What Causes a Deviated Septum and How Do You Fix It?

Anna Giorgi
·6 min read

Medically reviewed by John Carew, MD

A deviated septum is when your septum is in an abnormal or crooked position. This wall of cartilage and bone divides your nose into its left and right chambers.

There is a wide range of possible causes for a deviated septum. The problem can be present at birth. It can also occur due to trauma, certain diseases, or as a result of aging.

When your septum has moved to one side, it can cause nasal discharge, congestion, or problems with normal breathing. You may have a feeling that you can't breathe through your nose or can only breathe through one nostril. Treatment can relieve severe symptoms and restore your septum to its normal place.

This article describes the causes of deviated septum and methods for treating it.

Genetic or Inherited Causes

Genetic or inherited causes can result in a deviated septum that is present at birth. Neonatal (newborn) septal deviation can occur during fetal development or as a result of nasal injury in the womb.

Less commonly, nasal deviated septum has been linked with a wide range of autoimmune disorders. The condition can occur as a result of the destruction of nasal cartilage that occurs in the following autoimmune disorders, among others:

Because your nose is the most projected part of your face, it is vulnerable to trauma during intrauterine life and the childbirth process. Compressional and rotational forces can work to move the septum into an S or C shape or a position that does not always show an external deformity.

The incidence of neonatal septal deviation increases with the following conditions:

  • A higher amount of birth trauma

  • Being a firstborn baby

  • Prolonged and difficult labor

  • Cephalopelvic disproportion (a condition in which a baby's head does not fit through the opening of a mother's pelvis)

Among adults, nasal fractures account for more than 50% of all facial fractures in adults. A deviated septum that happens after the newborn period usually occurs from a sudden blow to one side of your nose that knocks your nasal septum out of position. This typically occurs during contact sports, rough play, playground games, or a traffic accident.

Aging-Related Causes

You can have a deviated septum and not know it until you get older. It is estimated that up to 100% of the population has some degree of septal deviation, though not every case is visible or causes deviated septum symptoms that require treatment.

With the natural process of aging, the cartilage in your nose can weaken and change shape, bending and deforming with age. This can lead to a deviated septum. If you have an existing deviated septum, the aging process can make an existing deviated septum more significant, causing symptoms for the first time or making existing symptoms worse.

Learn More: Why Do You Age?

Infection-Related Causes

You may have a deviated septum as a result of infection-related causes, such as the following:

Syphilis: Late-stage syphilis is a systemic disease (meaning it spreads throughout your body). It can show severe manifestations in your nose causing both superficial and deep ulcerations as well as gumma (a soft, tumor-like growth of the tissues, or granuloma), which occurs in people with syphilis. These formations can attack the cartilage in your septum, causing a deviated septum or other nose malformation.

Leprosy: Advanced cases of leprosy may lead to permanent damage to the cartilage or tissue in your septum, weakening your nasal bridge and surrounding areas. This can lead to a deviated septum.

Inflammatory disorders: Certain inflammatory disorders, such as allergies or chronic sinusitis (long-lasting swelling or infection in your sinuses), can cause your nasal passages to swell. When left untreated over time, these disorders can lead to a septal deviation.

Learn More: What Are the Symptoms of an Infection?

Can a Deviated Septum Heal On Its Own?

No, a deviated septum cannot heal on its own over time. Though a deviated septum may remain asymptomatic, it may worsen over time. If your deviated septum worsens, it can increase your risk of the following conditions, all of which can impact your quality of life:

  • Frequent sinus infections: An untreated deviated septum can cause frequent sinus infections. Persistent sinus infections lead to chronic inflammation and irritation of your nasal passages. As infections worsen, the problem can spread to infections in your brain or the tissue surrounding your brain. Luckily, this is exceedingly rare. Your risk of seizures and brain damage increases if an infection spreads to these areas.

  • Sleep apnea: Sleep apnea occurs when you periodically stop breathing during sleep. This can occur multiple times during sleep, robbing your brain and the rest of your body of the oxygen it needs to perform properly. Sleep apnea can also increase your risk of serious conditions, such as heart attack, heart failure, and stroke.

  • Frequent nosebleeds: Though most nosebleeds (epistaxis) resolve on their own, chronic severe episodes can lead to serious anemia or cardiac dysfunction.

  • Difficulty breathing: A deviated septum can obstruct one or both nostrils, making it difficult to breathe.

Deviated Septum Treatments

Several types of deviated septum treatments can improve your quality of life by relieving symptoms that may interfere with normal breathing, causing pain and poor sleep quality. The type of treatment your healthcare provider prescribes depends on your symptoms and other factors, including your age and other medical conditions.

You may find temporary relief with one or more of the following deviated septum treatments:

Learn More: Nasal Decongestants Overview and Side Effects

Deviated Septum Surgery

If your symptoms are serious enough to warrant treatment, you may qualify for deviated septum surgery. This surgery can permanently correct a deviated septum, thereby relieving symptoms and improving your quality of life.

A septoplasty is the preferred surgery to correct a deviated septum. For most people, this surgery is performed through your nostrils to avoid bruises or external signs of surgery. In children and teens, a septoplasty is usually reserved for after facial growth and development are complete.

If a patient so chooses, a septoplasty may be combined with a rhinoplasty (also known as a "nose job"). This surgery changes the external shape of your nose.

Learn More: Before and After Septoplasty

When To See a Healthcare Provider

A deviated septum is a fairly common, often asymptomatic condition. When symptoms occur, any of the following conditions may indicate that your condition is worsening or that another medical condition may be present.

Consult your healthcare provider if you have any of the following symptoms:

  • Difficulty breathing due to the obstruction of one or both nostrils

  • A blocked nostril (or both nostrils) that doesn’t respond to treatment

  • Frequent nosebleeds

  • Recurring sinus infections

  • Difficulty sleeping including loud nighttime breathing and snoring

Summary

A deviated septum is a relatively common problem that can exist with or without symptoms. Many people do not know they have this problem until they find it by chance. When symptoms occur, they can prevent normal breathing and cause other problems that interfere with your quality of life.

The problem will not improve over time. For some people, it can worsen with age. Nonsurgical treatments can improve symptoms during use. This treatment may be sufficient for some cases. Long-term relief can sometimes be achieved through surgery to correct the placement of a deviated septum to its original shape.

Read the original article on Verywell Health.