Treatment for deviated septum breathing issues

Deviated Septum, Defined

When the nasal septum, the thin wall that separates the nasal passages, is crooked or off-center, one side of the nose is smaller than the other. This condition is known as a deviated septum. This condition can lead to breathing difficulties, nasal congestion, and even frequent nosebleeds. While many people have some degree of septal deviation, only severe cases require medical attention. Treatment options range from medications to reduce swelling to surgical correction for more serious cases.

What are the common symptoms of a deviated septum?

A deviated septum can lead to various symptoms, but some individuals may not notice any significant issues. Here are some of the most common signs:

• Nasal congestion—One side of the nose may feel more blocked than the other, making breathing difficult.
• Frequent nosebleeds—The dry surface of the nasal septum can lead to irritation and bleeding.
• Noisy breathing during sleep—This can be caused by restricted airflow.
• Repeated sinus infections may be associated with a deviated septum.
• Some people experience facial pain or headaches due to pressure in their nasal passages.
• Postnasal drip—Mucus buildup can lead to throat irritation.
• Snoring or sleep apnea—A deviated septum can contribute to breathing difficulties during sleep.
• Preference for sleeping on one side—Some people unconsciously sleep on a particular side to improve airflow.

Causes

A deviated septum can be caused by several factors, including

• Congenital condition—Some people are born with a deviated septum due to irregular development in the womb.
• Nasal trauma—Injuries from accidents, falls, or contact sports can shift the nasal septum out of alignment.
• Aging—Over time, the cartilage in the nose can weaken, leading to changes in the septum’s shape.
• Autoimmune disorders—Certain conditions, like granulomatosis with polyangiitis, can damage nasal cartilage and contribute to septal deviation.

Diagnosis

A medical professional will usually perform a physical examination to diagnose a deviated septum. Here's how the procedure works: 

Here's how to proceed:

• Visual Inspection—A doctor examines the inside of the nose using a bright light and sometimes a tool to gently spread open the nostrils.
• Nasal Endoscopy: To see deeper into the nasal passages, a long, tube-shaped scope with a bright light at the tip is used if necessary.
• Symptom Assessment—The doctor may ask about breathing difficulties, nasal congestion, sinus infections, nosebleeds, and sleep disturbances.
• Response to Medications—Sometimes, a decongestant spray is used to see if symptoms improve, helping determine the severity of the deviation.

We may recommend surgical correction (septoplasty) if the deviation is severe and producing significant symptoms. 

Treatment

Treatment for a deviated septum depends on the severity of symptoms. Here are the main options:

Non-Surgical Treatments

• Decongestants—Help reduce swelling in nasal tissues, improving airflow.
• Antihistamines—Useful if allergies contribute to nasal congestion.
• Nasal steroid sprays—Reduce inflammation and improve breathing.
• Nasal strips can temporarily open the nasal passages for better airflow.

Surgical Treatment (Septoplasty)

If symptoms are severe and persistent, septoplasty is the only way to permanently correct a deviated septum. During this procedure:

• The surgeon straightens the nasal septum and repositions it in the center.
• Some cartilage or bone may be removed or reshaped.
• Recovery typically takes a few weeks, with noticeable improvement in breathing.

Rhinoplasty (Optional)

In some cases, rhinoplasty (nose reshaping surgery) is performed alongside septoplasty to improve the nose’s appearance.

Explain how effective the non-surgical treatments are.

Non-surgical treatments for a deviated septum can help manage symptoms, but they do not resolve the structural issue. Their effectiveness depends on the severity of the deviation and the specific symptoms being addressed. Here’s a breakdown:

Effectiveness of Non-Surgical Treatments

• Nasal Decongestants & Steroid Sprays—These can reduce swelling and improve airflow, but long-term use may lead to dependency or side effects.
• Nasal Dilators—Devices like adhesive strips or clip-on dilators can temporarily open nasal passages, improving breathing and reducing snoring.
• Nasal Irrigation—Using saline solutions can help clear mucus and reduce inflammation, providing relief from congestion.
• Sleeping Position Adjustments—Elevating the head or sleeping on a particular side can improve airflow and reduce nighttime breathing difficulties.
• Humidifiers—Adding moisture to the air can help soothe dry nasal passages and reduce congestion.
• Allergy Management—Controlling allergies can minimize nasal inflammation and congestion, improving overall breathing.

While these treatments can help alleviate symptoms, they do not permanently fix a deviated septum. For long-term relief, septoplasty remains the most effective option.

Septoplasty

Septoplasty is a surgical procedure designed to correct a deviated septum, improving airflow through the nasal passages. Here’s what you need to know:

Procedure

• The surgeon makes an incision inside the nose to access the nasal septum.
• The crooked cartilage and bone are repositioned or removed to straighten the septum.
• The mucous membrane is then repositioned, and stitches may be used to hold it in place.
• Depending on its complexity, the surgery usually takes 30 to 90 minutes to complete.

Recovery

• Most patients experience swelling and mild discomfort for a few days.
• Nasal packing or splints may be used to support healing.
• Full recovery can take a few weeks, with a noticeable improvement in breathing.

Risks

• Bleeding and infection (common risks with any surgery).
• Septal perforation (a hole in the septum).
• Changes in nasal shape or persistent symptoms require revision surgery.

Also, read https://www.henryford.com/services/sinus/conditions/deviated-nasal-septum.

What are the risks and benefits of septoplasty?

By surgically repairing a deviated septum, a procedure known as septoplasty can improve breathing and nasal airflow.  Here’s a breakdown of its benefits and risks:

Benefits

• Improved Breathing—Straightening the septum allows for better airflow, reducing nasal congestion.
• Reduced Sinus Infections—Proper airflow can lower the risk of recurrent sinus infections.
• Less Snoring & Sleep Apnea Symptoms—Many patients experience better sleep quality.
• Fewer Nosebleeds—A corrected septum reduces irritation and dryness that can lead to bleeding.
• Enhanced Quality of Life—Easier breathing can lead to better overall health and comfort.

Risks

• Bleeding & Infection—As with any surgery, there’s a risk of complications.
• Persistent Symptoms—Some patients may still experience nasal blockage.
• Septal Perforation—A hole in the septum may develop, requiring further treatment.
• Changes in Nasal Shape—Some patients notice subtle alterations in their nose’s appearance.
• Reduced Sense of Smell—Though rare, some patients report a diminished ability to smell.
• Need for Revision Surgery—If results are unsatisfactory, additional procedures may be required.

What is the recovery process after surgery?

Recovering from septoplasty involves several stages, and while most people heal well, it’s important to follow post-surgery care guidelines for the best results. Here’s what to expect:

Immediate Post-Surgery (First Few Days)

• Swelling & Congestion—Your nose may feel blocked due to swelling and nasal packing.
• Pain Management—Mild discomfort can be managed with prescribed pain relievers.
• Rest & Elevation—Keeping your head elevated helps reduce swelling and bleeding.
• Avoid Strenuous Activity—No heavy lifting or intense exercise for at least a week.

First Week

• Follow-Up Appointment—Your doctor may remove nasal packing or splints.
• Reduced Swelling—Breathing should start improving as inflammation decreases.
• Limited Physical Activity—Avoid bending over or straining to prevent complications.

Two to Four Weeks

• Gradual Improvement—Most swelling subsides, and nasal airflow improves.
• Avoid Irritants—Stay away from smoke, dust, and strong odors to prevent irritation.
• Resume Normal Activities: You can resume light exercise, but stay away from contact sports.

Long-Term Recovery (Up to Six Months)

• Final Healing—The nasal tissues continue to settle, and breathing function stabilizes.
• Follow-Up Visits—Your doctor may assess healing and address any concerns.
• Full Results—Most patients experience noticeable improvement in breathing.

Conclusion 

A deviated septum occurs when the nasal septum is off-center, leading to breathing difficulties, congestion, and other symptoms. While nonsurgical treatments can help manage symptoms, septoplasty is the only way to permanently correct the condition. The surgery improves airflow, reduces sinus infections, and enhances overall quality of life, though it carries some risks, such as bleeding, infection, or the need for revision surgery. Recovery takes a few weeks, with full healing occurring over several months.