A deviated septum (blue) can result in nasal obstruction.

The septum is an important support structure of the nose. As the center wall that divides the nose into two separate chambers, it lends shape and support as well as aids in the regulation of airflow through the nose. While the air is in the nose, large particles are filtered out, and the air is warmed and humidified before moving to the lower airway.

While the septum is the center divider, the outer walls are turbinates, which are mucosa (internal skin) covering bone.

What can go wrong?
Developmental and traumatic deformities of the nasal septum are common. Deviation of the nasal septum can result in nasal obstruction, sinus disease, a crooked nose or other structural problems. If the septum is very crooked, it may block airflow on one or both sides of the nose. Likewise, the turbinates can be too big or poorly positioned and can block the nose.

Most patients with nasal obstruction caused by septum deviation have constant, one-sided nasal blockage. Often it results from previous nasal trauma, although septum deviation can be developmental in origin. Septum deviation should not be confused with intermittent nasal obstruction that alternates sides or nasal congestion brought on by certain foods or environmental irritants.

What can be done for a blocked or crooked nose?
First, medications can be used to treat allergies, swelling or infection. Often these are prescribed by your primary care physician. If medications fail to improve the airflow, an otolaryngologist specializing in ear, nose and throat diseases (ENT physician) may be consulted to assess the septum and turbinates and possibly review the sinuses. The ENT will perform a physical examination including inspection of the external nose and the entire nasal passage using a nasal speculum.

If the septum is crooked enough to cause blockage or the turbinates cause blockage, and if medicine fails to improve breathing, then surgery may be appropriate. Septoplasty is a surgical procedure performed to correct structural weakness or deformity of the nasal septum.

Surgery can be performed inside the nose with no external scars to straighten the septum (septoplasty) and reduce the turbinates (turbinoplasty). Normally the surgery is done as an outpatient procedure with general anesthesia. After surgery, packing or splints may be placed in the nose that later are removed. However, absorbable packing may be used that does not require removal.

Recovery occurs over a few days to a week, usually with mild pain and a stuffy nose, as normal swelling occurs following any surgery. Over a number of weeks, the nose gradually improves and a more functional nose -- and better breathing -- result.

Jeffrey Beall, MD, is an otolaryngologist whose medical practice specializes in treatment of the ear, nose and throat. His office is located in Suite 205 of Sparks Medical Building, 2385 E. Prater Way, Sparks. For more information or an appointment, please call 358-4007.

Northern Nevada Medical Center 2375 E. Prater Way, Sparks, NV 89434 775-331-7000