The nasal septum is the wall between the left and right nostrils, separating the two nasal passages or airways. It is made of thin bone in the back and cartilage in the front, supporting the nose and directing airflow. When the cartilage or bone is not straight, the septum is said to be deviated. Having some deviation of the septum is common. The septum can be deviated at birth (congenital), can bend to one side or another as a part of normal growth during childhood, and can also be bent due to injury.
A crooked septum can make breathing difficult, and can also lead to snoring and sleep apnea. When a deviated septum is severe, it can block one side of the nose and reduce airflow, causing difficulty breathing through one or both nasal passages, and sometimes leading to recurrent sinus infections. Individuals with a deviated septum are also more prone to nosebleeds.
Surgery to correct a deviated nasal septum is called septoplasty, submucous resection of the septum, or septal reconstruction. During the procedure, the septum is straightened and repositioned in the middle of the nose, which may require trimming, repositioning and replacing cartilage, bone or both (inside the nose). Turbinates, or shelves on each side of the nose, are often reduced in conjunction with the operation. Septoplasty also may be done to allow access into the nose to remove nasal polyps.
Septoplasty is generally only needed when non-surgical treatments do not improve breathing problems or snoring. Septoplasty is typically an outpatient procedure, 60 to 90 minutes in length, and is usually performed under general anesthesia.