Deviated Septum – Readers’ Top Questions

"A lovely woman tries to see her septum in a hand mirror"

Is My Septum Straight?

Many nose job patients are surprised to discover the very middle of their noses – the septum – can present problems in how your nose looks and how it passes air on to the lungs.

You may already know the septum, a thin wall of bone and cartilage, divides the two nostrils, sitting in the middle of the nose. But knock the septum one way or another a tad too much and you may problems like constant nasal congestion, frequent sinus trouble and more.

Q: What are the signs of a perforated septum?

A: Signs of a perforation, or hole, in the septum may be obstruction in the upper nose, scabs or bleeding. Hearing whistling while breathing is a sure sign of a septum hole. For only nasal congestion, try a nasal saline spray and bedroom vaporizer.

Q: What if I do have a hole in my septum?

A: You may not hear whistling from a small hole. But a medium-size perforation causes bleeding and crusting while larger holes can block the breathing channel through the nose.  When ignored, the bigger holes can lead to collapse of the nasal bridge, a condition known as saddle nose.

(Read more about saddle nose.)

Q: Can I push my deviated septum back on my own to where it should be?

A: Just after a fracture of the septum, you could, but it would hurt tremendously. Plus, the risk of bleeding and bruising are present. After a few days, the septum heals in its broken position, meaning you can’t move it back by any method except surgery. Whatever the case, if your ability to breathe and function well are important, let an experienced nasal surgeon handle new and old septum fractures. Surgery to restore a septum to the middle of the nose is known as septoplasty.

Q:  What causes a hole in the septum besides cocaine?

A: The typical causes of septum perforation include intranasal cocaine abuse (“snorting”), blows to the nose in contact sports, fistfights, past nasal surgery, including nose jobs (rhinoplasty) not done well, auto wrecks and other trauma. Some people are just born with bent, twisted or crooked septums. A hole in the septum is repaired with a small plug made of silicone during nose surgery.

If you suffer from allergies, a nasal spray or antihistamines may help. Plus, the surgical repair of a deviated septum may – or may not – improve snoring.

Q: What is deviated septum surgery?

A: Read about deviated septum surgery including what happens before, after and during surgery.

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