Deviated septum and blocked nose: is septoplasty worth it?

What the septum is

The septum is the wall of cartilage and bone that divides the inside of the nose into two sides. It is rarely perfectly straight. A bend may be there from birth or follow an injury, sometimes from childhood, a fight, a football or a road accident. It only matters if it blocks the airway enough to cause problems.

Signs the septum may be the cause

• A nose that is blocked all the time, often worse on one side, not just with colds
• Breathing through the mouth, especially at night, with a dry mouth on waking
• Snoring and poor sleep
• Trouble breathing through the nose during exercise
• Repeated sinus problems or nosebleeds on the same side

Try these first

A blocked nose has many causes, and a specialist will want to rule them out. Allergic or non-allergic rhinitis, swollen turbinates (the shelves inside the nose), nasal polyps and enlarged adenoids can all cause blockage.

• A steroid nasal spray used correctly every day for several weeks: head tilted slightly forward, nozzle pointed towards the outside of the nostril, not the septum
• Salt-water rinses
• Stopping decongestant sprays such as xylometazoline or oxymetazoline if you have used them for more than a week. Overuse makes the nose more blocked, not less
• Treating allergy, and reducing dust and smoke at home where you can

What septoplasty can and cannot do

The operation is done through the nostrils, usually under general anaesthetic. The surgeon lifts the lining, removes or reshapes the bent part, and lays the lining back. The swollen turbinates are often reduced at the same time. There is no cut on the outside, and the shape of the nose does not change.

For people with a clear bend that matches their symptoms, septoplasty usually improves nasal breathing. It will not cure allergy, it does not always stop snoring, and it will not help a blockage caused mainly by something else. If you also want the outside of the nose changed, that is a different operation, rhinoplasty, and some surgeons combine the two.

Recovery

Most people go home the same day or the next day. The nose feels blocked, sore and crusty for one to two weeks, and you may have soft splints or packs in for a few days. Most people take one to two weeks off work.

• Do not blow your nose hard for the first week or two; sneeze with your mouth open
• Use the salt-water rinses and any sprays you are given
• Avoid heavy lifting, bending and strenuous exercise for about two weeks
• Keep away from dusty sites, smoke and people with colds
• Go to hospital at once for heavy bleeding that does not stop with pressure, increasing swelling or pain, or a high fever

Common questions