In brief
A deviated septum is very common and should not be treated just because it is visible. It becomes relevant when it contributes to documented nasal obstruction; in that case, after the turbinates, rhinitis and nasal valve have also been assessed, septoplasty may be indicated.
A deviated nasal septum is a deformity of the bony and cartilaginous wall that separates the two sides of the nose. It is very common and should not be treated just because it is visible: it becomes clinically relevant when it contributes to nasal obstruction or other problems that can be documented.
What symptoms can it cause?
- persistent nasal blockage, on one or both sides;
- mouth breathing and difficulty breathing through the nose;
- worsening during sleep or physical activity;
- in some patients, recurrent nosebleeds when the deviation contributes to local turbulence and dryness.
A deviation can, however, be present without symptoms. Moreover, the septum is not the only cause of obstruction: turbinates, rhinitis, polyps and the nasal valve must be assessed in the same patient.
How is it diagnosed?
Diagnosis starts from the history and examination of the nasal cavities. Nasal endoscopy can be useful to assess the back of the septum and look for other causes of obstruction. A CT scan is not needed to diagnose every septal deviation: it is used when there are additional indications, for example coexisting sinus disease or surgical planning needs.
When is septoplasty considered?
Septoplasty aims to correct the parts of the septum that functionally impair airflow, while preserving the support of the nose. It may be considered when the obstruction attributable to the deviation is clinically significant and is not explained or resolved by medically treatable causes. In some cases it is combined with a procedure on the turbinates; the two indications, however, must be assessed separately.
Septoplasty and septorhinoplasty are not the same
Septoplasty works mainly on the septum, for functional purposes. Septorhinoplasty combines functional correction with changes to the external structure of the nose when needed. The choice depends on the anatomy and goals of each case.
Read more: blocked nose and nasal obstruction (in Italian) · septoturbinoplasty: before and after surgery (in Italian).
Key references
- American Academy of Otolaryngology–Head and Neck Surgery. Clinical Indicators: Septoplasty.
Author: Dr Puya Dehgani-Mobaraki. Last reviewed: September 2026. Information content: it does not replace a specialist assessment.