Manifestations of a deviated nasal septum

Written by Li Rui
Otolaryngology
Updated on January 21, 2025
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Nasal septum deviation is a relatively common otolaryngologic condition, which may present clinical symptoms. The extent of these symptoms largely depends on the degree of the deviation and the individual's personal sensitivity. If the deviation is mild and not severe, it might not show any obvious symptoms and is usually discovered during physical examinations or nasopharyngoscope evaluations. Additionally, it may be accompanied by related clinical symptoms such as nasal congestion, nosebleeds, headaches, dizziness, and a decrease in the sense of smell. If these clinical symptoms occur, it is necessary to undergo nasopharyngoscopy and sinus CT scans to assess the specific degree of nasal septum deviation. Some patients may require surgical treatment.

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How to treat enlarged turbinates and a deviated nasal septum?

For the condition of enlarged turbinates and a deviated nasal septum, we need to understand that these are pathological changes in the anatomical structure of the nose. In dealing with anomalies in the anatomical structure, our first step should be to perform a CT scan, then assess the extent of the enlargement of the turbinates and the deviation of the nasal septum. If the condition is severe, and there are relatively prominent symptoms such as nasal congestion, nosebleeds, and even headaches, then we should consider correcting these abnormal structures surgically, by removing these anomalies or correcting the deviated nasal septum or addressing the factors causing the turbinate hypertrophy. If there are no significant symptoms or only minor deviation or enlargement, treatment usually involves medication, primarily nasal sprays such as intranasal corticosteroids. In summary, there are mainly two treatment methods: surgical and medical treatments.

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Can a deviated nasal septum be manually adjusted by hand?

A deviated nasal septum cannot be manually adjusted, as the site of deviation is deep within the nasal cavity and thus inaccessible by hand. A deviated nasal septum is a common and frequent condition encountered in otolaryngology. It mainly results from abnormal nasal septum development during the embryonic stage or from postnatal trauma to the nasal septum and pressure from nasal tumors causing the septum to deviate to one side. After developing a deviated nasal septum, the patient may experience continuous, progressive nasal congestion, as well as facial swelling, pain, and headaches among other symptoms. In severe cases, the deviation may lead to complications such as sinusitis and nasal polyps, which can be diagnosed with an endoscopic examination and sinus CT scan at a hospital. In terms of treatment, minor deviations of the nasal septum do not require intervention. However, if associated symptoms are present, localized surgical correction may be necessary and can be curative.

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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 Zhang Jun
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Can a deviated septum be detected by a CT scan?

A CT scan can detect a deviated nasal septum, which is a common and frequently occurring condition in otolaryngology, typically due to abnormal development of the nasal septum during the embryonic stage or from trauma or pressure from nasal tumors. When the nasal septum is deviated, it can cause persistent nasal congestion on both sides, as well as facial swelling, headaches, and may also lead to sinusitis or nasal polyps. Diagnosis can be confirmed with an endoscopic examination using an electronic nasal endoscope and a sinus CT scan at the hospital. If the deviation of the nasal septum is severe and accompanied by nasal congestion and headaches, surgical correction of the deviated septum may be necessary to completely resolve the symptoms.

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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.