Does a deviated nasal septum need to be treated?

Written by Li Mao Cai
Otolaryngology
Updated on September 28, 2024
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Deviated nasal septum is a common clinical occurrence in otolaryngology, and many people are told they have a deviated septum during a physical examination, or they feel uncomfortable with their nose and then find out they have a deviated septum when checking. Whether to treat these conditions depends on the specific circumstances. If there is no discomfort in the nose, breathing is normal, the sense of smell is unaffected, and there are no other clinical symptoms, surgery is unnecessary for a deviated septum discovered during a physical examination. However, if there are uncomfortable symptoms caused by the nasal cavity or deviated septum, and after examination, the doctor confirms that these are due to the deviated septum, then active surgical treatment is necessary. Only by correcting the deviated part can a satisfactory treatment outcome be achieved.

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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 Deng Bang Yu
Otolaryngology
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Can nasal septum deviation be treated under general anesthesia?

Nasal septum deviation refers to the deviation of the cartilage and bone tissue of the nasal septum towards one or both nasal passages, causing symptoms such as nasal congestion, blood-tinged nasal discharge or nosebleeds, and headaches. After the deviation of the nasal septum, nasal congestion can cause symptoms of snoring. Surgery for nasal septum deviation or other operations can be performed under general anesthesia. The deviated nasal septum does not affect the state of anesthesia. However, due to the presence of a deviated nasal septum, oral intubation should be chosen instead of nasal intubation during general anesthesia. If nasal intubation is desired, it should be performed on the side with a wider nasal passage. Thus, attention should be paid to the choice of intubation location during surgery under general anesthesia.

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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 Mao Cai
Otolaryngology
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How is a deviated nasal septum caused?

In this situation, we need to consider various factors. The most common primary cause is a congenital uneven development of the nasal septum, which leads to what we call congenital deviation of the nasal septum. Another cause is abnormal development or injury acquired later in life. For example, one common issue is children who snore loudly for extended periods during sleep and breathe through their mouths; they can develop enlarged adenoids, which might cause the upper jaw to protrude. This, in turn, can lead to abnormal development and deviation of the nasal septum. Additionally, injuries often occur when children are playing or accidentally during physical activities, leading to a direct impact on the nasal septum. Without immediate and proper attention, this can cause a deviation in the septum as development continues.

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Written by Deng Bang Yu
Otolaryngology
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Does a deviated septum require hospitalization?

The clinical treatment of a deviated nasal septum is primarily through surgical intervention, which involves the removal of the deviated cartilage and bone tissue to correct the structural deviation of the nasal septum. Therefore, hospitalization is required for the surgery, generally for about a week. According to usual procedures, the surgery is performed on the third day, followed by three to four days of intravenous fluid infusion to control and prevent infection. After discharge from the hospital post-surgery, the treatment does not end. Regular follow-up visits to the hospital are necessary to monitor the recovery from nasal mucosal inflammation and to observe the correction of the nasal septum deviation.