What is the nasal septum? What is a deviated septum?

I. What is the septum?

The septum is a structure that separates the right from the left nasal cavity.

It is the “hardware” in the middle of the nose, made of cartilage and bone.

The “software” is the pink stuff, known as the mucous membrane.

Both of these together make the septum, with the two pink sides that sandwich the hardware in the middle. Think of it like three layers (right pink mucosa – thin cartilage / bony layer of strength – left pink mucosa).

It is not the thing that holds your eyeglasses up or that you see in the mirror, and it is not just the skin between the nostrils. Amazingly, it goes “way back”, past the level of the eyeball (aka the globes).

Many people wonder if their disco days of the 1970’s made them have a deviated septum. What they mean is a perforated septum. That means a hole in the septum, or some kind of gap between the left and right; a loss of tissue; or the lack of the “hardware and software”. There are several causes for that. But that is very different from a deviated septum.

The septum might be deviated in the front. It might be only in the back (i.e. the “posterior” part of the nose). It might have a “spur”, which is the special name given to a bony spicule of bone that protrudes into one side or the other.

How to repair the deviated septum?

Many people do well with nasal sprays and do not need to have surgery. Sprays, either daily or as needed, can give the relief from breathing problems thought to be from the deviated septum. If those do not work, a patient would typically need a CT scan, which is a special X-ray series to document and assess the severity of the deviation. Interestingly, some people have a deviation on CT that is not seen in the office and the other way around is possible as well: some people have a deviation on the nasal endoscopy (the scope) that does not show up on CT.

When all these criteria are met, the patient might benefit from nasal septoplasty. These days, we often do this right in the office which only takes several minutes and you can go home the same day without any nasal packing.

In some cases, the deviation is so far forward in the nostrils, includes some part of the bony outer part of the nose (the part that holds the glasses) or includes a perforation (a hole in the septum). In these cases, the patient would probably benefit from something called a septorhinoplasty. This is what Hollywood would call “a nose job”.

In the end, the deviated septum

  • is not to be feared

  • is common

  • might create no symptoms

  • can be documented via several techniques

  • might be helped with nasal sprays

  • can be cured.

Call hudsonENT at 845-758-1456 for an evaluation by Dr. Kortbus and staff. Thank you for visiting our website, reading our web-log, and putting your trust in Dr. Kortbus!

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