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July 9, 2026

Deviated Septum: What Causes a Crooked Nasal Septum?

A deviation is when the bone and cartilage that separates your nasal cavity (nostrils) have shifted from the center. The nasal septum is the tissue that separates the right and left sides of your nasal cavity. A perfectly straight nasal septum forms two equally sized nasal cavities.

Air flows freely through both.

But about 8 out of 10 people, most of us, have a nasal septum that is slightly off-center. Many people are not aware of this because they have no complaints.

But if there is a more pronounced deviation, it may be difficult for air to flow through your nose. This can make it difficult for you to breathe. It can make you more likely to experience nosebleeds and other problems.

 

Symptoms of nasal septum curvature

A severely curved septum can make your nose look off-center.

Other symptoms of a deviated septum may include:

Difficulty breathing through your nostrils (usually worse on one side)

Facial pain

Headache

Loss of smell

Nasal congestion

Noisy breathing

Nosebleeds

Snoring

 

Causes of deviated septum

You can be born with a deviated nasal septum. A difficult birth can damage your nasal septum. As your nose grows, so does your septum, and sometimes it can tilt more to one side. This is the most common cause of a deviated septum. Other causes include the nose

There are injuries such as fractures.

-Risk factors

Activities or events that lead to a nose injury increase your risk. Examples include:

Car accidents, contact sports, falls, fights, inhaling addictive substances through your nose

You can't avoid all risks. However, you can take precautions such as wearing a seat belt. You can use protective equipment (such as a mid-face mask and helmet) when playing contact sports.

 

Complications of this ailment (undesirables)

A small nasal septum deviation may not cause any problems. However, a severely deviated septum can cause problems such as:

Chronic sinusitis

Dry mouth

Nasal congestion

Sleep apnea

Prolonged or frequent ear infections (in children)

 

Diagnosis and Tests

How do doctors diagnose this condition?

Your doctor will examine your nose using a nasal speculum.

This tool gently opens your nostrils, allowing your doctor to see inside your nose. He will look at your septum to see if it affects the size of your nasal passages. You can also take tests that show tissue deeper in your nose

You may need, such as:

Computed tomography scan

Nasal endoscopy

 

Management and Treatment

Most people do not need treatment for a deviated septum because they have few or no symptoms. You can treat mild symptoms with medication. But if a deviated septum is preventing you from breathing properly, you may need surgery.

 

Medications

Mild deviated septum may cause occasional symptoms. These symptoms may not appear until you become ill. You can treat these symptoms with over-the-counter medications. These include:

Antihistamines

Nasal steroid sprays

Nasal openers

However, do not use nasal decongestant sprays for more than three days in a row. This can result in recurrent congestion.

 

Deviated septum surgery

The only way to correct a deviated septum is septoplasty. If you have breathing problems or other bothersome symptoms (complaints), this surgery may be an option. During septoplasty, the surgeon reshapes your septum.

If your child needs surgery, the surgeon may postpone septoplasty until his nose is fully grown (until about 17-18 years of age).

Sometimes septoplasty is performed in conjunction with rhinoplasty. This surgery reshapes your nose. It can help if you are unhappy with the way your nose looks.

 

When should I see a doctor?

If your complaints prevent you from breathing, disrupt your sleep, or negatively affect other aspects of your life, talk to an otolaryngologist.

 

Dr. Tuğçe Pütürgeli Özer

Ear, Nose and Throat Diseases Specialist

European Board Certified ENT Surgeon

 

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