviated septum is present right from the birth.
Trauma – Injury to the nose can cause deviation of the septum. Injuries may occur during childbirth in case of infants. Accidents may cause nose injuries leading to deviation of septum. Contact sports, wrestling, automobile accidents are some other causes for occurrence of deviated septum.
Ageing – Ageing may naturally affect nasal structures. This may worsen an already existing deviated septum.
Rhinitis or rhino-sinusitis – These conditions wherein there is swelling and irritation in the nasal cavities or sinuses will cause narrowing of nasal passages from a deviated septum. This will eventually result in nasal obstruction.
Playing contact sports
Not using seat belt during riding a vehicle
Obstruction of one or both nostrils is a common complication of this condition. This can cause sinus problems which stay for long, snoring, disturbed sleep and being able to sleep only towards one side.
Pressure / congestion in nasal passages
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One needs to prevent injuries to the nose since it might cause DNS. Preventive measures include –
Wearing a helmet / mid-face mask when playing contact sports – football, volleyball etc Wearing a seatbelt while riding a vehicle
A thorough case history may be taken and you may be examined. Your doctor may also examine the inside of your nose using instruments. The back of your nose may also be examined with the help of scopes designed to do so. The nasal tissues will be closely examined. A deviated septum can be diagnosed based on the above examinations. This will also enable your doctor to understand the seriousness and prognosis of the disease.
You may also be referred to an ENT specialist for another opinion or for suitable treatments.
In many cases treatment is not needed for deviated septum. When the septum is severely deviated, surgery is the best option. The other treatment options may reduce the symptoms associated with septum deviation but will not resolve the actual problem.
Medicines reduce swelling
Nasal dilators open the nasal passages
Surgery correct the deviated septum
Decongestants i.e. medicines that reduce the swelling of nasal tissue and helps in opening up the airways of your nose
Antihistamines – medicines that helps in preventing allergy symptoms (stuffy, running nose)
Nasal steroid sprays – helps in reducing swelling of nasal passage and helps in drainage
Surgical interventions / Septoplasty
Septoplasty – Surgery may be considered when the symptoms don’t reduce in spite of administering medicines for a long time. The septum is straightened and repositioned in the center of the nose.
Reshaping the nose – Rhinoplasty – a surgical procedure to reshape your nasal septum is simultaneously performed along with septoplasty. This procedure modifies the bone and cartilage of your nose so as to change its size, shape or both.
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A condition explained in Ayurveda in the context of nasal disorders – Nasa Pratinaha / Nasanaha – can be compared to deviated nasal septum. The signs and symptoms of Nasanaha closely resemble those of DNS. Read related: Nasanaha treatment
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