The world we live in loves symmetry. Flowers that are ringed with petals of the same size are prettier than flowers with half their petals missing. Having two front teeth perfectly centered when you smile is considered more attractive than if they were shifted off to one side (on that note, have a look at a picture of Tom Cruise’s smile. But be aware – what has been seen cannot be unseen). However, the world we live in, and the bodies we live in, are often not symmetrical. If you have a look in the mirror, is one eye perhaps slightly larger or set lower than the other? Perhaps one of your hamstrings is more flexible than the other. Perhaps you have more gray hairs on one half of your head than the other half. And maybe, just maybe, your nostrils are different sizes.


What’s That About My Nostrils?

Now that you’ve carefully inspected and compared the size and shape of your two nostrils, you’ve realized that what’s been seen really cannot be unseen. Beyond those two little openings in your nose, there’s also a bit more going on farther inside. This is where the nasal septum comes in.

The nasal septum is a wall of cartilage that separates your two nostrils. Although on the outside of your nose, things might look reasonably symmetrical, inside, one nasal passage may be significantly larger than the other. This could be due to a deviated nasal septum, or in other words, a crooked wall.

It’s estimated that approximately 80% of the US population is living with a deviated nasal septum. This is just an estimate because many of these people – which may include yourself – are actually unaware that they have a crooked wall inside their nose.

In many cases, a deviated septum may cause no symptoms or problems at all, and you can continue throughout life believing you have perfectly symmetrical nostrils. In other cases, a deviated septum can be the cause of a variety of symptoms, perhaps even without you realizing it’s your crooked nasal septum to blame.


Reasons to Suspect You Have a Deviated Septum

The symptoms of a deviated nasal septum can vary from one person to another and may depend on the severity of the crookedness. To confirm your self-diagnosis of a deviated septum, it’s best to see an ENT doctor (otolaryngologist), who can perform a thorough examination. The examination will involve taking a good look into those nostrils with a scope as well as assessing other potential causes of your symptoms.

While a deviated septum may be a result of getting squeezed through the birth canal when you first entered the world, there may be other causative factors. Trauma or injury to the nose can displace the nasal septum to one side. The most common causes of nose trauma include rough or contact sports, such as football or boxing, and road accidents. If you can recall getting your nose mashed at some point in the past, coupled with your symptoms, there may be reason to believe you have a deviated septum.

So, what are the symptoms of a deviated septum? They can include:

  1. Difficulty breathing through one or both nostrils, due to crooked or narrowed nasal passages
  2. Frequent nosebleeds, due to changes in airflow causing the moist membranes of the inside of your nose to dry out
  3. Noisy breathing during sleep in young children
  4. Breathing through your mouth during sleep in adults
  5. Dry mouth from frequently breathing through the mouth instead of the nose
  6. Sensation of congestion, pressure, or fullness in your nose
  7. Preferring to sleep on a certain side as it may make it easier to breathe through a particular nostril
  8. Recurrent sinus infections as normal drainage from the sinuses is impaired
  9. Postnasal drip
  10. Sleep apnea

Do any of these apply to you? It’s important to know that even if you tick one (or all) of these boxes of deviated septum symptoms, it is still possible for your symptoms to be due to other causes. It’s also possible to have a deviated septum even if you’ve never been squeezed through a birth canal (perhaps you were born through caesarean), or ever been involved in a boxing match. Some people are simply born with a congenitally crooked septum. Once your ENT doctor has performed a physical exam and gained an understanding of your medical history, he or she will be able to determine whether your symptoms are, in fact, caused by a deviated nasal septum.


Deviated Septum Treatment

Not all instances of a deviated nasal septum need to be treated, especially considering that not all instances are symptomatic to begin with.

For mild cases, managing your symptoms may be sufficient to keep you happy. This can be achieved through medications such as decongestants, antihistamines, or steroidal nasal sprays to reduce any swelling in the nasal passages and improve airflow. However, these treatments will only serve to reduce or eliminate your bothersome symptoms; they won’t correct the deviation of the septum.

If your ENT doctor finds that your symptoms are severe enough to warrant surgical intervention, you may be advised to undergo a septoplasty which is a surgical procedure used to reconstruct the nasal septum, straightening it and recentering it in the middle of your nose. Any symptoms as a direct result of the deviated septum are then expected to resolve.

It can be difficult to identify your symptoms as being from a deviated nasal septum, especially if your nostrils look symmetrical from the outside. However, if you’ve been putting up with symptoms like difficulties breathing through your nose or frequent nosebleeds, it may be worth investigating a deviated septum as the culprit. Speak to your family physician or local ENT doctor.