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The nasal septum is a crucial component of the human nose since it divides the nasal cavity into two nostrils. It consists of cartilage in the front part and thin bone at the back. Though the septum is of a normal type in most people, it can take different forms. A deviated septum is common, meaning the septum is off-center. This condition causes health and cosmetic problems.
A deviated septum is one of the most common nasal problems since about 80% of adults have some form of deviation. However, only a small percentage of the population seeks medical help where surgery may be necessary. Nasal septum types include:
S Chiari type
This type of nasal septum deviation tends to be extremely medial, and such deviations can cause serious complications. These Chiari type divergence frequently cause sinus problems since they obstruct normal drainage.
S Cimetri type
This is a common form of deviation in people characterized by a dorsal bump on the septum that resembles the beak of a bird. Such a deviation often causes obstruction of the nasal airway and is frequently associated with other disorders like Cleft lip palate.
Upper nasal divergence
Usually, this divergence happens at the upper nasal floor and is closely associated with other anomalies. It can result in issues like hypoplasia of the maxillary sinus and around the eye socket.
Vomer ridge type
Vomer is the bone located at the base of the septum. Vomer ridge type deviation is common in people with medical conditions like nasal polyps and chronic sinusitis. This type of deviation creates a ridge along the vomer centerline, which may obstruct the airway.
The nasal septum divides the left and right nasal cavities or nostrils. Its main function includes facilitating airflow and ensuring each side of the nose performs optimally.
Support and shape
Alongside other nasal structures, the nasal septum gives support and shape to the nose. The septum comprises both cartilage and bone, which provides flexibility and strength.
Air filtration and humidification
As air passes through the nose, it gets filtered, warmed, and humidified before entering the lungs. The septum plays a role in directing airflow across the nasal turbinates. These are curled bony structures located in the sidewalls of the nasal passages that help filter and humidify the inhaled air.
Sense of smell
The complex nasal anatomy, which includes the septum, contributes to the olfactory system or sense of smell. This system plays a vital role in distinguishing odors.
Sinus drainage
The nasal septum, by partitioning the nasal cavity, ensures proper drainage of the sinuses into the correct space within the nasal passages. Proper functioning of the septum is therefore crucial when it comes to preventing sinus infections and maintaining good nasal health.
Composition
The nasal septum has cartilage at the front 1/3 portion, while the back 2/3 area has thin bone, mostly the vomer and perpendicular plate of ethmoid. The cartilage area makes the septum flexible, while the bony part is more rigid.
Deviated septum
A deviated nasal septum occurs when the septum bends or shifts to one side instead of sitting in the center. Such deviation can arise from physical injury, growth and development, or congenital reasons. A deviated septum often leads to breathing difficulties since it narrows one of the nostrils. It can also cause other symptoms like sinus infections and nosebleeds.
Surgical interventions
When severe problems develop due to septum deviation, medical intervention may be necessary. These include medications that manage symptoms like congestion and infections. One of the common surgical procedures is septoplasty when the septum is straightened to improve breathing.
Septum and other structures
The septum interacts with other nasal components, such as turbinates and nasal valves, to facilitate proper functioning of the nasal system in breathing and filtering air.
Nasal septum deviation and disorders can significantly impact quality of life. They often cause breathing difficulties, frequent sinus infections, and reduced sense of smell. In addition, individuals with a deviated septum experience dry mouth due to nasal obstruction during sleep. Others sleep with their mouths open, which can cause snoring and sleep apnea.
Post-trauma symptoms
In people involved in accidents or other forms of trauma, they may have breathing difficulties due to an injured nasal septum. The most common cause of nasal septum injury is nasal trauma. A swollen septum commonly occurs after nasal trauma, causing obstruction and difficulty breathing through the nose.
Chronic sinusitis
The nasal septum divides the nasal cavity into 2 equal parts. If it's deviated, it can obstruct one or both sides, causing stagnant mucus, which leads to chronic sinusitis. This condition causes thickened mucus that can't drain properly, resulting in infection, inflammation, and congestion. Symptoms include facial pain, pressure headaches, and post-nasal drip.
Nasal polyps
These are soft growths that appear inside the nose due to prolonged inflammation from allergies, asthma, or infections. They tend to obstruct the nasal passages and sinuses, causing breathing difficulties. Because they arise in the nasal lining, they can also cause further deviation of the nasal septum.
Rhinocerebral mucormycosis
This is a rare but serious fungal infection that affects people with weakened immune systems and those with diabetes. It usually starts in the nasal cavity and spreads to the septum and sinuses.
Choosing the right treatment for nasal septum-related problems depends on the severity of the symptoms and the individual needs and medical history of the patient.
Watchful waiting
This is a good option when symptoms are minor. People with mild nasal congestion, occasional sinus infection, and rare nosebleeds don’t need medication or medical intervention. Simple home remedies like saline nasal sprays and steam inhalation help them.
Medication
For those with moderate symptoms, medical treatments help manage symptoms. They may take medication such as antihistamines to relieve allergy-induced nasal congestion or sinus infection nasal corticosteroids to reduce inflammation. Infections associated with nasal septum deviation may require antibiotics.
Surgery
People with severe symptoms and chronic nasal congestion, frequent nosebleeds, and sleep apnea may require surgical interventions. Septoplasty surgery can straighten the deviated septum to improve breathing. This is ideal when nasal obstruction significantly impacts daily life, causing sleep disturbances or recurrent infections.
Lifestyle changes
People with mild or moderate symptoms can benefit from lifestyle adjustments. These include staying hydrated to help thin mucus, using a humidifier to prevent dry nasal passages, or avoiding irritants like tobacco smoke and pollution.
Avoid irritants
Avoiding irritants like smoke and pollution helps in managing nasal congestion. For people whose nasal congestion is triggered by allergies, keeping the house clean to prevent the accumulation of dust, pet dander, and mold will eliminate potential allergens.
Using humidifiers
Using humidifiers can help relieve nasal congestion. This is because humidifiers add moisture to the air, which can help soothe dry nasal passages. This tends to be particularly helpful in dry climates or during the winter months when indoor air can become excessively dry.
When the septum leans to one side, it can narrow the airway, making it hard for air to pass through. This causes difficulty in breathing. An obstructed nasal passage reduces airflow, which makes people breathe through the mouth. Deviated septums can lead to frequent sinus infections. In such cases, mucus accumulates in the sinuses, creating an environment for bacteria to thrive.
A healthy nasal septum appears as a thin, vertical wall of cartilage, evenly dividing the two nasal passages. It should sit in the center of the nose, creating equal airflow through both nostrils. The surface of the septum is smooth and pale, like the inside lining of the nose.
A deviated septum can contribute to obstructive sleep apnea by blocking airflow through the nasal passages. When the septum is misaligned, one nostril may be more obstructed than the other, making it difficult to breathe at night. This causes snoring and interrupted breathing.
