What is the nasal septum?

The nasal septum divides the nasal cavity into two sides.  It extends from the front of the nose all the way to the back.  Near the front, it is composed of cartilage, changing to bone about half way back.  The septum is lined by tissue on each side, called mucosa. 

What is a deviated septum?

A deviated septum is a condition in which the nasal septum is shifted away from the midline into one side of the nasal cavity.  This can cause obstruction of airflow through that side (or the other side in some cases).

What are the symptoms of a deviated septum?

Typically nasal obstruction, in general, is the main symptom.  A deviated septum can cause congestion or blockage on one or both sides of the nose, leading in some cases to frequent mouth breathing.  Sometimes this is worse at night.  Blockage can interfere with sports, especially running.  The nose is designed to heat and humidify air on its way to the lungs.  Heated and humidified air transfers oxygen better, allowing better performance.  Mouth breathing, caused by septal deviation, becomes more pronounced at higher levels of exertion.   Air delivered to the lungs through the mouth bypasses the humidification and warming effects of the nasal cavity and prevents maximum performance.

Why would the side opposite the septal deviation be more obstructed?

There are other structures in the nose called nasal turbinates that are attached to the sidewalls of the nasal cavity on each side.  The turbinate is a ridge of bone lined with tissue that swells in response to allergies, environmental irritants, or simply as part of the natural "nasal cycle".  When the septum is deviated to one side, the turbinate on the opposite side undergoes "compensatory hypertrophy", meaning it expands to take up the extra room.  Because this enlargement can fluctuate, these changes in airflow are detected by the patient as obstruction.  The deviated septum does not fluctuate, resulting in  fixed obstruction.  In other words, since the one side is always obstructed, the brain "doesn't know any better" in terms of the nasal airflow on the deviated septum side. 

How is a septal deviation repaired?

A septoplasty is a surgical procedure to straighten a deviated septum.  It typically involves making incisions inside the nose to access the bone and cartilage of the septum.  The surgery is performed in an outpatient setting and usually takes less than 1 hour.

What is the recovery like?

Postoperative pain is usually minimal.  Dr. Bridges does not place plastic splints inside the nose.  These splints, called "Doyle splints" have been proven to be unnecessary and only cause discomfort.  Usually only soft rolled nonstick gauze is placed in the nose after surgery that is removed the next day in the clinic.  Bleeding is usually minimal.  Patients can typically return to work in a few days.  The nose may be mildly congested for a week or two as the swelling resolves. 

Will I have black eyes or swelling on the outside of my nose?

There is usually no bruising or external swelling with a septoplasty.  For very severe septal deviations, rarely a rhinoplasty approach is necessary, resulting in some external swelling and bruising.