PERSISTENT ONE-SIDED NASAL CONGESTION: COULD IT BE A DEVIATED SEPTUM?

Persistent nasal congestion, especially when it occurs on one side, difficulty breathing during sleep, or frequent mouth breathing can be associated with various underlying causes. Among them, a deviated nasal septum is a common structural abnormality that may significantly affect nasal airflow and breathing.

1. What is a deviated nasal septum?
The nasal septum is the structure located between the two nasal cavities. It is mainly made up of cartilage and bone and serves to separate the two sides of the nasal cavity.
A deviated nasal septum occurs when the septum is displaced from the midline. It may become curved, bent, or develop a septal spur that protrudes into the nasal cavity.

A deviated septum may result from:

Uneven development of the nasal structures.
Trauma to the nose from daily activities, sports, or accidents.

2. What symptoms can a deviated nasal septum cause?

When the deviation affects nasal airflow, symptoms may include:

Persistent or recurrent nasal congestion.
One side of the nose feeling more blocked than the other.
Snoring or the need to breathe through the mouth during sleep or physical activity.
Nasal dryness, crusting, or recurrent nosebleeds in some cases.
A feeling of pressure or heaviness around the nose or face.

However, these symptoms are not specific to a deviated nasal septum. Nasal congestion can also be associated with allergic rhinitis, chronic rhinitis, enlarged nasal turbinates, nasal polyps, or other nasal and sinus conditions.

3. Why can a deviated septum cause nasal congestion?

A deviated septum can narrow the nasal passage on one or both sides, affecting the normal flow of air through the nose.

In addition to structural factors, nasal congestion may become more pronounced when the patient also has:

• Allergic rhinitis.
• Chronic rhinitis.
• Swollen nasal mucosa.
• Enlarged nasal turbinates.
• Sinusitis or other nasal and sinus conditions.

Therefore, people with a similar degree of septal deviation may experience very different levels of symptoms.

4. Does a deviated septum always require treatment?

A deviated nasal septum is relatively common, and not every case requires intervention. If there are no symptoms or only mild symptoms that do not significantly affect daily activities or sleep, surgery may not be necessary.

Treatment decisions should be based on:

• The severity and location of the septal deviation.
• The degree of nasal airway obstruction.
• The patient’s actual symptoms.
• Other accompanying nasal conditions.

Therefore, you should not rely solely on imaging results or the appearance of a deviated septum to conclude that surgery is necessary.

5. How is a deviated nasal septum diagnosed?

An ENT specialist will combine the patient’s symptoms with a physical examination to determine the underlying cause of nasal congestion.

The evaluation may include:

Reviewing symptoms such as nasal congestion, breathing difficulties, snoring, and any history of nasal trauma.
Examination of the external and internal structures of the nose.
Nasal endoscopy to directly assess the nasal septum, turbinates, nasal mucosa, and areas that may be causing obstruction.
Evaluation for accompanying nasal and sinus conditions when necessary.
Sinus CT scan when clinically indicated.

6. Septoplasty

When a deviated nasal septum causes significant nasal airway obstruction and symptoms that affect quality of life, an ENT specialist may consider septoplasty.

In some cases, the doctor may also evaluate and treat other conditions at the same time, such as enlarged nasal turbinates or other nasal and sinus disorders, when clinically indicated.

7. When should you see an ENT specialist?

You should consider seeing an ENT specialist if you experience one or more of the following:

• Persistent or frequently recurring nasal congestion.
• Long-lasting congestion predominantly affecting one side of the nose.
• Difficulty breathing through the nose, especially during sleep or physical activity.
• Frequent mouth breathing.
• Persistent snoring.
• Recurrent nosebleeds or nasal dryness.
• Persistent or frequently recurring nasal and sinus symptoms.
• Nasal congestion that does not improve significantly despite treatment.

The appropriate treatment should be determined after an ENT specialist has examined and assessed your condition.

If you experience persistent nasal congestion, especially on one side, or difficulty breathing through your nose during sleep, consider seeing an ENT specialist to identify the underlying cause rather than continuing self-treatment for an extended period.