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Deviated nasal septum treatment options

A deviated nasal septum only requires treatment if it is causing nasal obstruction in one or both sides of the nose. In addition, patients with obstructive sleep apnea who have difficulty using a continuous positive airway pressure device (CPAP), may better tolerate the device if they undergo treatment.

If a patient is a candidate for treatment, medical options include:

  • Nasal steroid spray
  • Breath-right strip
  • Nasal saline spray or high-volume irrigation
nasal cavity with deviated septum and inferior turbinate enlargement
Figure A: View of a right nasal cavity. Airflow is blocked (known as nasal obstruction) due to a deviated nasal septum and swelled inferior turbinate (hypertrophy).
nasal cavity after surgery
Figure B: View of a right nasal cavity (from Fig. A). Surgery to straighten the septum (endoscopic septoplasty) and reduce the inferior turbinate (inferior turbinate reduction) now allows air to flow freely throughout the nasal cavity (no nasal obstruction).

If the nasal obstruction does not improve enough with medical treatment, surgery may be an option. The most common procedure is called a septoplasty. A septoplasty involves removing the deviated portions of septal bone and cartilage while keeping the tissue linings (mucosa) of the septum intact to prevent a hole in the septum. The end result of this procedure is the widening of the nasal cavity inside the nose where the septum was blocking airflow, resulting in increased airflow through one or both sides of the nose. This procedure should not affect the external appearance of the nose.

Depending on the patient’s anatomy, location of the nasal obstruction, and whether or not the patient wants the external appearance of their nose to be altered, a rhinoplasty may be more appropriate than a septoplasty. Patients should always talk with their rhinologist (doctor specializing in sinus and nasal care) who can refer them to a facial plastic surgeon.