What Is a Deviated Septum?

Medically reviewed by John Carew, MD

A deviated septum is when the thin wall (septum) that separates the two nostrils of the nose is bent or crooked. Ideally, the septum is centered, allowing balanced airflow between the left and right nasal passageways. When the septum is deviated, it leans to one side, obstructing airflow through one or both nostrils. Difficulty breathing is a hallmark symptom of a deviated septum, though some people may have no symptoms.

Almost everyone has some degree of a deviated septum. Some people are born with it, while others may develop a deviated septum after injury or trauma to the face (e.g., a broken nose). Depending on the severity of symptoms, treatment may include conservative measures, such as saline sprays. More severe cases may require surgery to straighten and reposition the septum to improve airflow.

Deviated Septum Symptoms

Deviated septum symptoms vary from person to person. People with mild cases may have no symptoms, while others with a more crooked septum may experience more severe symptoms. With a deviated septum, you may experience one or more of the following symptoms:

• Difficulty breathing through one or both nostrils

• Nasal stuffiness or congestion

• Nosebleeds

• Frequent sinusitis (sinus infections)

• Loud breathing or snoring during sleep

What Causes a Deviated Septum?

A deviated septum can occur when trauma or injury to the nose causes the septum to bend or become crooked. A broken nose, for example, is a common cause of a deviated septum.

Some people with a deviated septum have no history of trauma to the nose or face, which suggests it is a genetic trait much like other facial features (e.g., eye color and shape). This means that the way your nasal septum is shaped and positioned can be determined by the genes you inherited from your parents. Sometimes, a deviated septum forms during fetal development or occurs due to trauma during childbirth.

Risk Factors

Certain factors can increase the risk of developing a deviated septum, including:

• Playing contact sports

• Not wearing a seatbelt when traveling in a vehicle

• Having a family history of a deviated septum, especially when there is no history of trauma or facial injury

Diagnosis

Healthcare providers (usually otolaryngologists, or ear, nose, and throat specialists—also called ENTs) can usually diagnose a deviated septum by examining the nose using a bright light and nasal speculum. They will use the nasal speculum to gently separate your nostrils and view your nasal passageways for any visible deviation.

In some cases, procedures are performed to confirm the diagnosis. Common approaches to diagnosing a deviated septum include:

• Nasal endoscopy: A thin, flexible tube with a light (endoscope) is inserted into the nostrils to get a detailed look at the nasal passages and assess the position of the septum. This helps ENTs examine the extent and location of the deviation and evaluate its impact on airflow.

• Computed tomography (CT) scan: This provides detailed images of the nasal structures to help evaluate the severity of the deviation and identify any other nasal or sinus issues (e.g., nasal polyps).

Treatments for a Deviated Septum

Treatment for a deviated septum can help relieve symptoms and improve nasal airflow to make breathing easier. Treatment options vary, depending on the severity of symptoms.

Non-Surgical Treatments

If you have a mildly deviated septum, initial treatment may focus on alleviating nasal congestion and may include the following: 

• Antihistamines: Over-the-counter antihistamine medications, such as Zyrtec (cetirizine) or Allegra (fexofenadine), may be helpful for people with allergies or allergic rhinitis that worsens nasal congestion with a deviated septum.

• Corticosteroid nasal spray: Prescription nasal sprays can reduce inflammation and swelling in the nasal passageways to temporarily relieve congestion.

• Nasal saline irrigation: Rinsing the nasal passages with a saltwater solution or saline nasal sprays can help clear mucus to reduce congestion.

Surgery

A surgical procedure called septoplasty is the standard gold treatment for moderate to severely deviated septums. During a septoplasty procedure, the cartilage and bones that make up the septum may be reshaped or cut and removed, then reinstated into the correct position. This helps reposition and straighten the septum to ensure both nasal airways are open. 

Septoplasty is highly effective—research shows that up to 85% of people who had the procedure report a reduction in symptoms once they fully recover from surgery.

Prevention

It isn't always possible to prevent a deviated septum since it can be present from birth or due to an accidental traumatic injury to the nose. You may lower your risk of experiencing a broken nose that can lead to a deviated septum by:

• Wearing protective gear when participating in contact, road, and ball sports (e.g., helmets, face guards)

• Wearing a seatbelt when traveling in a motor vehicle

• Limiting activities that can cause facial injury such as wrestling, boxing, etc

Complications

Most people do not need treatment for a mild deviated septum. But if severe deviations are left untreated, it can potentially lead to complications, such as:

• Chronic sinusitis: The deviated septum can disrupt the normal drainage of the sinuses, leading to recurrent or chronic inflammation and sinus infections.

• Nasal obstruction: The misalignment of the septum can result in persistent nasal congestion and obstruction, making it difficult to breathe through the nose.

• Sleep apnea: A deviated septum can contribute to sleep apnea due to a lack of airflow through the nasal passages during sleep.

• Headaches and facial pain: The persistent nasal congestion and pressure caused by a deviated septum can lead to chronic headaches or facial pain.

Related: Ways To Get Rid of Pesky Post-Nasal Drip

Living With a Deviated Septum

Symptoms of a mildly deviated septum can usually be managed with conservative treatments, such as antihistamines or corticosteroid nasal sprays. If the air in your home is dry, it may be helpful to use air humidifiers to moisturize the air, prevent nasal dryness and relieve stuffiness. 

Surgery can provide long-term relief for a deviated septum that causes symptoms that interfere with your quality of life, such as headaches or chronic sinus infections.

Work closely with your healthcare provider to determine the best treatment for you. With the proper treatment, most people with a deviated septum can breathe normally and comfortably.

Frequently Asked Questions

Does a deviated septum get worse with age?

Aging causes changes to the nasal tissues, leading to increased nasal dryness, nasal passageway narrowing, and postnasal drip. These natural changes can lead to worsened deviated septum symptoms for some people.

What happens if you don't fix a deviated septum?

Most people with a deviated symptom do not require treatment and can manage symptoms with medications, such as nasal sprays. However, when a moderate to severe deviated septum is left untreated, it can lead to ongoing symptoms such as chronic nasal congestion, recurring sinus infections, sleep-disordered breathing, headaches, and facial pain.

What is the success rate of deviated septum surgery?

Septoplasty, the surgical correction of a deviated septum, has a high success rate. While individual experiences may vary, studies have shown that the procedure can improve nasal airflow, reduce congestion, and alleviate associated symptoms in up to 85% of patients.

How painful is deviated septum surgery?

Septoplasty to treat a deviated septum is performed under anesthesia, so you will not feel pain during the procedure. Mild discomfort and nasal congestion are common during the initial recovery period. Pain management strategies, including prescribed medications, can help relieve pain during healing.

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