Septum or Nasal Septum

What is the septum or nasal septum?

The septum or nasal septum is located in the middle of the two nostrils or nostrils; It is lined by mucosa which produces mucus, and is made up of cartilage and bone. This structure divides the nose in two, directs the air we breathe into the airway, and provides support and structure to the nose (see image). 

Source: U.S. National Library of Medicine. (n.d.). Septoplastia – Serie-Indicaciones: MedlinePlus enciclopedia médica. MedlinePlus. https://medlineplus.gov/spanish/ency/esp_presentations/100038_2.htm.

What causes a deviated septum and what are the symptoms?

The septum can be twisted or deviated as we grow during childhood, or when we suffer a blow to the nose (see image).

Source: U.S. National Library of Medicine. (n.d.). Septoplastia – Serie-Indicaciones: MedlinePlus enciclopedia médica. MedlinePlus. https://medlineplus.gov/spanish/ency/esp_presentations/100038_2.htm.

The most common symptom is the inability to breathe properly through one or both nostrils. This, depending on the severity, can cause a deformity in the nose or that we breathe through the mouth most of the time which can limit physical activity, cause bad breath, hoarseness or sleep-related breathing disorders, recurrent nosebleeds, headaches, runny nose and, in childhood it can affect the development of certain structures in the face.


In severe cases the deformity of the nasal septum can obstruct the drainage of the paranasal sinuses causing recurrent infections or sinusitis (click here to read what it is sinusitis), alterations in smell, pressure or pain in the face, fever and a feeling of blocked ears.

How is a septal deviation diagnosed and how is it corrected?

It is important to see a specialist in the nose and paranasal sinuses (otolaryngologist) if you suspect or have symptoms caused by a deviated nasal septum. 

During the consultation, the specialist doctor will not only take note of your important medical history, he will also examine your nose in order to diagnose the cause of your condition either manually or with the help of a small camera called an endoscope. 

En caso de tener una desviación septal, el médico podrá solicitar una tomografía computarizada de nariz y senos paranasales, el cual brinda imágenes detalladas del interior de tu nariz y senos paranasales para lograr visualizar detalladamente el grado  y localización de desviación del septum, o si existen algún otra condición médica asociada (ver imagen).

CT scan showing nasal septum deviation (yellow arrow)

In turn, if surgical treatment is required, this study also helps the surgeon to plan the surgery in order to provide you with the best possible results. 

By going to an otolaryngologist, you will be given a diagnosis and treatment. Commonly a deviation of the nasal septum which causes symptoms and does not improve with medical treatment, requires a surgical correction called rhinoseptumplastia or septumplastia. There are several surgical techniques to correct a septal deviation, such as: closed, open or endoscopic approach. Your doctor will recommend the best treatment for you. 

The decision to have any surgical procedure should be after the surgeon knows all the patient’s medical history and has fully explained as well as discussed the surgical procedure, possible complications and risks.

* This information does not take the place of your doctor's advice. Please consult your healthcare provider for information about a specific medical condition.

References 

Becker, D. (2003). Septoplasty and turbinate surgery. Aesthetic Surgery Journal, 23(5), 393–403. https://doi.org/10.1016/s1090-820x(03)00208-5 

Grover, N. (2017). Septoplasty and Nasal Airway Surgery. Otorhinolaryngology: Head and Neck Surgery (2 Volumes), 1894–1894. https://doi.org/10.5005/jp/books/13036_130 

Nedev, P. (2010). Rhinoseptoplasty – complications, mistakes or unpredictable deformities. International Bulletin of Otorhinolaryngology, 6(1), 23. https://doi.org/10.14748/orl.v6i1.7058 

U.S. National Library of Medicine. (n.d.). Septoplastia – Serie-Indicaciones: MedlinePlus enciclopedia médica. MedlinePlus. https://medlineplus.gov/spanish/ency/esp_presentations/100038_2.htm.