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What is a Deviated Nasal Septum? (Signs, Symptoms, and Causes)

December 18th, 2017 | 5 min. read

By Kathleen Rose McDonald, MD

deviated nasal septum.jpg

Around 2.2 million Americans have a deviated nasal septum. That's one in 124 people. Actually, it’s fairly common to have an uneven septum. As much as 80 percent of all nasal septums have some degree of deviation, according to estimates by the American Academy of Otolaryngology. You most likely won't need medical attention with a deviated septum unless it’s causing you health complications or impacts your quality of life negatively.

Do you need to get your deviated septum evaluated and fixed?

Houston ENT and Allergy has 9 convenient locations with ENT physicians specializing in treating a deviated nasal septum.




The cartilage in your nose separating your nostrils is your septum. Generally, it rests at the center dividing your nostrils evenly. But, this isn’t always the case for some individuals. In fact, there are many people whose septum is uneven making one of their nostrils bigger than the other one. When this unevenness becomes severe, it's called deviated nasal septum, which and may cause a variety of health issues, like making it difficult to breathe or causing a blocked nostril.


Signs and Symptoms of a Deviated Nasal Septum

There are certain signs of a deviated nasal septum you can look out for. For instance:

  • Do you experience uneasy airflow when closing your mouth and taking a deep breath through both of your nostrils?

  • Are you finding it difficult to breathe freely?

In some situations, a deviated nasal septum can cause an illness you have to become more severe. It can cause other complications as well.

Typically, individuals with this condition only experience minor deviation. When you have a deviated septum, usually other people can't even tell. In these cases, it’s unlikely you'll have symptoms. Even so, possible deviated nasal septum symptoms include:

  • Nosebleeds: It’s harder for air to pass through your nose with a curved septum. Because of this, there are more chances of your nasal membranes to dry out and this makes you more vulnerable to nose bleeding.  

  • Difficulty breathing: With your nasal misalignment, air has a harder time passing through one half of your nose; therefore, it becomes more challenging to breathe. This issue increases when you have allergies or a cold. It may be easy to breathe through the other side though.

  • Loud breathing or snoring while sleeping: A deviated septum can cause nasal congestion which may lead to snoring and loud breathing while you're sleeping. Sometimes, this condition can either contribute to or cause sleep apnea. Sleep apnea is a severe disorder that stops your breathing during your sleep.

  • Sinus infections: The more your airway is clogged, the more likely you'll develop regular sinus infections. Cold symptoms like chronic post-nasal drip often come with a deviated septum. Pressure, nasal congestion, and a dry nose often come with sinus infections.

If your deviated septum is severe, you may experience facial pain. Sometimes, individuals with this condition only experience symptoms if they have ailments like an upper respiratory tract infection or even just a cold.

With these ailments, the respiratory infection causes inflammation in the nose that intensifies mild deviated septum-related airflow problems temporarily. For these individuals, once they recover from their cold and this inflammation in their nose subsides, they often recover from their deviated septum symptoms too.


Causes of a Deviated Nasal Septum

Deviated nasal septum causes may include:

Nose Injuries

Trauma or certain injuries can move your nasal septum out of position and cause a deviated septum. In both adults and children, there are a wide range of possible accidents that could cause an injury to the nose and therefore a deviated septum. Some examples include:

  • Automobile accidents

  • Contact sports

  • Tripping on a curb or sidewalk and colliding with someone

  • Roughhousing

Often, individuals don't even realize they have a severe injury to their nose.


Complications at Birth

Conditions that are present at the time of birth may cause a deviated septum that happens while the fetus is developing and becomes noticeable once born or from injuries during childbirth.



The process of aging can also affect a deviated septum and other nasal structures over time. It can make the condition worse.

Rhinosinusitis or rhinitis development may bring attention to nasal passage narrowing due to a deviated septum and lead to nasal obstruction.

You may be at a higher risk of a deviated nasal septum if you:

  • Don't wear a seatbelt while riding in a vehicle

  • Play contact sports


Deviated Septum and Sleep Apnea

How does a deviated nasal septum contribute to or cause sleep apnea? Depending on how severe your condition is, there's risk of developing obstructive sleep apnea (OSA). Having good airflow through your nasal passages is important for good breathing, since things that cause your airway to narrow can result in problems breathing.

Individuals with nasal obstructions often sleep with their mouth open, and this can contribute to sleep breathing disorders like sleep apnea and snoring. This happens because your pharyngeal lumen narrows in a few ways:

  1. When you open your mouth while sleeping, your mandible and chin move inferiorly and posteriorly to force your tongue in the same direction — directly narrowing your pharyngeal airway.
  2. Also when you open your mouth during sleep it reduces the tension and length of the muscles that surround your airway — increasing resistance in the airway.
  3. If you attempt breathing through your nose even when you have a blockage, it increases negative thorax pressure.

When your upper airways narrow, it causes pressure leading to a collapse at the narrowing area and thereby causing sleep apnea while you're sleeping.

Many sleep apnea patients have a deviated nasal septum. Nasal obstruction isn't a direct cause of OSA or other apneas, since the airway collapse isn't inside the nose. But, there is an association between a deviated septum and sleep disorders like sleep apnea.

To improve your breathing while you're sleeping and prevent sleep apnea, you need to clear any obstructions of your nasal passages. There is treatment for this.

If you experience regular nosebleeds, blocked nostrils or nostril not responding to treatment or repeated sinus infections, make an appointment with your doctor.


Key Takeaways about Deviated Nasal Septum

If you suspect a deviated septum, you’ll need to see an ear, nose and throat (ENT) specialist. They discuss your symptoms with you and will ask about any past trauma to your nose or if you’ve had nasal surgery in the past.

The ENT doctor will exam your nose thoroughly and carefully view the general appearance of it which includes your nasal septum position. They’ll use a nasal speculum and bright light to open your nostril gently and inspect the inside.

Before opting for surgery, and depending on the severity of your deviated nasal septum and your symptoms, your ENT doctor may try different medications to see if they help you breathe better. One such medication is nasal steroid spray. There could be treatment options for dealing with a deviated septum as well such as the Vivaer Nasal Airway Remodeling procedure.

Typically, surgery in the form of a procedure known as a septoplasty can correct this condition. The surgeon will usually perform the procedure on an outpatient basis, so you don't have to worry about having to stay at the hospital. The surgeon performs the procedure through your nostrils exclusively so you won't see any incision scars or bruising. Surgery generally takes a couple hours and you're done. We’ll cover the indications and reasons for a septoplasty procedure in a future article.

In summary:

  • Your septum is cartilage separating your nostrils.

  • When your septum is off-centered, you have a deviated septum.

  • Nosebleeds and difficulty breathing are the most common symptoms.

  • Injuries or previous treatment damage cause a deviated septum — or you're born with it.

  • Surgery in the form of septoplasty may correct a deviated septum.


Now that you know what this condition is, its symptoms and its causes, what’s next?

Get Evaluated for a Deviated Nasal Septum by Houston ENT & Allergy Services

Give Houston ENT & Allergy Services a call or complete our online form to set up an appointment for a full evaluation of your deviated nasal septum. The ENT (ear, nose, and throat) doctor will perform a physical examination and go over your medical history to determine the severity of your deviated septum.


Learn More About The Vivaer Airway Remodeling Procedure!




Kathleen Rose McDonald, MD