The nasal septum consists of cartilage and bone that should form a straight partition dividing the nose into two equal chambers. When this partition develops irregularly or becomes damaged, it creates uneven passages that disrupt normal airflow. The deviation can take various forms, from gentle curves to sharp angles, developing gradually during facial growth, appearing suddenly after an injury, or existing from birth. The position and severity of the deviation determine its impact on breathing and the need for treatment.
Deviated Septum Treatment in Singapore
A deviated septum occurs when the thin wall separating the nasal passages (nasal septum) is significantly displaced to one side.
This misalignment creates uneven nasal passages, leading to breathing difficulties and other complications. While some degree of septal deviation is present in up to 80% of people, only severe cases typically require medical intervention.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
How Does a Deviated Septum Develop?
Symptoms of Deviated Septum
A deviated septum causes a variety of symptoms that can interfere with daily life. Common symptoms include:
- Breathing Difficulty: The most prominent symptom involves difficulty breathing through one or both nostrils. This obstruction often becomes more noticeable during physical activity or when lying down.
- Nasal Congestion: Chronic stuffiness, particularly affecting one side of the nose more than the other, commonly occurs. This congestion typically remains constant regardless of environmental factors or allergies.
- Sleep Disturbance: Breathing difficulties often worsen during sleep, leading to mouth breathing, dry mouth, and potential sleep quality issues. Some individuals experience noisy breathing or snoring due to the irregular airflow patterns.
- Sinus Infections: Impaired drainage from uneven nasal passages can increase susceptibility to sinus infections. These infections may occur more frequently and persist longer than usual.
- Nosebleeds: The altered airflow can cause the nasal tissues to become dry and crusty, particularly on the side with greater exposure to airflow, leading to an increased frequency of nosebleeds.
Causes and Risk Factors
Multiple factors contribute to the development of a deviated septum, from congenital conditions to acquired causes.
Physical Trauma: Impact injuries from sports, accidents, or falls frequently cause septal deviation. The nose’s prominent position makes it particularly vulnerable to facial trauma, with even seemingly minor impacts potentially affecting septal alignment.
Developmental Factors: Natural growth patterns during childhood and adolescence can influence septal position. Some individuals develop deviation during these growth periods without any traumatic event.
Congenital Conditions: Some people are born with septal deviation due to foetal development patterns or complications during childbirth. These cases often become more apparent as facial structures grow and develop.
Diagnosis of Deviated Septum
Accurate diagnosis requires thorough examination using several approaches. Commonly used diagnostic methods include:
- Physical Examination: Doctors begin with a visual inspection of the nose, followed by an examination of internal nasal structures at our clinic. Using a bright light and nasal speculum, they assess the visible portion of the septum. A nasal endoscope provides detailed views of deeper structures, revealing the extent and pattern of deviation.
- Imaging Studies: CT scans offer detailed cross-sectional views of nasal structures, helping identify the location and severity of septal deviation. These images also reveal any associated conditions affecting the sinuses or surrounding structures that may influence treatment planning.
- Differential Diagnosis: Doctors must distinguish septal deviation from other conditions causing similar symptoms, such as chronic rhinitis, nasal valve collapse, or nasal polyps. This process includes assessing nasal cycle variations and ruling out other structural abnormalities.
Treatment Options
Treatment follows a systematic approach, beginning with conservative management before considering surgical intervention when necessary.
Non-Surgical Treatment
- Nasal Decongestants: These medications provide temporary relief by shrinking swollen nasal tissues and opening airways. Available in both oral and nasal spray forms, they offer short-term symptom management. Nasal sprays should not exceed three days of continuous use due to rebound congestion risk.
- Nasal Steroid Sprays: Prescription steroid nasal sprays reduce inflammation in the nasal passages, potentially improving breathing when the deviation is mild to moderate. These medications require several weeks of consistent use for maximum benefit.
- External Nasal Strips: These adhesive strips physically pull nasal passages open, offering temporary relief particularly beneficial during sleep and physical activity. While effective, they require regular reapplication.
Surgical Treatment
- Septoplasty: This procedure addresses septal deviation by straightening and repositioning cartilage and bone. Performed through the nostrils, ENT surgeons make incisions to remove or reshape deviated portions while preserving the structural integrity of surrounding tissues. This technique aims to improve airflow and alleviate symptoms such as nasal obstruction and difficulty breathing.
- Combined Surgical Approaches: In some cases, additional procedures are performed alongside septoplasty to address specific issues. Turbinate reduction reduces the size of enlarged nasal structures (turbinates) to improve airflow and breathing. Septorhinoplasty combines septoplasty with cosmetic enhancements to improve both nasal function and appearance. Endoscopic sinus surgery treats sinus-related conditions, such as chronic inflammation or blockages, that may affect nasal function. These combined approaches ensure comprehensive treatment tailored to each patient’s needs.
Are Your Symptoms Affecting Your Quality of Life?
Consult our MOH-accredited specialist for an accurate diagnosis & personalised treatment plan today.
Prevention and Management of Deviated Septum
Effective management combines preventive measures with ongoing care strategies. Regular nasal irrigation helps maintain clear passages and reduce inflammation. Humidifier use in living spaces prevents nasal dryness and irritation. Those participating in contact sports should wear appropriate protective gear to prevent nasal injuries. Environmental modifications, including air purification and irritant avoidance, help minimise nasal inflammation and associated symptoms.
For Singaporeans & Singapore Permanent Residents
Medisave & Insurance Shield Plan approved
Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.
Frequently Asked Questions (FAQ)
How can I tell if my breathing problems are specifically from a deviated septum?
A deviated septum typically causes asymmetric breathing difficulties, where one nostril consistently feels more blocked than the other, regardless of position or time of day. Unlike allergies or colds, these symptoms remain constant and do not respond to allergy medications.
Is it possible for a deviated septum to worsen over time?
While the basic structure of the deviation usually remains stable, ageing, injury, or chronic inflammation can cause additional tissue changes that may worsen symptoms gradually.
Can a deviated septum cause headaches?
Yes, a deviated septum can contribute to headaches, especially when it causes sinus blockages or uneven pressure in the nasal passages.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.
Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.
- 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
- 2016 – Best Educator Award (Eastern Health Alliance)
- 2016 – “Wow” Award (Patient Compliment)
- 2014 – Eastern Health Alliance Caring Award – Silver
- 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
- 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
- 2007 – Singhealth Best Doctor Award
Qualifications
- MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
- MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
- MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
- FAMS – Fellow of the Academy of Medicine Singapore
Make an Enquiry
Fill up the form and our friendly clinic staff will get back to you promptly.
Our Location
A Specialist Clinic for Sinus, Snoring & ENT
38 Irrawaddy Road #08-45
Mount Elizabeth Novena Hospital
Singapore 329563
Mon – Fri: 9:00 am – 5:00 pm
Sat: 8:30 am – 12:00 pm