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What You Need to Know About the Nasal Septum

Although you have probably not given it much the thought, the nose is actually two organs divided into a right and left side by a structure called the nasal septum. The septum is more complicated than it appears, consisting of four fused bones and a piece of soft tissue cartilage. The nasal septum forms by the fusion of two of the largest of the four bones. One bone grows down from the top and the other grows up from the bottom of the nasal cavity. When the two bones meet, they stop growing (image left). If one or both bones continue to grow, the septum will bend or deviate to one side. Since growth rarely stops at the same time for both bones, about eighty per cent of normal people end up with a deviated or deflected septum. In some people an injury to the nose causes deviation. For the majority, a deviated septum causes no symptoms. The most common symptom of a deviated septum is nasal blockage. This frequently occurs on the side of deviation but can also occur on the opposite side. Obstruction is worsened by swelling of the lining of the nose by allergies, and intermittently by cold viruses. A markedly deviated septum can cause sinus infection by blocking drainage from the sinuses. It has also been linked to frequent nose bleeds. If the septum deflection is shaped into a bony spur, it can impinge the side wall of the nose causing headaches that can be confused with migraines. (image right) Consideration of surgical correction depends on the underlying symptoms. If nasal congestion is the primary problem, allergic evaluation and treatment should be optimized prior to considering repair. Many patients are disheartened to find surgery does not correct their symptoms when the underlying problem is allergies. If no allergies are present, an adhesive strip on the bridge of the nose (Breathe Right) is effective for many. If a deviated septum is causing chronic sinusitis, the septum must be repaired to relieve the obstructed sinuses. Unilateral headaches from a septal spur will also benefit from surgical repair. Cosmetic deformities must also be repaired surgically. If you have been told your symptoms are related to a deviated septum, be certain to have your allergies evaluated prior to considering surgery.