The nasal septum is a thin structure separating the two sides of the nose. If it is not in the middle of the nose, then it is deviated.

The nasal septum is composed of two parts. Toward the back of the head the nasal septum is rigid bone, but further forward the bone becomes cartilage. With one finger in each nostril this cartilage can easily be bent back and forth. If the nasal septum is sufficiently displaced to one side, it will impede the flow of air and mucus through the nose. This condition, called a deviated septum, can cause symptoms and disease.

A deviated septum can be a simple variation in normal structure or the result of a broken nose. Any narrowing of the nasal passageway that it causes will threaten the drainage of secretions from the sinuses, which must pass through the nose. It is a general rule of medicine that when flow is obstructed, infection results. People with allergic rhinitis (hay fever) are at greater risk of obstruction because their nasal passageways are already narrowed by the swollen membranes lining them. The result is sinusitis, which can be acute and severe or chronic and lingering.

It is easy to see that a septum is deviated. It is more difficult to determine if that deviation needs correction. It is common for a patient to complain that he/she can breathe through only one nostril. Then the diagnosis is easy. A deviated septum may also contribute to snoring, sleep apnea, and chronic sinus disease.

The definitive treatment is surgical repositioning of the septum, accomplished by breaking it loose and fixing it in a proper place while it heals. Decongestants like pseudoephedrine or phenylpropanolamine will shrink the membranes and thereby enlarge the passages. Antihistamines, nasal cortisone spray, and other allergy treatments may also be temporarily beneficial.

What to Expect after Surgery

The surgery is normally done as outpatient surgery.  You will have two splints internally, one on each side of the septum to hold the septum in place while the bones are resetting.  These are not visible.  After 14 days, these will be removed in the office.  Saline irrigation is encouraged to help keep the lining of the nose clean while the splints are in place.