What Is Septal Deviation (Deviated Septum)?

Septal deviation is the displacement of the cartilage and bone structure that forms the partition inside the nose away from the midline. Normally, the septum should be straight and divide the nasal cavity equally into two sides; however, it may become deviated due to congenital anatomical differences or trauma experienced throughout life.

This condition is commonly referred to among the public as “bone in the nose,” “flesh in the nose,” or “crooked nose.”

Septal deviation is not only an aesthetic issue; it is also a serious cause of obstruction that directly affects breathing function. When the airflow inside the nose is narrowed, individuals may experience many symptoms that reduce daily life comfort and sleep quality.

What Is Turbinate Hypertrophy?

Commonly known as nasal turbinate enlargement, this condition is one of the frequent causes of breathing difficulty. The turbinates are responsible for warming and humidifying the air passing through the nose. Turbinate hypertrophy may occur due to conditions such as allergic rhinitis and sinusitis.

What Causes Septal Deviation?

Congenital Causes

Position in the womb, pressure during passage through the birth canal, and genetic factors.

Trauma

Blows to the nose, falls, sports injuries, or accidents.

Deviations Developing in Adulthood

Changes in nasal structure over time and asymmetric development during growth.

Who Should Suspect Septal Deviation and Turbinate Hypertrophy?

Individuals experiencing one or more of the following symptoms are likely to have septal deviation:

• Difficulty breathing through the nose
• Chronic nasal congestion
• Snoring
• Sleeping with the mouth open
• Recurrent sinusitis attacks
• Headache
• Decreased sense of smell
• Poor sleep quality and sleep disorders

Patients with these symptoms should be evaluated by an ENT (Ear, Nose, and Throat) specialist.

How Is Septal Deviation and Turbinate Hypertrophy Diagnosed?

The diagnosis is easily made by endoscopic examination of the inside of the nose. Endoscopic evaluation clearly demonstrates both septal deviation and other causes of nasal obstruction (turbinate enlargement, polyps, edema, etc.).

How Is Septal Deviation Treated?

The only permanent treatment for septal deviation is surgery. This surgical procedure is called septoplasty, during which the deviated bone and cartilage structures are corrected to restore proper nasal airflow.

How Is Septoplasty Performed?

• Performed under general anesthesia.
• Takes an average of 40–45 minutes.
• The deviated portions of the septal bone and cartilage are corrected or reshaped.
• Associated turbinate hypertrophy is usually reduced with radiofrequency.
• Silicone nasal splints are placed.
• The long gauze packs used in the past are no longer used.
• With current techniques, absorbable sutures are used.

Modern septoplasty procedures are not painful or difficult surgeries as they once were. Patient comfort is maintained at the highest level.

Does the Nasal Bone Grow Back After Septoplasty?

After septoplasty performed with the correct technique, the likelihood of the nasal bone or cartilage becoming deviated again is quite low. The success rate of the surgery is approximately 85%.

What Is the Postoperative Process Like?

The recovery process after septoplasty is quite comfortable. Immediately after surgery, patients often notice easier breathing.

• Early breathing comfort is achieved since traditional packing is not used.
• Mild blood-tinged discharge from the nose may occur during the first 2 days.
• As mucosal edema decreases, breathing becomes easier.
• Nasal congestion during the first week is normal.
• Hospitalization is not required.
• Patients can usually return to work within a few days.
• Sutures dissolve on their own and do not need to be removed.

What Happens If Septal Deviation Is Not Treated?

• Poor sleep quality
• Decreased oxygen levels at night
• Snoring
• Sleep apnea (breathing cessation during sleep)
• Dry throat
• Chronic pharyngitis
• Frequent nosebleeds

For this reason, it is important that patients experiencing nasal obstruction are evaluated without delay.

Can Septoplasty and Aesthetic Nose Surgery Be Performed Together?

Yes. In patients who have both septal deviation and dissatisfaction with the shape of their nose, functional (septoplasty) and aesthetic (rhinoplasty) procedures can be performed together in a single session. Since septal deviation is one of the main factors contributing to nasal deformity, it should be remembered that these procedures are interconnected.

With this combined approach, healthy breathing function is restored while the shape of the nose is made more harmonious with the face.