A deviated septum occurs when the wall of bone and cartilage between the nostrils, known as the septum, sits off center, narrowing one nasal passage side of the nose and reducing airflow through the nasal cavity.
Many people have some degree of nasal septum deviation and never notice it. Problems usually only start when the deviation is significant, or when swelling from allergies, colds, haze exposure, or air-conditioning dryness makes an already narrow passage feel entirely blocked. Thankfully, there are treatment options available from an ENT specialist, such as Dr Barrie Tan in Singapore.
Symptoms of nasal septum deviation are usually felt as an airflow imbalance. The most common symptoms are a blocked nose on one side, poor sleep quality, and recurrent nasal congestion that does not match the severity of a cold.
A normal nasal cycle can cause mild alternating stuffiness across the day. A deviated septum more often causes a persistent, predictable blockage on one side, especially at night and difficulty breathing. That’s one way to know if you have a deviated septum. Other common deviated septum symptoms include:
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If you believe you or a loved one has a deviated septum, contact us today so that we can start working on a plan towards better breathing.
Deviated septum sinusitis is frequently discussed, but a deviated septum alone does not automatically cause chronic sinus infections. Many with deviations never develop sinusitis or sinus infections, while others with septum deviations have sinus disease driven by allergies, polyps or environmental triggers.
As symptoms often overlap with those of allergic rhinitis, nasal septal deviation can be overlooked without a proper examination. A common symptom of blockage may be attributed to other causes. This is why accurate deviated septum diagnosis matters before deciding on deviated septum treatment or surgery.
You should see an ear, nose and throat (ENT) specialist when nasal blockage is persistent, one-sided, or affecting sleep, exercise, or daily function. Deviated septa in Singapore lead to many patients tolerating the pain and discomfort for years, seeking help only when sleep becomes fragmented or when congestion persists despite using nasal sprays.
An assessment with a specialist is recommended if you have a persistent one-sided blockage for weeks, frequent nosebleeds due to blood vessel irritation, worsening snoring, concerns about obstructive sleep apnea, disturbed sleep, suspected deviated septum or sinusitis, or difficulty tolerating CPAP because you cannot breathe comfortably through your nose.
It’s also worth a professional assessment if you have a history of nasal trauma or nose injuries, or if you have broken your nose, which has changed your breathing patterns.
A typical deviated septum diagnosis includes a detailed history covering blockage patterns, sleep quality, sinus symptoms, allergy triggers, past injuries, and current nose injuries.
An examination is performed with a nasal speculum and, where needed, a nasal endoscopy to assess deeper nasal passages structures in the nasal cavity. Imaging, such as a CT scan, is reserved for specific situations, usually when sinus disease or complex anatomy needs evaluation.
Diagnosis is crucial because it distinguishes structural narrowing from swelling-related blockage, which directly affects treatment decisions and determines if the deviated septum can be treated effectively.
Medications cannot straighten the septum, but non-surgical care can reduce swelling and significantly improve airflow when inflammation is a factor.
Deviated nasal septum treatment often begins with saline rinses, intranasal steroid sprays, and targeted allergy management. Short courses of decongestants may be used selectively. Medical treatment only helps manage symptoms and cannot physically correct the structural deviation.
When to See an ENT Specialist
Consult an ENT specialist for a deviated septum if symptoms like persistent nasal blockage, breathing difficulty (especially during exertion), frequent nosebleeds, chronic sinus infections, loud snoring, or sleep apnea significantly impact your daily life, indicating a need for professional evaluation and treatment.
Deviated nasal septum treatment is personalised and depends on whether symptoms arise from structure, inflammation, or both. If your symptoms don’t improve with medication, an operation might be needed to directly fix the blockage in your nose. That is why surgical intervention is sometimes necessary to correct a deviated septum.
Surgery may involve a septoplasty alone or a septoplasty combined with a turbinate reduction. Sometimes, a more extensive surgery called septorhinoplasty or reconstructive surgery is necessary if the outer shape of the nose is also contributing to breathing difficulties. Septoplasty improves airflow but does not cure allergies or chronic rhinitis, so ongoing medical management may still be required after surgery.
A septoplasty typically costs $6,500 or more. This does not include initial consultation, assessment fees or follow-up appointments.
A septoplasty is usually performed as a surgical procedure under general anaesthesia with incisions inside the nose, leaving no visible scars in most cases. Many patients undergo the procedure as day surgery or nasal surgery. Nasal splints or packs may be used temporarily, depending on the surgeon’s preference and the anatomy.
Deviated septum surgery is generally safe, but it carries recognised surgical risks and potential complications. These include bleeding, infection, septal perforation, adhesions, persistent blockage, changes in smell, temporary numbness of the upper teeth or lip, and, in rare cases, more serious issues.
Clear discussion of expectations, careful surgical technique, and structured follow-up are key to safe recovery and good outcomes. While most patients recover well, severe cases may require additional care. Using protective gear during contact sports in the long term can help prevent future injuries.
MBBS, MRCS (Edinburgh), MMed (Otorhinolaryngology), FAMS
Dr Barrie Tan is an ENT specialist at Gleneagles Hospital, Singapore, with more than 20 years of clinical and surgical experience. He previously served as Head of ENT and Director of the Centre for Hearing and Ear Implants at Singapore General Hospital. The information provided is not intended as medical advice. More about our medical experts.
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