Is surgery necessary for a deviated septum?

Written by Deng Bang Yu
Otolaryngology
Updated on September 18, 2024
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Nasal septal deviation refers to the situation where the cartilage and bone tissue of the nasal septum lean toward one side of the nasal cavity, representing a structural deviation. However, having just this deviation is insufficient for a complete diagnosis of a deviated septum. Symptoms such as nasal congestion, nosebleeds, and headaches must also be present to fully diagnose it. Treatment for a nasal septal deviation often involves surgical correction; however, surgery is not necessary for asymptomatic individuals with mere structural deviation. Surgery is opted for cases with structural deviation accompanied by symptoms like nasal congestion, nosebleeds, and headaches.

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Written by Deng Bang Yu
Otolaryngology
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Is surgery necessary for a deviated nasal septum?

Nasal septum deviation is a structural abnormality where the cartilage or bone of the nasal septum leans towards one or both sides of the nasal cavities. Clinically, a perfectly vertical nasal septum does not exist; there is always some degree of deviation, but the extent can vary significantly. If nasal septum deviation is accompanied by symptoms such as nasal congestion, nosebleeds, or even headaches, a sinus CT scan should be conducted to assess the degree of deviation. If the deviation is severe, then surgery is definitely necessary. For cases with no clinical symptoms and only minor deviation, surgery is not required.

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Written by Zhang Jun
Otolaryngology
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Can a deviated nasal septum be treated without surgery?

Whether surgery is required for a deviated septum primarily depends on the clinical symptoms of the patient. Deviated septum is a common condition in otolaryngology, with over 90% of people having some form of septal deviation. It is mainly caused by abnormal development of the nasal septum during the embryonic stage or by later traumatic injuries, fractures, or pressure from nasal tumors causing the septum to deviate to one or both sides. After the septum deviates, it can lead to persistent nasal congestion and is also associated with pain in the eyes and face, and headaches. A deviated septum can also lead to complications such as sinusitis and nasal polyps. A detailed examination at a hospital, typically using an endoscope, can confirm the diagnosis. If a patient with a deviated septum experiences no symptoms, no treatment may be necessary. However, if the patient suffers from persistent nasal congestion accompanied by headaches, then localized corrective surgery may be required.

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Written by Gao Tian
General Surgery
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Does a deviated septum require surgery?

First, it is necessary to ascertain the degree of deviation, as a normal person's nasal septum is usually somewhat deviated. It is recommended to visit an otolaryngology department to complete relevant examinations to determine the extent of the deviation, and then decide on the next steps. If the deviation is severe and accompanied by clinical symptoms such as nasal congestion and nasal discharge, surgical treatment may be considered. However, for those who do not have symptoms and whose breathing is not affected, surgery is generally not considered. Therefore, the decision should be based on clinical symptoms and the degree of deviation. After surgery, it is important to rest, avoid strenuous activity, keep the area clean and dry, and prevent infection.

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Written by Deng Bang Yu
Otolaryngology
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The main reason that a deviated septum causes headaches

In clinical practice, a deviated nasal septum can be structural, which often leads to symptoms such as nasal congestion, nosebleeds, and headaches. There are primarily two reasons why a deviated nasal septum may cause headaches. First, the deviated septum directly irritates the middle turbinate, leading to anterior ethmoid nerve syndrome and severe headaches. Second, the deviated septum may lead to secondary conditions such as rhinitis or sinusitis, which also cause headaches. Therefore, in clinical practice, surgical intervention is needed to correct a deviated nasal septum causing headaches. Before surgery, a CT scan is usually conducted to rule out sinusitis or other diseases causing the headaches. However, it is important to inform patients preoperatively that even after the surgery, headaches caused by the deviated septum may not be completely relieved or eliminated. This is crucial information to communicate to patients before the procedure.

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Written by Li Rui
Otolaryngology
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Symptoms of a deviated septum

The symptoms of a deviated nasal septum can vary significantly from person to person. Some individuals with a mild deviation might not exhibit any obvious clinical symptoms and are only diagnosed during a physical examination or an endoscopic nasal examination. However, if the deviation is more pronounced, it may cause various symptoms such as nasal congestion, runny nose, nosebleeds, headaches, and dizziness. In some cases, it can also lead to sinusitis, characterized by sudden acute purulent nasal discharge, nasal congestion, headaches, and a reduced sense of smell. Overall, this is a relatively common condition and most patients see good results after timely and standard medical treatment.