Should I have surgery for my deviated nasal septum?


A nasal septal deviation is not always the cause of nasal obstruction, and not always requires surgery. Check out this guest article written by Dr. Luciano Lobato Gregorio, an otolaryngologist certified by the Brazilian Association of Otolaryngology and Head and Neck Surgery, and clinical staff member at the Israelita Albert Einstein Hospital in São Paulo, SP.

Dr. Luciano-Lobato-Gregorio

A common question from patients is “Should I have surgery to correct my deviated nasal septum?”  Only sometimes is the answer yes. Nasal obstruction may be caused by many different factors other than septal deviation, such as enlarged turbinates (spongy expansible tissue inside the nose), and even significant nasal lesions, benign or malignant.

The nasal septum is part bone and part cartilage, and divides the nasal cavity into two parts. Imagine that the nose is a cave divided into two equal parts by a wall—this wall is the nasal septum.

Patients with a deviated septum often complain that there is less air coming into one of the nostrils. It is important to remember that there are also complex deviations—to both sides— that hinder the airflow in both nostrils. There are also other structures inside the nasal cavity that can cause obstruction, but in this post, we will focus on this central structure that generates so much controversy.

straight septum and deviated nasal septum

There is a saying that God does not make straight lines. And that law is no different for our nose. The nasal septum is often tortuous, and medical literature classifies septal deviations in a number of ways.

The anatomy of the septum is so complex that an easy classification to describe it is inadequate. Basically, it can be classified in degree (accentuated or not), location (anterior, posterior, superior or inferior) and type (bony or cartilaginous). However, what is most important is the discomfort that this tortuosity causes the patient. Since a septum is almost never completely straight, the patient and surgeon may opt for some type of treatment, which often involves surgery. And yes, there are patients with a deviated septum who do not even notice a nasal airway obstruction.

It is important to remember that for otolaryngologists, obstruction is not the only reason for that a patient would benefit from a septoplasty. Other reasons include a septal deviation associated with repeated episodes of sinusitis (on the same side as the deviation), some headaches (rare problem called Sluder’s, or rhinogenic headache), and to use septal cartilage for nasal plastic surgeries—move the cartilage for reconstruction and improvement of the nasal appearance.

Therefore, before you undergo surgery—even if you have been diagnosed with a deviated nasal septum—first see if the symptoms really bother you, and don’t forget the other possible causes for nasal obstruction. If the deviation is not the cause of your obstruction, an operation will not help, and you will continue with your nasal obstruction. Therefore, the evaluation by a qualified professional is so important; preferably a doctor certified by the Brazilian Association of Otolaryngology and Head and Neck Surgery (ABORLCCF).

To find a doctor, of any specialty, anywhere in Brazil, check out our website:

See also in ProcuraMed:

Gym noise may be harming your hearing. What you can do.

Sudden hearing loss: what you should know

Esta postagem também está disponível em: Portuguese (Brazil)

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