Deviated Septum Surgery

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Deviated Septum and Sinus Infections: Cause, Diagnosis & Treatment

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In this complete guide we explain the connection between deviated septum and sinusitis (aka sinus infections), including the underlying connection, how can you tell if a deviated septum is the cause of your sinus problems, and how can you treat it.

Can a Deviated Septum Cause Sinus Infections?

A sinus can be defined as a cavity or hollow space in bone or other tissues. Sinuses are of many types and are found in different parts of the body.

The nose contains “paranasal” sinuses (air-filled spaces surrounding the nasal cavity) which are lined by respiratory mucosa (membrane). This membrane is responsible for secreting mucus1Anatomy, Head and Neck, Nose Sinuses.

Sinus infections, or sinusitis, is defined as inflammation of the nose and the paranasal sinuses, occurring with two or more of the following symptoms:

  • Blockage/congestion
  • Discharge
  • Loss of smell and symptoms lasting less than 12 weeks
  • Other symptoms including toothache, pain, and fever2Sinusitis and its management.

The impact of a deviation of the nasal septum on sinus infections or sinusitis is unknown. This is because the nasal septum deviation can occur with different patterns and severity, therefore researchers are not aware of how much and how often the occurrence of nasal septum deviation leads to sinusitis3CLASSIFICATION OF NASAL SEPTAL DEVIATIONS – RELATION TO SINONASAL PATHOLOGY.

Some researchers have tried to divide the type of defects of the nasal septum into different classes, and they have found some trends regarding the correlation of nasal septum defects with sinus infections. (The classes of nasal septum deviation include seven different types, which are part of a broader classification based on the plane of the deviation, horizontal and vertical.)4Correlation Study Between Nasal Septal Deviation and Rhinosinusitis

The researchers found the following results5Correlation Study Between Nasal Septal Deviation and Rhinosinusitis:

  1. 1
    Amongst horizontal deviations, type 4 deviation is most commonly associated with occurrence of sinusitis (see Figure 1 below for an image of type 4 deviation)
  2. 2
    Type 1 and 2 vertical deviations are linked to sinusitis because they occur in the nasal valve area
  3. 3
    Posterior (towards the back) deviations are more likely to develop sinus infections in comparison to anterior (towards the front) deviations

Figure 1.0: Different types of septal deviation. Type 7 is indicated to be a mixed type of septal deviation (middle)

Figure 2.0: indicates different parts of the nasal septum. A (anterior), B (middle) and C (posterior).

Will a Corrected Deviated Septum Stop My Sinus Infections?

Septoplasty is surgery that involves correction of a deviated septum to improve nasal function.

Nasal septum defects are one of the causes of sinusitis or sinus infections, because they can lead to inflammation and blockage of the nose and paranasal sinus.

A randomised study was performed to understand the effectiveness of septoplasty in improving symptoms of sinusitis in patients with significant septal deviation. Researchers found that septoplasty alone was significantly beneficial in improving symptoms of sinusitis as the success rates amongst the patients were 99.3%. These results suggest that septoplasty can be useful in  patients suffering with persistent sinus infections6Is Septoplasty Alone Adequate for the Treatment of Chronic Rhinosinusitis with Septal Deviation?.  

Other Sinusitis Treatments When You Have a Deviated Septum

If your sinus infections are caused by a deviated septum you should seriously look into having your septum corrected through septoplasty (also known as deviated septum surgery).

But if that’s not possible, here are some things you can do at home to reduce the septum’s impact on your sinus problems7Natural Treatment of Chronic Rhinosinusitis:

  1. 1
    Consuming Vitamin C rich foods: Vitamin C is also called ascorbic acid, and a reduction of vitamin C levels in blood is linked with increased histamine (a compound present in the body responsible for causing allergic reactions).

Consuming more vitamin C-rich foods such as citrus fruits, kiwi, mango, and vegetables such as broccoli, tomatoes, and peppers can be effective in preventing allergic problems relating to sinusitis8Vitamin C.

vitamin c

Figure 4.0: Shows different types of foods that contain high levels of vitamin C.

  1. 2
    Bromelain: Bromelain is a group of enzymes having anti-inflammatory properties (reducing inflammation) and mucolytic properties (making the mucous thin). It is commonly derived from pineapple fruit.

Several studies have shown that bromelain can be effective in reducing nasal inflammation and can provide a faster recovery from sinusitis. Moreover, Bromelain also provides relief from symptoms by thinning the mucous amongst those suffering from upper respiratory disorders such as sinusitis9Natural Treatment of Chronic Rhinosinusitis.

  1. 3
    N-acetyl cysteine supplement: Foods such as onion contain N-acetyl cysteine (45mg NAC per Kg). It is an antioxidant and a precursor of amino acids which form proteins. However, its effectiveness comes from its mucolytic activity. The mucous is broken down by N-acetyl cysteine into smaller and thinner units. This makes clearance of mucous through the nasal canal easier. It has been reported in some studies that this clearance can be improved by up to 35%. The typical adult dose is 600 to 1500 mg daily. It is a very safe supplement, even at very high dosage. However, you may experience some side effects such as nausea, vomiting and digestive problems10Natural Treatment of Chronic Rhinosinusitis.
  2. 4
    Saline nose drops: Using nasal drops not only cleanses the nose area but also removes mucous secretions.

Research recommends the use of 5% saline solution, instead of 3% or 0.9% solutions as it has been shown to be more effective to reduce histamine. In the research it was observed that people who used saline nose drops, reported improvement in their quality of life and minimal side effects. Furthermore, about 87% compliance rate was measured in one of the studies.

It is suggested that nasal drops should be used 1 to 3 times per day as they are an effective, simple and well tolerated method to control symptoms related to sinus infections11Natural Treatment of Chronic Rhinosinusitis.

Figure 5.0: shows the correct way of applying nasal drops (right) and the wrong way of applying nasal drops (left).

  1. 5
    Lifestyle changes: Improving air quality in households using high quality particulate air filtration reduces household mold levels and airborne fungi. People with sinus problems should limit their exposure to animal dander and dust mites. Furthermore, a study was able to find a relationship between natural gas use for cooking and upper respiratory disorders including sinusitis. Identifying and removing the sources of infection and allergens can help with decreasing recurrence of sinusitis12Natural Treatment of Chronic Rhinosinusitis.

Sources:

  1. 1
    Anatomy, Head and Neck, Nose Sinuses
  2. 2
    Sinusitis and its management 
  3. 3
    CLASSIFICATION OF NASAL SEPTAL DEVIATIONS – RELATION TO SINONASAL PATHOLOGY
  4. 4
    Correlation Study Between Nasal Septal Deviation and Rhinosinusitis.
  5. 5
    Is Septoplasty Alone Adequate for the Treatment of Chronic Rhinosinusitis with Septal Deviation?
  6. 6
    Natural Treatment of Chronic Rhinosinusitis. 
  7. 7
    Vitamin C.

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Deviated Septum and Sleep Apnea: Cause, Diagnosis & Treatment

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In this complete guide we explain the connection between deviated septum and sleep apnea:

  • What is the underlying connection between a deviated septum and sleep apnea?
  • How can you tell if a deviated septum is causing your sleep apnea?
  • How can you treat it?

Can a Deviated Septum Cause Sleep Apnea?

Sleep-related breathing disorders sit on a broad continuum, which ranges from simple or primary snoring at one end and obstructive sleep apnea at the other end.1The role of the nose in snoring and obstructive sleep apnoea: an update

Sleep apnea is usually defined as cessation (stoppage) of airflow into the lungs which lasts for more than 10 seconds. Obstructive sleep apnea is defined as a common disorder characterized by repetitive episodes of nocturnal (night time) breathing cessation due to upper airway failure. Obstructive sleep apnea is a serious condition because of its effects on cardiovascular outcomes.2Obstructive sleep apnoea syndrome and its management.

A deviated nasal septum is related to restricting the nasal airflow, which leads to causing nasal obstruction3The Reason of Dissatisfaction of Patient after Septoplasty. This becomes more critical when the patient lies down (supine), as it leads to increased nasal resistance and restricts the flow even further.4The role of the nose in snoring and obstructive sleep apnoea: an update

There can be other causes of sleep apnea, apart from a nasal septum defect. These include other structural abnormalities such as enlarged turbinates (small structures present in the nose) and nasal valve collapse, and inflammatory causes, including nasal polyps (abnormal tissue growth), sinusitis and rhinitis.5The role of the nose in snoring and obstructive sleep apnoea: an update

Certain factors, such as snoring, day-time sleepiness, poor quality of sleep and sleep disturbances, are all associated with sleep apnea.

Figure 1.0: Shows the differences between a normal (left) and blocked airway (right).

Will a Corrected Deviated Septum Help Sleep Apnea?

Nasal obstruction is one of the major signs that septoplasty (deviated septum surgery) is needed, and as nasal obstruction is related to symptoms such as sleep apnea, septoplasty should successfully improve symptoms related to sleep apnea and other sleep disturbances.

Several studies have been undertaken to understand the effects of septoplasty on sleep apnea. One such study found that parameters that measure sleep apnea such as apnea-hypopnea index (severity of sleep apnea), severity of obstructive sleep apnea syndrome, and mean oxygen saturation, all showed significant improvements. In addition to this, the sleep satisfaction scores of patients improved significantly as well6Clinical Effect of Surgical Correction for Nasal Pathology on the Treatment of Obstructive Sleep Apnea Syndrome..

Another study depicted similar results, with significant improvements in sleep quality, nasal obstruction, snoring and sleep apnea7​Effects of Functional Septoplasty in Obstructive Sleep Apnea Syndrome.

Other Sleep Apnea Treatments When You Have a Deviated Septum

If your sleep apnea is caused by a deviated septum we strongly recommend you look into having your septum corrected through deviated septum surgery (aka “septoplasty”).

But if it’s not possible for you to have septoplasty surgery soon, there are a number of things you can do at home to reduce the septum’s impact on your sleep apnea.

Here are our recommendations:

  1. 1
    Continuous positive airway pressure (CPAP): Continuous positive airway pressure is a type of therapy in which airflow is introduced into the airways to maintain a continuous pressure to allow the airways to open, while they are breathing at the same time.

CPAP has shown in hundreds of studies to improve measures of sleep apnea, and is considered the “gold standard” of obstructive sleep apnea treatment. Measures that have been improved by CPAP in studies include reducing apnea-hypopnea index (severity of sleep apnea), and sleepiness.

It has been suggested that patients who have moderate to severe sleep apnea should consider continuous positive airway pressure therapy as it has shown in many studies to benefit health, quality of life and workplace productivity8Diagnosis and treatment of obstructive sleep apnea in adults.

Figure 3.0: depicts a continuous positive airway pressure machine (left) being used by a patient.

  1. 2
    Oral Appliances: Patients who cannot use CPAP therapy and have mild to moderate sleep apnea can make use of oral appliances.

Oral appliances improve upper airway configuration and prevent collapse by changing the position of the jaw and tongue9Oral Appliance Treatment for Obstructive Sleep Apnea: An Update.

It has been shown in studies that these devices can enlarge the airway space. The best practice for oral appliance therapy involves fitting of the oral appliance by a dentist who has extensive experience and additional training in dental sleep medicine.

Research has shown that oral appliances can be as effective as continuous positive airway pressure therapy in patients with mild to moderate symptoms, and that these devices tend to provide better adherence in patients10Diagnosis and treatment of obstructive sleep apnea in adults.

Figure 4.0: shows oral appliance used to improve sleep apnea symptoms

  1. 3
    Lifestyle changes: The Canadian Thoracic Society guidelines recommend that patients with sleep disordered breathing should make changes to excessive alcohol consumption and sedative use11Diagnosis and treatment of obstructive sleep apnea in adults.

It has also been seen in research that exercise of modest intensity and weight loss by 10% of current weight in overweight and obese patients resulted in reductions in apnea-hypopnea index, hence, improving symptoms of sleep apnea12Diagnosis and treatment of obstructive sleep apnea in adults.

Some studies also suggested the use of dietary modification and implementing sleep hygiene, in order to reduce symptoms of sleep apnea13Lifestyle Modification for Obstructive Sleep Apnoea.

Sources:

  1. 1
    The role of the nose in snoring and obstructive sleep apnea: an update
  2. 2
    Obstructive sleep apnoea syndrome and its management.
  3. 3
    The Reason of Dissatisfaction of Patient after Septoplasty
  4. 4
    Clinical Effect of Surgical Correction for Nasal Pathology on the Treatment of Obstructive Sleep Apnea Syndrome.
  5. 5
    Oxygen Saturation.
  6. 6
    Effects of Functional Septoplasty in Obstructive Sleep Apnea Syndrome.
  7. 7
    Diagnosis and treatment of obstructive sleep apnea in adults.
  8. 8
    Oral Appliance Treatment for Obstructive Sleep Apnea: An Update.
  9. 9
    Lifestyle Modification for Obstructive Sleep Apnoea.

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Deviated Septum and Breathing Problems: Cause, Diagnosis & Treatment

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In this guide we explain the connection between deviated septum and breathing problems, including the underlying connection, how can you tell if a deviated septum is the cause of your breathing problems, and how can you treat it.

Table of Contents
1 Can a Deviated Septum Cause Breathing Problems?
2 Will a Corrected Deviated Septum Stop My Breathing Problems?
3 Deviated Septum Breathing Relief

Can a Deviated Septum Cause Breathing Problems?

Yes – in fact, one of the major consequences of having a nasal septum deviation is nasal obstruction.

Nasal breathing delivers approximately 70% of airflow to the lungs, but if the nasal airway is obstructed, airflow through the nose is limited and can have a significant impact on the day-to-day life of the patient.

A patient suffering from nasal obstruction may show signs of nasal congestion or stuffiness, nasal blockage, trouble breathing through the nose, trouble sleeping, and problems with breathing during exercise.

It has been shown in research that nasal obstruction can cause resistance during breathing and affect the airflow, which causes an imbalance between the pressure difference that is required between the atmosphere and the lungs during normal breathing.

There exists significant differences amongst individuals with nasal septum deviation and the extent of their nasal obstruction - however, it has been identified that the deflections that occur towards the anterior nose (at the front side) have a detrimental impact on the nasal valve and hence, cause severe obstruction of the nasal airflow in comparison to those that occur posteriorly (at the back side) and towards the middle of the nose.

Figure 1.0: A normal nasal septum is compared to a deviated nasal septum. Nasal airflow is limited due to the collapse of the nasal valve (bottom right).

It is important to note that nasal septum deviation is not the sole cause of nasal obstruction-related breathing problems. Mucosal inflammation, allergic rhinitis, rhinosinusitis, nasal polyposis and certain specific neural pathways can also cause nasal obstruction, and a correct diagnosis can only be performed by a medical expert.

Spirometry is an initial procedure that can sometimes be used to measure the movement pattern of the air during breathing and can estimate the level of nasal obstruction.

Figure 2.0: Depicts the procedure of the spirometry test.

Will a Corrected Deviated Septum Stop My Breathing Problems?

Several studies have been done to evaluate the effectiveness of septoplasty, which is a surgical procedure to correct a deviated septum. These studies compared the breathing competence of individuals before and after the surgery using spirometry values. The results from these studies indicate that septoplasty was extremely beneficial in improving breathing problems in patients with nasal septum deviation.

Nasal obstruction in patients with a deviated septum is one of the major reasons to consider a septoplasty. Septoplasty not only improves the airflow but can also correct breathing patterns, increase the capacity of air taken in during breathing, and improve deep breathing. In addition to this, some studies indicate lesser use of medication after the operation in patients suffering from asthma.  

Figure 3.0: Nasal passage is obstructed before the surgery (left) and is reconstructed which leads to more space for the nasal airflow (right).

Deviated Septum Breathing Relief

If your breathing problems are caused by a deviated septum, we recommend looking into having your septum corrected through deviated septum surgery (also known as “septoplasty”).

But if you can’t have septoplasty done soon, here are some things you can do at home to reduce the septum’s impact on your breathing problems:

  1. 1
    Use of medications: Although nasal obstruction can have various causes, the principal cause of nasal obstruction is inflammation. This inflammation may cause increased nasal secretions and tissue swelling. Both of these factors lead to nasal flow congestion and decreased airflow. Non-prescription drugs such as antihistamines, nasal decongestants and anti-inflammatory can be used to improve some symptoms of nasal obstruction and hence, can be beneficial in improving breathing.
  2. 2
    Using a heated humidifier device: This device makes use of a water reservoir and a breathing circuit to deliver molecular water vapor directly to the patient. It has been observed that using such a device can improve nasopharyngeal (involving nose and mouth) symptoms of patients with nasal disorders.

Figure 4.0: Shows how does and a heated humidifier looks and functions.

  1. 3
    Nasal breathing exercises: Nasal breathing exercises such as those performed during yoga have shown to improve symptoms involving inflammation, which in turn improves nasal airflow. In one study, two groups of patients with nasal obstruction were given the same treatment and one of the two groups was asked to perform nasal breathing exercises for three months. Results from this study indicated that the group that practiced nasal breathing received greater benefit in comparison to those who did not practice any nasal breathing exercises.

Figure 5.0: Shows a group of people performing Yoga involving nasal breathing exercise. This exercise involves taking a deep breath, followed by expiration from only one nostril and other nostril blocked by the means of a finger.

Sources:

  1. 1
    Improvement of Pulmonary Functions Following Septoplasty: How Are Lower Airways Affected?
  2. 2
    Pulmonary function improvement following septoplasty.
  3. 3
    What is Nasal airway obstruction?
  4. 4
    Nasal obstruction as a risk factor for sleep-disordered breathing. 
  5. 5
    Nasal Obstructions, Sleep, and Mental Function. 
  6. 6
    Nasal Obstruction.
  7. 7
    Epidemiology and burden of nasal congestion.
  8. 8
    Pathophysiology of nasal congestion.
  9. 9
    Diagnosis and Management of Nasal Congestion
  10. 10
    The effects of heated humidifier in continuous positive airway pressure titration.
  11. 11
    Nasal Breathing Exercise and its Effect on Symptoms of Allergic Rhinitis.
  12. 12
    Treatment of Congestion in Upper Respiratory Diseases.
  13. 13
    The Reason of Dissatisfaction of Patient after Septoplasty.
  14. 14
    Role of Spirometry in Detection of Nasal Obstruction

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Deviated Septum Treatment: Types of Surgery, Natural Home Remedies & More…

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Deviated Septum and Sinus Infections: Cause, Diagnosis & Treatment

Deviated Septum Side Effects: Can a Deviated Septum Cause…?

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In this comprehensive guide, we answer the question “What problems can a deviated septum cause?”

We cover all of the known side effects of a deviated septum, along with links to supporting studies - everything from a deviated septum’s effect on sleep, snoring, breathing problems, allergies, and much more. In plain English!

Let’s jump in…

Quick Navigation
Does a Deviated Septum Affect Sleep?
Can a Deviated Septum Cause Sleep Apnea?
Can a Deviated Septum Cause Snoring?
Can a Deviated Septum Cause Sinus Infection?
Can a Deviated Septum Cause Nasal Drip?
Can a Deviated Septum Cause Nose Bleed?
Can a Deviated Septum Cause Breathing Problems?
Can a Deviated Septum Cause Headaches?
Can a Deviated Septum Cause Allergies?
Can a Deviated Septum Cause Anxiety?
Can a Deviated Septum Cause Heart Problems?
Can a Deviated Septum Cause Fatigue?
Can a Deviated Septum Cause Mucus in the Throat?
Can a Deviated Septum Cause Eye Problems?
Can a Deviated Septum Cause Vertigo?
Can a Deviated Septum Cause Ear Problems?
Can a Deviated Septum Cause Dizziness?

Does a Deviated Septum Affect Sleep?

Yes, the presence of deviated septum can affect sleep quality. 

About 80% of people have some degree of a deviated nasal septum. While most cases do not show symptoms (they are “asymptomatic”, in medical lingo) some people may experience difficulty in breathing due to nasal obstruction. 

Nasal septum deviation is a common cause of long-lasting nasal obstruction. In some patients, sleeping on their back can move the tongue to the back of the throat, causing further narrowing of the airway. So, the obstruction of air passage due to deviated septum may contribute to sleep disturbances and reduce sleep quality.1Michels Dde S, Rodrigues Ada M, Nakanishi M, Sampaio AL, Venosa AR. Nasal involvement in obstructive sleep apnea syndrome. Int J Otolaryngol. 2014;2014:717419.

Can a Deviated Septum Cause Sleep Apnea?

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While deviated septum does not directly cause sleep apnea, the presence of deviated septum can worsen sleep apnea.

The nasal airway is the preferred route of respiration while we are awake and during sleep. Nasal obstruction, either partial or complete, can cause snoring and obstructive sleep apnea.2OLSEN, K. D., & KERN, E. B. (1990). Nasal Influences on Snoring and Obstructive Sleep Apnea. Mayo Clinic Proceedings, 65(8), 1095–1105.

Obstruction of the nasal passages due to deviated septum may produce more disturbance during sleep. In 2-4% of people, loud snoring can be associated with a more serious disorder called sleep apnea in which breathing is completely obstructed. The obstruction may last for more than 10 seconds causing the individual to wake up and start breathing again.3OLSEN, K. D., & KERN, E. B. (1990). Nasal Influences on Snoring and Obstructive Sleep Apnea. Mayo Clinic Proceedings, 65(8), 1095–1105. 

However, apnea is primarily caused due to reasons such as excess weight, smoking, alcohol consumption, family history, craniofacial abnormalities (related to the head and face). 

A doctor can help assess the primary cause of through an examination.4Rappai M, Collop N, Kemp S, deShazo R. The nose and sleep-disordered breathing: what we know and what we do not know. Chest. 2003;124(6):2309‐2323).

Can a Deviated Septum Cause Snoring?

Yes, a deviated nasal septum can cause snoring.

The presence of a deviated nasal septum narrows either of the nostrils and, in some cases, obstructs breathing.

As the body tries to inhale regular amounts of air from a narrowed passage, sounds or vibrations are produced. The effect is more prominent during sleep, causing snoring.5Georgalas, Christos. “The role of the nose in snoring and obstructive sleep apnea: an update.” European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery vol. 268,9 (2011): 1365-73.

Can a Deviated Septum Cause Sinus Infection?

Sinuses are air-filled spaces present on the facial bones around your nose.

There are four pairs of sinuses present. The linings (inner skin) on these sinuses secrete a slimy substance called mucus, which traps foreign particles and drains them out through the throat after mixing with saliva.

This entire cleansing process defends against unwanted foreign particles (which is called “mucociliary clearance”) and aids in maintaining healthy sinuses.6Prasad S, Varshney S, Bist SS, Mishra S, Kabdwal N. Correlation study between nasal septal deviation and rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2013;65(4):363-366.

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Sometimes a deviated septum narrows the drainage channel of the sinus and interferes with sinus ventilation and drainage, thereby increasing mucus accumulation and bacterial activity, increasing the chances of sinus infection.7Prasad S, Varshney S, Bist SS, Mishra S, Kabdwal N. Correlation study between nasal septal deviation and rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2013;65(4):363-366.

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Research suggests that a nasal septal deviation obstructs the normal pathways of mucociliary transport (draining of mucus embedded with foreign particles), increasing the chances of inflammatory sinus disease.8Gregurić T, Baudoin T, Tomljenović D, Grgić M, Štefanović M, Kalogjera L. Relationship between nasal septal deformity, symptoms and disease severity in chronic rhinosinusitis. Eur Arch Otorhinolaryngol. 2016;273(3):671-677.

Can a Deviated Septum Cause Nasal Drip?

The nasal and sinus mucosa (inner lining of nose and sinus) produces approximately one liter of mucus every day.

The regular functioning of the body ensures that mucus produced by the paranasal sinuses and nasal cavity is transported into the throat and is eventually swallowed.9Lubbe, Darlene. (2014). An approach to the patient with a post-nasal drip and rhinosinusitis. South African Family Practice. 51. 376-380.

Usually, mucus is thin in consistency and drips harmlessly down the back of your throat, mixed with saliva. But a deviated septum can delay the flow and cause the mucus to build up and thicken. The patient may become aware of the presence of a mucus, dripping down the back of the nose or accumulating in the throat (also known as postnasal drip or phlegm).10Lubbe, Darlene. (2014). An approach to the patient with a post-nasal drip and rhinosinusitis. South African Family Practice. 51. 376-380.

Can a Deviated Septum Cause Nose Bleed?

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Yes, a deviated septum can cause bleeding of the nose (epistaxis).

In some cases, deviated septum causes a nasal blockage which leads to a disruption of airflow. The resulting obstructed flow of air causes dryness of the skin of the septa and enlargement of blood vessels in the nose. Breaking of these vessels leads to nose bleeding. 

Sometimes crusts are formed due to drying of the nose. While blowing the nose, these crusts wear off, inducing bleeding.11Fatakia A, Winters R, Amedee RG. Epistaxis: a common problem. Ochsner J. 2010;10(3):176-178.

Can a Deviated Septum Cause Breathing Problems?

In some cases of a deviated septum, a complete or partial nasal blockage occurs. This can lead to reduced nasal airflow and difficulty in breathing. The presence of conditions such as rhinitis (inflammation of inner skin of nose) due to allergy or infection can further amplify the effect and cause difficulty in breathing.12Fettman N, Sanford T, Sindwani R. Surgical management of the deviated septum: techniques in septoplasty. Otolaryngol Clin North Am. 2009;42(2):241-viii.

Can a Deviated Septum Cause Headaches?

Yes, a deviated nasal septum is associated with headaches.

The presence of a deviated nasal septum may cause blockage of the sinus opening. This could lead to accumulation of mucus and the build-up of pressure within the sinus. An increase in the pressure and poor ventilation of the sinuses results in occasional headaches.13Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-406.

It is also believed that when mucosa (inner skin) of the sidewall of the nose comes in contact with the deviated nasal septum, nerve receptors present on the nasal mucosa (inner skin of nose) release chemicals (“substance “P) which are responsible for causing a headache.14Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-406.

Can a Deviated Septum Cause Allergies?

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A deviated septum doesn’t directly cause allergies. But the presence of allergies and exposure to irritants in the air can cause excessive swelling of the mucosal lining of the nose. This can block nasal breathing. Presence of deviated septum can worsen these symptoms and increase the discomfort.15Gulec, T.C., Yoruk, O., Gulec, M. et al. Benefits of submucous resection on sleep quality, daytime and dream anxiety in patients with nasal septal deviation. Sleep Biol. Rhythms 11, 227–236 (2013)

Approximately 50% of all cases of rhinitis (inflammation of the inner skin of the nose) are caused by an allergy.

Allergic rhinitis is a mixed disorder characterized by one or more of the following nasal symptoms: sneezing, itching, runny nose, and/or nasal congestion. It is often accompanied by symptoms involving the eyes, ears, and throat, including postnasal drainage (thickened mucus running down the throat).16Akhouri S, House SA. Allergic Rhinitis. [Updated 2020 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan

Can a Deviated Septum Cause Anxiety?

The primary symptoms of septal deviation include nasal obstruction, headache, and a reduced sense of smell. But research also suggests that these primary symptoms can have a huge impact on a patient’s quality of life due to difficulty in breathing, disturbed sleep, and loss of productivity. This could increase the occurrence of psychological distress such as depression and anxiety.

Studies have also reported an association between allergic rhinitis and anxiety levels.17Ma Q, Su K, Fu Z, Wang P, Shi H. Anxiety and depression in patients with nasal septal deviation. Am J Otolaryngol. 2020;41(3):102450.

Can a Deviated Septum Cause Heart Problems?

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Deviated nasal septum with nasal obstruction affects the body as a whole. Nasal obstruction disrupts the ventilation of the lungs by obstructing airflow. This reduces the supply of oxygen in the lungs and causes an increased respiratory and heart rate. 

An increased respiratory rate does not allow sufficient functioning of the lungs. This can lead to hypoxia (decrease oxygen) and hypercapnia (increased carbon dioxide).

All these factors may affect the autonomic nervous system (which controls breathing, heart rate, and blood pressure) and can impact its normal functioning. As a result, deviated nasal septum patients may be prone to several respiratory and cardiovascular disorders.18Smitha SG, Jagannath B, Mathew AS. Impact of Septal Correction on the Blood Pressure of Hypertensive Patients with Deviated Nasal Septum. Indian J Otolaryngol Head Neck Surg. 2016;68(1):46-51. doi:10.1007/s12070-015-0840-9

Can a Deviated Septum Cause Fatigue?

The presence of deviated septum obstructs the airway and can lead to difficulty in breathing. In some, this can be associated with snoring and may aggravate conditions like obstructive sleep apnea.19Georgalas, Christos. “The role of the nose in snoring and obstructive sleep apnoea: an update.” European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery vol. 268,9 (2011): 1365-73.

In obstructive sleep apnea, there is a full or partial blockage of breathing pathways with the cessation of airflow into the lungs which lasts for more than 10 seconds, causing the individual to wake up and start breathing again.20Georgalas, Christos. “The role of the nose in snoring and obstructive sleep apnoea: an update.” European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery vol. 268,9 (2011): 1365-73.

Due to repeated arousals associated with sleep apnea, daytime wakefulness, mood, and alertness are compromised. Sleep disruption, even without sleep loss, can cause daytime drowsiness, fatigue, and irritability.21Georgalas, Christos. “The role of the nose in snoring and obstructive sleep apnoea: an update.” European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery vol. 268,9 (2011): 1365-73.

Can a Deviated Septum Cause Mucus in the Throat?

Yes, a deviated septum can cause mucus in the throat.

Nasal mucociliary clearance is a fundamental defense mechanism of the nose, in which germs entering the nose and sinuses are trapped in the mucus (a slimy substance produced by inner lining) and cleared from the airway. This is required to maintain the health of the nose and sinuses.

However, deviated septum in some patients alters the airflow in the nasal cavity and weakens the mucociliary clearance in nasal and sinus mucosa. This leads to the accumulation and thickening of mucus which flows from the back of the nose into the throat.22Proctor DF, Adams GK 3rd. Physiology and pharmacology of nasal function and mucus secretion. Pharmacol Ther B. 1976;2(3):493-509

Can a Deviated Septum Cause Eye Problems?

No, a deviated septum doesn’t cause any eye problems.

However, in the case of sinus infection, the sinuses swell up and the nose becomes congested and gets filled with mucus. Due to the physical proximity of the sinus, patients may experience pain in and around the eye. One can feel the pressure in the upper part of the face, including behind the eyes.23Baroody FM. How nasal function influences the eyes, ears, sinuses, and lungs. Proc Am Thorac Soc. 2011;8(1):53-61.

Can a Deviated Septum Cause Vertigo?

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Vertigo is characterized by the feeling of the head-spinning or things spinning around you, along with dizziness.

The primary cause of vertigo symptoms is unknown, but cases are thought to be associated with head and neck trauma, migraine, inner-ear infection, and surgery.24Low WK, Willatt DJ. The relationship between middle ear pressure and deviated nasal septum. Clin Otolaryngol Allied Sci. 1993;18(4):308-310.

Deviated septum doesn’t cause vertigo. But a few studies suggest that surgical procedures involving correction of the deformed nose or a deviated septum (Septorhinoplasty) are associated with vertigo. It is primarily triggered by sudden changes in the head’s position. It is considered to be one of the possible early post-operative complications of Septorhinoplasty. However, the occurrence of such complications is rare.25Koc EA, Koc B, Eryaman E, Ozluoglu LN. Benign paroxysmal positional vertigo following septorhinoplasty. J Craniofac Surg. 2013;24(1):e89-e90.

Can a Deviated Septum Cause Ear Problems?

Patients with a deviated nasal septum may have middle ear disorders, particularly in the ear on the same side of the obstructed nasal passage.26Low WK, Willatt DJ. The relationship between middle ear pressure and deviated nasal septum. Clin Otolaryngol Allied Sci. 1993;18(4):308-310.

The Eustachian Tube (ET) is a tube that connects the middle ear cavity and the nasopharynx (throat) and provides middle ear ventilation. A functional ET is crucial for balancing the middle ear pressure.27Kaya M, Dağlı E, Kırat S. Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?. Turk Arch Otorhinolaryngol. 2018;56(2):102-105

Nasal septum deviation is the most frequent cause of nasal obstruction, and it may harm middle ear ventilation. Insufficient ventilation is an important cause of middle ear inflammatory diseases. Nose, sinus, and nasopharyngeal diseases and nasal obstructions can also impair the ET functions.28Kaya M, Dağlı E, Kırat S. Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?. Turk Arch Otorhinolaryngol. 2018;56(2):102-105

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Can a Deviated Septum Cause Dizziness?

Dizziness means the feeling of light-headedness. In some cases, the presence of nasal obstruction due to deviated septum can block eustachian tube functions. This leads to an inability to equalize pressure in the middle ear and maintain balance in your body, causing dizziness.

Middle-ear disturbances can also cause dizziness in those suffering from allergies, colds, and sinus infections.29Kaya M, Dağlı E, Kırat S. Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?. Turk Arch Otorhinolaryngol. 2018;56(2):102-105

Sources:

  1. 1
    Georgalas, Christos. “The role of the nose in snoring and obstructive sleep apnoea: an update.” European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery vol. 268,9 (2011): 1365-73.
  2. 2
    (Rappai M, Collop N, Kemp S, deShazo R. The nose and sleep-disordered breathing: what we know and what we do not know. Chest. 2003;124(6):2309‐2323).
  3. 3
    Mekhitarian Neto L, Fava AS, Lopes HC, Stamm A. Epidemiological analysis of structural alterations of the nasal cavity associated with obstructive sleep apnea syndrome (OSA). Braz J Otorhinolaryngol. 2005;71(4):464‐466.
  4. 4
    Bugten, V., Nilsen, A.H., Thorstensen, W.M. et al. Quality of life and symptoms before and after nasal septoplasty compared with healthy individuals. BMC Ear Nose Throat Disord.2016;16:13
  5. 5
    Ertugay CK, Toros SZ, Karaca CT, et al. Is septoplasty effective on habitual snoring in patients with nasal obstruction? Eur Arch Otorhinolaryngol. 2015;272(7):1687‐1691.
  6. 6
    Kohler M, Bloch KE, Stradling JR. The role of the nose in the pathogenesis of obstructive sleep apnoea and snoring. Eur Respir J. 2007;30(6):1208‐1215.
  7. 7
    Kiyohara N, Badger C, Tjoa T, Wong B. A comparison of over-the-counter mechanical nasal dilators: a systematic review. JAMA Facial Plast Surg. 2016 June 30
  8. 8
    Chen, Wen-Chyuan et al. “Treatment of snoring with positional therapy in patients with positional obstructive sleep apnea syndrome.” Scientific reports vol. 5 18188. 11 Dec. 2015.
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    Ramar, Kannan et al. “Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine vol. 11,7 773-827. 15 Jul. 2015

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Deviated Septum and Headaches: Cause, Diagnosis & Treatment

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In this complete guide we answer the question “Can a deviated septum cause headache?” (short answer: yes), and we also explain:

  • The connection between a deviated septum and headaches or migraines; and
  • Treatments for headaches caused by a deviated septum
Quick Navigation
​Can a Deviated Septum Cause Headaches (or Migraines)?
​Can Fixing Deviated Septum Help Migraines (and Headaches)?
​Alternative Remedies for Deviated Septum & Headaches?

​Can a Deviated Septum Cause Headaches (or Migraines)?

Yes, the presence of deviated septum can cause headaches.

The deviated nasal septum may cause blockage of the sinus opening (which aids in the drainage of mucus). This could lead to the accumulation of mucus (a slimy substance produced by the inner lining of nose and sinus) and the built-up of pressure within the sinuses. An increase in pressure and reduced oxygen supply due to poor ventilation of the sinuses (hypoxia) causes headache and facial pain in the region of the affected sinuses.1Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-406.

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However, some patients with a deviated septum and no apparent nasal symptoms experience migraine-type headaches. This is also known as a contact point headache.

This occurs when the inner skin (mucosa) of structures present on the sidewall of the nose comes in contact with the deviated nasal septum. The mucosal contacts stimulate nerve receptors present on the nasal mucosa (inner skin of nose) and release chemicals (e.g., substance P) which transmit pain and cause migraine-like headache.2Kwon SH, Lee EJ, Yeo CD, et al. Is septal deviation associated with headache?: A nationwide 10-year follow-up cohort study. Medicine (Baltimore). 2020;99(20).

​Can Fixing Deviated Septum Help Migraines (and Headaches)?

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Fixing deviated septum is considered one of the possible treatments to relieve headaches, but not a definitive treatment.

Headaches are usually caused by multiple factors. Research suggests that headaches can be classified into the following groups:

  • One where headaches are caused by sinus problems or infections
  • One where headaches are related to causes other than sinus such as seasonal allergies, migraine, nerve pain, or vascular problems
  • One where cause is unknown

It may be challenging for the otolaryngologist (ENT doctor) to identify the origin of headaches.

In cases where the cause is unknown, the headache could be related to contact point headaches. In such cases, correction of the deviated septum and that of the structural abnormalities on the sidewall of the nose is important. This helps avoid mucosal contacts and subsequent headache.3Tosun F, Gerek M, Ozkaptan Y. Nasal surgery for contact point headaches. Headache. 2000 Mar;40(3):237-240. DOI: 10.1046/j.1526-4610.2000.00034.x.

In cases with abnormalities related to nose and sinus, septoplasty (deviated septum surgery) is sufficient to relieve the symptoms of the sinus infection.4Bayiz U, Dursun E, Islam A, et al. Is septoplasty alone adequate for the treatment of chronic rhinosinusitis with septal deviation?. Am J Rhinol. 2005;19(6):612-616

Complete history taking, preoperative evaluations, multidisciplinary consultations, initial medical therapy, long observations, are essential steps for the correct diagnosis of the cause and better surgical outcomes.5Huang HH, Lee TJ, Huang CC, Chang PH, Huang SF. Non-sinusitis-related rhinogenous headache: a ten-year experience. Am J Otolaryngol. 2008;29(5):326-332.

​Alternative Remedies for Deviated Septum & Headaches?

If your headaches are caused by a deviated septum, but you’re unable to get septoplasty surgery (also known as deviated septum surgery), here are some things you can do at home to help reduce your headaches:

  • Medical therapy
  • If the headache is caused by sinus infection, it may be treated medically with nasal decongestants and steroid sprays. In cases of allergic sources, antihistamines (or anti-allergics) can be prescribed. The doctor may also prescribe antibiotics. Medicines such as Triptan (serotonin) are known to lessen migraine-type headaches.6Evans, K. L. (1998). Recognition and Management of Sinusitis. Drugs, 56(1), 59–71.
  • Inhalation of steam twice daily helps in clearing mucus accumulation and moistens the dried nasal mucosa (inner lining).7Evans, K. L. (1998). Recognition and Management of Sinusitis. Drugs, 56(1), 59–71.
  • The use of saline (salt water) irrigation or flushing of nose helps in mucociliary clearance (draining of mucus embedded with foreign particles), which eases congestion.8Egan M, Hickner J. Saline irrigation spells relief for sinusitis sufferers. J Fam Pract. 2009;58(1):29-32

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  • Acupressure techniques may provide relief by massaging one or more acupressure points for 1-2 minutes.
  • Joining of valleys: Massaging the point in the space between the thumb and the index finger can reduce headache.9Hendrich, S., Kahanov, L., & Eberman, L. E. (2011). Acupressure for Tension Headache. International Journal of Athletic Therapy and Training, 16(3), 37–40.
  • Gates of consciousness: Massaging at the base of the skull above the nape of the neck
  • Temporal region: Massaging the center of the temporal region, or temple
  • Mind-Body Techniques
  • Biofeedback: This process allows patients to gain greater awareness and control over their body by using electronic or other instruments, with the goal of being able to manipulate all the body's systems at will.The patient is asked to control bodily processes that are involuntary, such as muscle tension, blood pressure, or heart rate by observing these metrics. This allows many patients to reduce their stress levels, resulting in fewer headaches.10Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
  • Yoga: Yoga is another form of mind-body therapy. This includes physical exercise with breathing and relaxation. This may help individuals to deal with the emotional aspects of chronic pain.11John PJ, Sharma N, Sharma CM, Kankane A. Effectiveness of yoga therapy in the treatment of migraine without aura: a randomized controlled trial. Headache. 2007;47(5):654-661. You can learn more from the video below.
  • Regular and frequent aerobic and neck stretching exercises can help decrease headaches.12Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
  • Dietary approaches
  • Skipping meals and intake of some food additives and sugar substitutes may induce headaches. In those cases, a more regular and balanced diet is likely to help13Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
  • Research suggests that reduced magnesium levels in the body can aggravate headaches. So, the inclusion of a magnesium-rich foods (Black-eyed peas, soy nuts, cooked beans, tofu, almonds, cashews, flaxseed) can help. Riboflavin or vitamin B2 (found in milk, cheese, eggs, leaf vegetables, liver, kidneys, lean meats, and legumes) are also effective in relieving headaches14Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
  • Not drinking enough water is a well-known migraine and headache trigger, and it is advisable to increase the frequency of your water intake15Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
  • Herbal approaches
  • Intake of herbs such as Feverfew (Tanaceturn parthenium), Butterbur root (Petasites hybridus), Guarana (Paullinia cupana) and Ginger (Zingiber oficinale), Gingko (Gingko biloba), and Valerian root (Valeriana oficinalis) may help some patients with headaches16Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
  • External application of peppermint extract and eucalyptus have relaxing effects. Aroma of lavender oil and clove can also help reduce headache17Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.

Sources:

  1. 1
    Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-406.
  2. 2
    Kwon SH, Lee EJ, Yeo CD, et al. Is septal deviation associated with headache?: A nationwide 10-year follow-up cohort study. Medicine (Baltimore). 2020;99(20).
  3. 3
    Tosun F, Gerek M, Ozkaptan Y. Nasal surgery for contact point headaches. Headache. 2000 Mar;40(3):237-240. DOI: 10.1046/j.1526-4610.2000.00034.x.
  4. 4
    Bayiz U, Dursun E, Islam A, et al. Is septoplasty alone adequate for the treatment of chronic rhinosinusitis with septal deviation?. Am J Rhinol. 2005;19(6):612-616.
  5. 5
    Huang HH, Lee TJ, Huang CC, Chang PH, Huang SF. Non-sinusitis-related rhinogenous headache: a ten-year experience. Am J Otolaryngol. 2008;29(5):326-332.
  6. 6
    Evans, K. L. (1998). Recognition and Management of Sinusitis. Drugs, 56(1), 59–71.
  7. 7
    Egan M, Hickner J. Saline irrigation spells relief for sinusitis sufferers. J Fam Pract. 2009;58(1):29-32
  8. 8
    Hendrich, S., Kahanov, L., & Eberman, L. E. (2011). Acupressure for Tension Headache. International Journal of Athletic Therapy and Training, 16(3), 37–40.
  9. 9
    Mauskop, A. (2001). ALTERNATIVE THERAPIES IN HEADACHE. Medical Clinics of North America, 85(4), 1077–1084.
  10. 10
    John PJ, Sharma N, Sharma CM, Kankane A. Effectiveness of yoga therapy in the treatment of migraine without aura: a randomized controlled trial. Headache. 2007;47(5):654-661.

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