Deviated septum

Diagnosis

History taking: Your healthcare provider will inquire about your symptoms during the assessment. They may ask questions such as:

• Providing a detailed description of your symptoms and their duration
• Inquiring about the presence of breathing difficulties
• Assessing the impact on your sleep quality and any snoring
• Exploring your medical history concerning sinus issues or nasal congestion

Physical examination: During the examination of your nasal passages, the physician will use a bright light and occasionally a specialized tool to gently widen your nostrils. In some cases, a slender, tube-shaped scope equipped with a bright light at the tip may be used to inspect the deeper regions of your nasal passages. The doctor may also evaluate your nasal tissues both before and after applying a decongestant spray.

Treatment

Medication: Initial treatment for a deviated septum often focuses on symptom management. Your doctor may recommend the following approaches:

• Decongestants: These medications aim to reduce swelling in nasal tissues, thereby facilitating improved airflow through both nostrils. Decongestants come in both pill form and nasal sprays. However, it is crucial to exercise caution when using nasal sprays, as excessive and prolonged use can lead to dependency and exacerbate symptoms upon discontinuation. Oral decongestants may also have stimulating effects, potentially causing restlessness, elevated blood pressure, and an increased heart rate.
• Antihistamines: These medications can prevent allergy symptoms and alleviate a stuffy or runny nose. They may also offer relief for non-allergic conditions like a cold. Some antihistamines can induce drowsiness and affect your ability to perform tasks requiring physical coordination, such as driving.
• Nasal steroid sprays: Prescription nasal corticosteroid sprays can reduce nasal swelling and aid in drainage. It typically takes 1 to 3 weeks for these sprays to achieve their maximum effect, so it’s essential to follow your doctor’s instructions for their use.

Surgery:

• Septoplasty: During a typical septoplasty procedure, the nasal septum is straightened and repositioned in the center of the nose. This may involve cutting and removing portions of the septum before reinserting them in their correct position. The degree of improvement achievable through surgery depends on the severity of the deviation. Surgery can potentially alleviate symptoms related to the deviated septum, particularly nasal obstruction. However, it cannot cure other nasal or sinus conditions, such as allergies, affecting the nasal lining tissues.
• Rhinoplasty: In certain cases, rhinoplasty (nose reshaping surgery) may be performed alongside septoplasty. Rhinoplasty involves altering the bone and cartilage in your nose to change its shape, size, or both.