There’s a decent chance you have a deviated septum — a displacement of the thin wall between your nostrils that can make one nasal passage smaller than the other.
Around 80 percent of Americans have this condition, according to the American Academy of Otolaryngology–Head and Neck Surgery Foundation. For most, a deviated septum presents no symptoms and carries no risk. But for some, a deviated septum can affect breathing and overall health.
Unfortunately, some people with deviated septums might not catch the issue until they focus on fixing other problems. For instance, one study found that 66 percent of patients seeking relief for allergy-related congestion also had deviated septums.
Here’s how to tell if you have a deviated septum, the risks it carries and what type of treatment can manage these risks.
What is a deviated septum? How might you know if you have one?
Your nasal septum is the thin wall of cartilage between your left and right nasal passages. It’s considered “deviated” if it’s off-center or displaced to one side, making one nasal passage narrower than the other.
“Though some people do suffer injuries that can damage the nose and cause a deviated septum, for most people, it’s congenital — they were born with it, ” says Dr. Madeleine Schaberg, an otolaryngology specialist and surgeon at Mount Sinai Hospital in New York.
For many who are affected, this asymmetry is slight, even unnoticeable. Yet for some, the asymmetry might be debilitating. Symptoms of a severely deviated septum include facial pressure or pain, sinus headaches and a greater likelihood of nosebleeds, sinus infections or sleep apnea. But the most significant sign is impaired breathing.
You usually can’t breathe well through one side of the nose, Schaberg points out. “You can breathe a little bit through one side of the nose, but not at all through the other,” she says. ”You may notice this more when you’re sick with a cold or suffering from allergies.”
Schaberg says she typically sees people come in for deviated septum diagnoses in their mid-to-late 20s. They’ll often realize they might be affected after reading a news article or taking a yoga class and being unable to breathe through their nose, she says.
What are the risks of an untreated deviated septum?
In severe cases, a deviated septum presents several health risks.
- Worsening symptoms, including difficulty breathing: A deviated septum is not a condition that will resolve itself on its own. Its symptoms (trouble breathing through either nostril, facial pressure, sinus headaches, etc.) will persist and become more problematic with age.
- Recurrent sinus infections (sinusitis): Sinus infections happen when fluid builds up in the sinuses, which are air-filled pockets in the face. A deviated septum could prevent fluids from draining the sinuses effectively when you have a cold or allergies, allowing germs to grow and causing an infection. In rare cases, these infections could spread elsewhere in the body, leading to serious issues such as blindness and meningitis.
- Sleep apnea: A deviated septum can contribute to obstructive sleep apnea, a condition in which breathing is interrupted during sleep. Sleep apnea can cause loud snoring and daytime tiredness. Untreated sleep apnea can lead to more serious health issues like high blood pressure and heart trouble.
Luckily, a deviated septum is not life-threatening for most people; it’s more of a quality-of-life issue. While it’s OK to breathe through your mouth, “breathing through your nose humidifies and filters the air, making it more comfortable than breathing through your mouth,” Schaberg says.
How do you fix it?
If you think you may have a deviated septum, the first step is getting a proper diagnosis from a specialist.
“Your primary care physician isn’t looking into your nose with a camera — they’re looking at the outside or superficially inside,” Schaberg says. “An ENT [ear, nose and throat specialist] will use a small speculum or camera to look at all the structures in there. There are lots of things that can cause obstructions. With a small camera, we can tell you what the actual problem is.”
Addressing a deviated septum may require a reconstructive surgery called septoplasty. Typically an outpatient procedure, a septoplasty costs approximately $3,500 and up out of pocket.
“We do a ton of surgeries for this,” Schaberg says. “It’s very low-risk. It’s not one-size-fits-all — it’s tailored to the specific patient — but it should take about two hours, and you can go home the same day.”
Many people feel congested for a few days after surgery, but within a week to 10 days, any underlying symptoms should disappear.
“Within a month, everything should be where it should be,” Schaberg says. “Patients are very happy with the results.”