Deviated Septum

The wall-like structure that divides the nose in two is called the septum. When this structure is bent or shifted to the right or left, or sometimes to both sides in a “C” or “S” shape, it is called a “deviated septum.”

A deviated septum may result from pulling and pushing forces during the formation of the facial bones, or from nasal trauma during or after birth. As a result, the nasal cavity narrows in certain areas and certain problems arise. This condition is popularly described as “having a bone in the nose,” “having flesh in the nose” or “having a broken nose.”

Problems caused by a deviated septum:

• Nasal congestion that is always on the same side or alternates between right and left

In the natural working pattern of the nose, at certain intervals one side of the nose alternately takes in more air while the other rests. Normally, a person does not notice this. However, people with a nasal problem do notice it.

• Dryness, burning, and a foreign body or catching sensation in the throat due to constant mouth breathing
• Dryness inside the nose and nosebleeds
• Snoring and, as the problem progresses, pauses in breathing during sleep (apnea)
• Headache and facial pain that cannot be otherwise explained
• Frequently recurring sinusitis requiring long-term medication
• Persistent postnasal drip that does not improve with medication
• Middle ear problems

How is deviated septum surgery (septoplasty) performed?

The operation is performed through the inside of the nose under local or general anesthesia. Through an incision that cannot be seen from the outside, the bent and excess parts of the cartilage and bone are removed or straightened. Where possible, the removed cartilage is straightened and put back in place. If the turbinates inside the nose are also enlarged and make breathing difficult, they are reduced at the same time. The incision is closed with dissolvable stitches. At the end of the operation, packs are placed inside the nose and removed a few days later. There are many different nasal packs, and today mostly silicone packs with built-in channels that allow some breathing are used. In suitable patients, the operation can also be completed without packing.

Today, there is no treatment option other than surgery for a deviation inside the nose.

What should be done if there is also a problem with the external framework of the nose?

A deviation inside the nose often occurs together with a deviation of the external structure of the nose. If the external problem would prevent correction of the internal deviation or make breathing difficult, both problems should be corrected together. In other words, both the inner wall of the nose (the septum) and its external framework should be addressed (septorhinoplasty, rhinoplasty).

The parts causing obstruction inside the nose are removed and used to correct deformities of the external nasal structure and to support weak areas.

Nasal surgeries are among the operations most frequently performed by ENT specialists. Whether performed under local or general anesthesia, the patient is up and about the same day, and recovery is complete within a few weeks.

What can happen if surgery is not performed?

If nasal congestion is not treated, apart from the continuation of the complaints listed above, pauses in breathing during sleep, known as “sleep apnea,” may develop, especially in people who snore. Over time this can lead to heart rhythm disorders and, over the years, to high blood pressure and enlargement of the heart.

In sleep apnea, one of the key elements of treatment is relieving nasal obstruction.