Deviated Nasal Septum: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Deviated Nasal Septum?
An ENT doctor, also called an otolaryngologist, is an ear, nose, and throat specialist who treats a deviated nasal septum. This doctor can also decide whether surgery is an option. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a deviated nasal septum?
The nasal septum is the bone and cartilage that divides the inside of the nose in half. Ideally, the left and right nasal passages are equal in size. A deviated septum is one that is off-center, and it may or may not cause symptoms. As many as 80 percent of people have a septum that is off-center.
The septum is covered by a mucous membrane, a thin lining that has many blood vessels in it.
Symptoms
The most common symptom of a badly crooked septum is trouble breathing through the nose, which is usually worse on one side.
- Trouble breathing through one or both nostrils.
- Nosebleeds.
- Sinus infections.
- Noisy breathing during sleep in infants and young children.
- Mouth-breathing during sleep in adults.
A crooked septum can get in the way of sinus drainage and cause repeated sinus infections. If the blockage is severe, it may force mouth-breathing at night, which can worsen sleep disorders. A septal spur headache is a headache caused by pressure from the septum on the linings inside the nose.
Causes and who gets it
An injury or trauma to the nose can make the septum crooked. However, people with normal growth and development, and no history of injury or a broken nose, can also have a deviated septum.
Related problems can include lower turbinates that get too big. Turbinates are finger-like structures in the nose that warm and moisten the air you breathe.
How doctors diagnose it
Your primary care provider or an ENT specialist will look at your symptoms and any known nose damage or surgeries. They will examine your nose inside and out. They might recommend more tests based on your needs. Surgery plans are usually based on your symptoms and a visual check of the septum.
Treatment
Treatment depends on how bad the symptoms are. Medical treatment can include a nasal steroid spray and a saline (salt water) spray. In one study, people with at least moderate nasal blockage tended to improve over time with medical treatment.
When the septum is clearly crooked and symptoms are severe enough, an ENT specialist may suggest surgery if medical treatment fails. Septoplasty is the preferred surgery to fix a deviated septum. It is usually done through the nostrils, so there is no bruising or outward sign of surgery. The operation averages about one to one and a half hours. It can be done with local or general anesthesia, usually as outpatient surgery. It is not typically done on young children unless the problem is severe, because the face is still growing. In a trial of adults, septoplasty helped nasal blockage and quality of life more than sprays did.
Risks of septoplasty can include:
- Problems from anesthesia.
- Bleeding or infection.
- A hole between the right and left sides of the nose, called a septal perforation.
- Numbness of the upper teeth and nose.
- A change in the outer shape of the nose.
When to see a doctor
Talk with your primary care provider or an ENT specialist if you have trouble breathing through your nose. A deviated septum can sometimes lead to repeated nosebleeds. Call 911 or go to the emergency room if bleeding will not stop.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can listen to your symptoms and look at your nose. They can also refer you to an ENT specialist if surgery may be needed.
Common questions
Does a deviated septum need surgery?
Not always. An ENT specialist may suggest surgery when symptoms are severe enough and medical treatment fails.
How common is a deviated septum?
It may be very common. It is estimated that as many as 80 percent of people have an off-center septum, and it may or may not cause symptoms.
Can a deviated septum cause nosebleeds?
Yes, it sometimes can. The septum is covered by a lining that has many blood vessels in it.
How long does septoplasty take?
Septoplasty takes about one to one and a half hours on average, depending on the type of deformity. It can be done with local or general anesthesia, usually on an outpatient basis.
Sources
- ENT Health - Deviated Septum
- MedlinePlus - Septoplasty series, Indications
- BMJ via PubMed Central - Septoplasty versus medical management for nasal airways obstruction
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
