While the American Academy of Otolaryngology – Head and Neck Surgery estimates that up to 80% of the population has a deviated nasal septum, many of us live in blissful ignorance of the fact that one of our nostril passages is larger than the other. The nasal septum is the wall of cartilage separating the two nostrils. Congenital conditions during fetal development or injuries to the nose from contact sports or motor vehicle accidents can result in this septum not quite sitting evenly between the nasal passages. For many, this isn’t an issue while others may experience symptoms that are less than desirable, prompting them to seek treatment from an ENT doctor. What problems could a crooked nasal septum possibly cause, you may ask? As it turns out, a few.

Difficulty breathing
It stands to reason that having nostrils that aren’t quite as open and friendly to airflow as usual can result in some impediment to breathing. For some people, this nasal obstruction may be apparent only during conditions that cause the nasal passages to swell and narrow further, such as during a cold or allergy season. Others may notice chronic nasal congestion on the one side of the nose, or perhaps even both sides. Another commonly listed symptom is awareness of the nasal cycle. The nasal cycle refers to the normal switching of some degree of obstruction from one side of the nose to the other, however, it isn’t typical for this to be so pronounced that you can recognize it, and may be indicative of a deviated septum.

Sinus infections
Recurrent sinus infections and inflammation, also known as chronic sinusitis, can be associated with a deviated septum. The sinuses are air-filled cavities located in specific areas around the face. As a crooked septum interferes with drainage of mucus from the sinuses into the nasal cavity, this can be a prime environment for bacteria to grow, leading to repeated episodes of infection and inflammation in these spaces.

Sleep disturbances
This applies to both the person with the deviated septum and also the person who is unfortunate enough to share their living space. Nasal congestion from a deviated septum can result in loud breathing, snoring and sleep apnea during sleep. While some studies have linked the presence of a deviated septum with sleep apnea – a sleep condition involving sudden pauses in breathing – not all experts support the claim that a deviated septum directly causes sleep apnea, but rather the presence of the restricted nasal passage exacerbates the existing upper airway obstruction responsible for the sleep apnea and makes it more apparent. Several studies have found that correcting a deviated septum can help to improve abnormal breathing during sleep, resulting in a better night’s rest.

The nasal passages are lined with a delicate mucus membrane, rich in blood vessels. With a deviated septum, airflow through the nose is more difficult, which results in a drying of these membranes. This dehydrated environment makes your nose more susceptible to nosebleeds.

There is some suggestion of a link between a deviated septum and asthma, via the bridge of nasal congestion. As we’ve seen, a deviated septum can be responsible for an obstructed nasal passageway and recurrent sinus infections. The theory is that this chronic inflammation and congestion of the airways acts as both an underlying cause and a trigger for asthma, and studies have shown that people with both sinusitis and asthma tend to have more severe asthma symptoms that are more difficult to control when compared to asthmatics without sinusitis.

Turbinate Hypertrophy
Turbinates are nasal radiators that clean, warm, and moisten air before it reaches our lungs. They can become inflamed due to allergies, infections, weather changes, medications, and a deviated septum. When they continually become inflamed, it is chronic and referred to as turbinate hypertrophy. When the nasal septum deviates to one side, the turbinate that becomes inflamed is usually on the opposite side. A turbinate reduction (turbinoplasty) and straightening of the nasal septum (septoplasty) can open both nasal airways allowing you to breathe freely again while also relieving susceptibility to chronic sinus infections, chronic post nasal drip, headaches, snoring and sleep apnea.

If you find yourself checking several of the boxes above, it’s possible you have a deviated nasal septum. Your ENT doctor can discuss the various treatment options with you, which may be medicinal, such as with a nasal steroid spray, or an effective surgical procedure known as a septoplasty or, as mentioned, a turbinate hypertrophy, so you can breathe easier and return to your expected and deserved lifestyle.