How can I tell if I have a deviated septum?

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I'm starting to think I might have a deviated septum and that it might be responsible for decades of suffering with rhinitis and sinusitis, hay fever, allergies to pet hair, cigarette smoke, perfumes, scented laundry detergent, scented deodorant, wool and the list goes on?! How can I tell? I know someone who had surgery to fix a deviated septum and her nasal issues were very similar to mine. After her surgery, her allergies improved enormously--plus, whatever they did made her nose look nicer than when she'd gone in! Her surgery was covered under her health insurance, also. Can you point me in the right direction to help me find out if this is my problem too? I don't want to suffer any more if i don't have to.

sessy-no1

F, 33, Tennessee

As you probably know, the nasal septum is the narrow wall of bone and cartilage which separates the two nasal passages in the nose. If the septum is out of alignment, pushed to one side or crooked, the condition is called a deviated septum.



A deviated septum can cause difficulty breathing through the nose, increased nasal congestion, frequent sinus infections, post-nasal drip and frequent headaches. Some deviated septum sufferers also experience frequent nosebleeds, strained or noisy breathing through the nose, and even obstructive sleep apnea.

While each of those symptoms alone may indicate a deviated septum, the only way to be sure is to go to your doctor for a physical examination, at which point your doctor will use a nasal speculum to open the nostrils wide enough to see inside. In some cases your physician may also use an endoscope -- or possibly even a CT scan -- to more clearly visualize the nasal passages.

Often doctors will first prescribe antihistamines or decongestants in the effort to treat the deviated septum symptomatically. If your nasal symptoms don't respond to medications, you may need a septoplasty.

A septoplasty is a common plastic surgery procedure used to correct a deviated nasal septum. During a septoplasty the septum is surgically repositioned towards the midline of the nose. In most cases, deviated septum surgery can be performed as an outpatient procedure.

It may require parts of the septum to be excised prior to being realigned and sometimes, in more severe cases, the nose itself must be reshaped via rhinoplasty in order to ensure unimpeded nasal breathing.

To address your question about allergies: there's no correlation between a deviated septum and allergic symptoms. However, both allergies and a deviated septum can interfere with nasal breathing. If you do suffer from both issues, it's possible that the combined effect could be reduced via septoplasty.

I can't offer you any specific medical advice without a direct examination, but if you are suffering from nasal obstruction, breathing problems, facial pain, frequent rhinitis or other common deviated septum symptoms, then septal deviation is certainly a potential cause. I encourage you to make an appointment with a board-certified otolaryngologist for an examination.

Allergic rhinitis is a common condition and is an immune system response. A deviated septum is a physical condition caused by a nasal septum which is poorly aligned within the nasal cavity. The two conditions are unrelated, save for the fact that they may both obstruct airflow and interfere with nasal breathing. A deviated septum, however, will not cause typical allergic responses like itchy eyes, tearing or coughing.



A deviated septum is something you're either born with or the result of a nose injury.

If your nasal breathing issues are accompanied by frequent nose bleeds, sleep disorders, mouth breathing, frequent dry mouth and other non-allergic symptoms then you may have a deviated septum. Another common indicator of a deviated septum is difficulty breathing, but only on one side of their nose.

Other indications of a crooked septum include migraine headaches, chronic sinusitis, and a dry mouth while sleeping due to nighttime mouth breathing.

If you experience relief from antihistamines, nasal decongestants or nasal sprays, it’s a relatively good indication your issue may not be a deviated septum.

The only way to confidently diagnose a deviated septum is through a direct examination of the nasal cavity. If you feel that your conditions may indicate septum deviation, I recommend making an appointment with an ear, nose and throat doctor (ENT) who is certified by the American Academy of Otolaryngology and has extensive experience diagnosing and performing septoplasty procedures.

Your doctor will examine your nose using a nasal speculum, or by performing a nasal endoscopy or CT scan of the nose. If your doctor determines that your septum is crooked, he or she may recommend a septoplasty.

Septoplasty surgery is a common procedure. Barring unusual cases of a severely deviated septum, or cases in which combined sinus surgery or rhinoplasty is necessary, the procedure is generally quick and relatively painless. Patients usually feel dramatically better two or three days following the surgery, and typically return to work within one to two weeks.

For patients with deviated septums, the surgery can offer tremendous benefits and a dramatic improvement to quality of life.

Breathing problems are usually caused by enlarged turbinates (side walls of of the nose), allergies or nasal septal deviation. However, there are several distinctions between allergies and the symptoms of septal deviation.

Allergies are a response to an overactive immune system. When the immune system overreacts, it can cause a runny nose, nasal congestion, post-nasal drip or pressure in the sinuses.

While a deviated septum can share some symptoms similar to those caused by allergies, it is not related to the immune system. Instead, it is often the result of trauma or a congenital defect.
And while allergies can often be treated effectively with medication, septal deviation can only be addressed with surgery.

Also, septal deviation cannot make your allergy symptoms worse; only an allergic attack can have this effect.

I would advise you to set up an in-person consultation with a board-certified otolaryngologist who performs procedures such as septoplasty. He or she will use an intra-nasal speculum to examine the inside of your nose and determine if you have a deviated septum.
Make sure to ask to see before-and-after pictures of actual patients who have had septoplasty with that surgeon.

Also, if you have allergies that affect your nasal cavity, try an over-the-counter saline nasal spray. It may clear up some of your problems.

The only way to determine if you have a deviated septum is by visiting a doctor. Any doctor should be able to diagnose a deviated septum, whether it’s your primary care provider, an otolaryngologist or a facial plastic surgeon.

Your best bet is to consult with an otolaryngologist who is board-certified by the American Academy of Otolaryngology and has fellowship training in facial plastic surgery. This type of surgeon has the most training and experience with septum surgery and other types of head and neck surgery.

If you have already been considering a nose job, your surgeon should be able to determine if you have a deviated septum through an exam taken during your initial consultation.

If you have a severely deviated septum as well as allergies, it would make sense that you are having problems with your nasal cavity as well as difficulty breathing. Also, these two conditions have common symptoms, so people sometimes confuse the two or conclude that one is worsening the other. For example, both conditions can negatively affect the sinus cavity. Both airborne allergens and a deviated septum can generate symptoms similar to a common cold, such as swelling and an increase in mucus, which can result in a sinus infection. However, it is important to note that a deviated septum will not worsen your allergy symptoms.

A deviated septum does not exacerbate allergy problems. However, if you are experiencing chronic nasal breathing problems, a stuffy nose and/or nose and facial pain, these may be symptoms of a nasal septum deviation.

The only way to know for sure is to schedule an appointment with a board-certified otolaryngologist (ear, nose and throat doctor) or facial plastic surgeon. By performing a thorough diagnosis, the surgeon should be able to determine whether you have a deviated septum or if there are other reasons behind your symptoms. A crooked septum, enlarged turbinates, allergies or a sleep disorder such as sleep apnea may also be responsible for your breathing difficulties.

Your surgeon will be able to provide you with the appropriate medical advice, including what type of surgery or other treatment is best for your case.

If you do have a deviated septum you will most likely need to undergo a septoplasty to correct it. This procedure clears the nasal passages and restores proper airflow.

The best way to ensure a successful surgery is to locate a qualified surgeon experienced in this type of surgery. During your initial consultation the surgeon should address both your functional (i.e., breathing) and aesthetic concerns and goals and explain the details of the procedure, such as where the incisions will be placed as well as the benefits and potential risks of surgery, recovery and so forth.

During your consultation, ask to see before and after photos of patients with similar concerns. If you like what you see in terms of their postoperative results, then this may be the surgeon for you.

If you undergo the procedure for functional rather than cosmetic reasons, there’s a better chance that it will be covered by your insurance.

Dr. Alexander Ovchinsky has 10 Revision Rhinoplasty before & afters:

Revision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRevision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRevision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRhinoplasty (nose job) before image performed by Dr. Alexander OvchinskyRhinoplasty (nose job) after image performed by Dr. Alexander Ovchinsky

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Hi sessy-no1,

It is very possible that you could benefit from deviated septum surgery. Surprisingly, 80% of the population suffer from of a deviated septum.  

A deviated septum can impede breathing through the nose and cause dry mouth. This is because people with the condition tend to breathe through their mouths more in order to compensate for the reduced airflow reaching their lungs. It can also cause excessive congestion, facial pain, blocked sinus drainage, repeated sinusitis, recurring nosebleeds, headaches and even sleep apnea.

For additional information on deviated septum surgery, I suggest that you check out this article on our blog.

Best,

Diana