Deviated Septum Surgery

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

August 10, 2020 by Marc Leave a Comment

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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.
  9. 9
    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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