Overview

A deviated septum occurs when the thin wall (nasal septum) between your nasal passages is displaced to one side. In many people, the nasal septum is off-center — or deviated — making one nasal passage smaller.

When a deviated septum is severe, it can block one side of your nose and reduce airflow, causing difficulty breathing. The additional exposure of a deviated septum to the drying effect of airflow through the nose may sometimes contribute to crusting or bleeding in certain people.

A nasal blockage or congestion (obstruction) can occur from a deviated nasal septum, from swelling of the tissues lining the nose or from both.

Treatment of nasal obstruction may include medications to reduce the swelling or nasal dilators that help open the nasal passages. You'll need surgery to correct a deviated septum.

Symptoms

Most septal deformities result in no symptoms, and you may not even know you have a deviated septum. Some septal deformities, however, may cause the following signs and symptoms:

  • Obstruction of one or both nostrils. This blockage (obstruction) can make it difficult to breathe through the nostril or nostrils. You may notice this more when you have a cold (upper respiratory tract infection) or allergies that can cause your nasal passages to swell and narrow.
  • Nosebleeds. The surface of your nasal septum may become dry, increasing your risk of nosebleeds.
  • Facial pain. There is some debate about the possible nasal causes of facial pain. A possible cause of one-sided facial pain could be a severe deviated septum in which surfaces within the nose touch and cause pressure.
  • Noisy breathing during sleep. A deviated septum or swelling of the intranasal tissues can be one of the many reasons for noisy breathing during sleep.
  • Awareness of the nasal cycle. It is normal for the nose to alternate being obstructed on one side, then change to being obstructed on the other. This is called the nasal cycle. The nasal cycle is normal, but being aware of the nasal cycle isn't typical and can indicate nasal obstruction.
  • Preference for sleeping on a particular side. Some people may prefer to sleep on a particular side in order to optimize breathing through the nose at night if one nasal passage is narrowed.

When to see a doctor

See your doctor if you experience:

  • A blocked nostril (or nostrils) that doesn't respond to treatment
  • Frequent nosebleeds
  • Recurring sinus infections

Causes

A deviated septum occurs when your nasal septum — the thin wall that separates your right and left nasal passages — is displaced to one side.

A deviated septum can be caused by:

  • A condition present at birth. In some cases, a deviated septum occurs during fetal development and is apparent at birth.
  • Injury to the nose. A deviated septum can also be the result of an injury that causes the nasal septum to be moved out of position.

    In infants, such an injury may occur during childbirth. In children and adults, a wide array of accidents may lead to a nose injury and deviated septum. Trauma to the nose most commonly occurs during contact sports, rough play such as wrestling or automobile accidents.

The normal aging process may affect nasal structures, worsening a deviated septum over time.

Swelling and irritation of the nasal cavities (rhinitis) or sinus cavities (rhinosinusitis) also can further narrow the nasal passage from a deviated septum, resulting in nasal obstruction.

Risk factors

For some people, a deviated septum is present at birth — occurring during fetal development or due to injury during childbirth. After birth, a deviated septum is most commonly caused by an injury that moves your nasal septum out of place. Risk factors include:

  • Playing contact sports
  • Not wearing your seat belt while riding in a motorized vehicle

Complications

If you have a severely deviated septum causing nasal blockage (obstruction), it can lead to:

  • Dry mouth, due to chronic mouth breathing
  • A feeling of pressure or congestion in your nasal passages
  • Disturbed sleep, due to the unpleasantness of not being able to breathe comfortably through your nose at night

Prevention

You may be able to prevent the injuries to your nose that can cause a deviated septum with these precautions:

  • Wear a helmet or a midface mask when playing contact sports, such as football and volleyball.
  • Wear a seat belt when riding in a motorized vehicle.