What Doctor to See for a Deviated Septum? Who to See & What to Expect

If you suspect you have a deviated septum and have already done a self-test at home, your next step is to see a doctor.

But what type of doctor should you see for a deviated septum?

In this article we explain the medical professionals who specialize in deviated nasal septum, and what you can expect during the examination.

What Doctor Can Tell You If You Have a Deviated Septum?

The doctor who deals with deviated nasal septum is known as Otolaryngologist (or ENT specialist).

An Otolaryngologist is a Doctor of Medicine who specializes in disorders of the head and neck, mainly related to ears, nose, and throat. The word “oto-rhino-laryngology” comes from the Greek words – “oto” for ear, “rhino” for nose, and “larynx” for throat.

Otolaryngologists perform a variety of surgical procedures for the treatment of the ear, nose, sinuses, pharynx, larynx, oral cavity, neck, thyroid, salivary glands, bronchial tubes, and esophagus. They also deal with cosmetic surgery of the head and neck region.

An Otolaryngologist has ~13 years of university training which includes four years of medical school and five or more years of specialty training. Some of them additionally opt for 1-2 years of subspecialty training.¹Canadian Society of Otolaryngology - Head & Neck Surgery

Septoplasty Done by ENT or Plastic Surgeon?

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You might be wondering if it’s best to get your deviated septum surgery done by an ENT (Ear, Nose & Throat doctor) or a plastic surgeon.

The surgery involving the correction of a deviated septum is known as septoplasty. It is mostly performed by an Otolaryngologist (ENT specialist). ²Canadian Society of Otolaryngology - Head & Neck Surgery

Many Otolaryngologists are trained to conduct facial plastic surgeries which is one of the subspecialties of Otolaryngology. It includes reconstructing and re-shaping the nose, ears, jaws, and facial area to restore or enhance function and appearance. ³Canadian Society of Otolaryngology - Head & Neck Surgery

What to Expect During the Deviated Septum Examination?

The diagnosis of deviated septum involves gathering information from several sources:⁴Chandra RK, Patadia MO, Raviv J. Diagnosis of nasal airway obstruction. Otolaryngol Clin North Am. 2009;42(2):207-vii.

Patient’s complete history: This includes chief complaint, associated symptoms, medical history, use of medication, possible allergic triggers, and history of previous surgery (if any)
A physical examination of nose:

Inspection: This involves using an instrument to gently spread the nostrils along with use of light to examine the inside of the nose and septum. The inspection will focus on external support structures, followed by an assessment of internal support structures
Palpation: This involves the doctor touching the cartilaginous and bony part of the nose to check for alignment, irregularities, and tenderness

Nasal endoscopy: Nasal endoscope is used examine septum and adjacent structures of the sidewall of the nose. A thin, flexible tube with a tiny camera and light is inserted into the nose after spraying anesthesia
Imaging: Doctors may advise for X-rays, CT scans, or MRIs for an accurate three-dimensional diagnosis of a deviated septum. CT (Computed tomography) is used to evaluate structural or bony abnormalities such as a deviated septum, nasal bone fractures, and sinus disease. MRI is used for assessing the soft tissue of the nose

Additional diagnostic tests may be asked by the doctor to further confirm the septal deviation:

Acoustic rhinometry (AR): This test assesses the area and length of the nose and nasal cavity by measuring the auditory reflection of a sound signal⁵E W Fisher; V J Lund; G K Scadding."Acoustic rhinometry in rhinological practice: discussion paper". Journal of the Royal Society of Medicine. 1994,87 (7): 411–413.
Rhinomanometry (RMM): This test helps determine the respiratory function of the nose. It measures pressure and flows during normal inspiration and expiration through the nose⁶Aziz, T., Biron, V.L., Ansari, K. et al. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J of Otolaryngol - Head & Neck Surg.2014; 43,11.
Nasal spectral sound analysis (NSSA): This test provides an indirect method of dynamically assessing the nasal airflow by analyzing noise in the nasal cavity⁷Aziz, T., Biron, V.L., Ansari, K. et al. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J of Otolaryngol - Head & Neck Surg.2014; 43,11.

Once a septal deviation is diagnosed, medical therapy such as topical nasal steroids, antihistamines (antiallergic), and decongestants is recommended to the patient. If the medical therapy is not effective, a surgical procedure may be considered to correct the deviated septum.

Sources:

1
Canadian Society of Otolaryngology - Head & Neck Surgery
2
Canadian Society of Otolaryngology - Head & Neck Surgery
3
Chandra RK, Patadia MO, Raviv J. Diagnosis of nasal airway obstruction. Otolaryngol Clin North Am. 2009;42(2):207-vii.
4
E W Fisher; V J Lund; G K Scadding."Acoustic rhinometry in rhinological practice: discussion paper". Journal of the Royal Society of Medicine. 1994,87 (7): 411–413.
5
Aziz, T., Biron, V.L., Ansari, K. et al. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J of Otolaryngol - Head & Neck Surg.2014; 43,11.

What Doctor to See for a Deviated Septum? Who to See & What to Expect

What Doctor Can Tell You If You Have a Deviated Septum?

Septoplasty Done by ENT or Plastic Surgeon?

What to Expect During the Deviated Septum Examination?

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