Septum Deviated? Not All Need Fixing

Before Turbinate Reduction

Many consumers of cosmetic surgery know about deviated septums, but many more write to nasal surgeons, asking:

• What is a deviated septum?

The septum — a thin wall of cartilage and bone inside your nose — separates your two nostrils. Many people have sinus-like problems and think perhaps their septum is bent or twisted and needs surgical repair.

For instance, one reader who thought he was plagued with sinusitis wrote to the famed Mayo Clinic asking about the cause of his inner nose woe. (Read more about the sinus complaint.)

Deviated septums are common – perhaps 75 percent of people have one.

Just because you seem to have sinusitis complaints due to a possibly crooked septum, there may be no reason at all to have nasal surgery to repair it.

Another common fact: true sinus infections are very bad news indeed. But facial pressure, clogged noses, and a dripping nose do not a true sinusitis diagnosis make.

If it really were sinusitis, you would experience:

• High fever
• Nausea
• Yellow, green or brown pus pouring out of your nose
• Vomiting
• Swelling and pain of the face

A diagnosis is made with certainty by x-rays or CT scans. Moreover, your doctor would sample the nose drainage and send a specimen to the laboratory to determine the cause.  The doctor would probably prescribe an antibiotic plus some heavy duty pain meds.

(Read more about actual sinus infections.)

The dead-bang giveaway: when patients tell rhinoplasty surgeons they have” three to four sinus infections yearly,” we know the cure may very well be found in structures, like the septum, inside the nose.

So what does the person do who frequently has:

• Congestion in the nose
• A dripping schnozzle that may also block up at night
• Snoring
• Sleep apnea

First step: have the situation evaluated by a head and neck (ear, nose and throat) specialist. Other medical causes may be responsible for your sinus-like symptoms.

And maybe your septum is bent or a little crooked. But it may not be the bugbear, after all.

Sometimes, the culprits and co-conspirators are a shelf-like structure inside the nose known as turbinates which can become enlarged.

Most often, turbinates enlarge from allergies. A badly deviated septum and enlarged turbinates are a troublesome duo and need to be managed if the patient is having breathing problems or sinus infections.

If your plastic surgeon thinks a deviated septum is responsible for your nasal troubles, the surgical repair of the septum is known as septoplasty. Not to worry, the surgery is done inside your nose, leaving no surgical scars at all on the outside.

And, be sure to ask if the turbinates need “a little off the top”.