What is a deviated septum? It depends on which septum you mean. The term generally pertains to the wall separating the two pathways of air until they reunite in the back of the nose, the nasopharynx. The nasal septum is composed of skin, bone, hyaline cartilage, plus a little connective tissue. Its main bony component is the vomer (Latin for plowshare). To the top of this bone is the ethmoid bone, which contributes a perpendicular plate extension to the nasal septum. Since these are bones located in the face as opposed to externally, it is hard to see and fracture them. The structure that is easily palpated from outside is the cartilage of the septum, which anyone who picks their nose can feel for themselves. Two bones, the maxillary and the palatine bone, give minor contributions to the nasal septum with their crests. However, these crests serve mostly to keep the vomer in place, as well as mark the point where the cartilage that used to be the septum finished growing, somewhat like a marker for how a jigsaw is supposed to fit together.
The deviated septum is present in a large percentage of people. Some sources cite that up to 80% of all people have a deviated septum. Most people don’t find it diffficult to live with one, as the degree of deviation many not be too high. Of course, the degree of variation will differ among all people, and therefore some people find the condition to be burdensome. This is merely to correct the general notion that the answer to the question of what is a deviated septum always needs medical attention.
A problematic deviated septum is most often caused by blunt impact to the face. The septal cartilage may be softer than bone, but it is still firmly attached to the vomer and perpendicular plate of the ethmoid, which are thin and can be injured. Another possible cause is congenital deformity. This one is caused by compression, or perhaps breaking, of the nose while the baby’s head passes through the mother’s vagina. This is not a common complaint among mothers, so it is safe to say that this event is rare, but it is a common cause for a problematic deviated septum. A study in 2010 by Cashman, Farrell, and Shandilya states that there no agreement for closed reduction nasal surgery is indicated for newborns. Besides these, genetic factors for a deviated septum include Ehlers-Danlos Syndrome and Marfan Syndrome. These two are genetic errors affecting connective tissue, especially collagen. Collagen is the primary component of cartilage, and cartilage is the precursor to bone. If the cartilage fails to form correctly, then there will be structural defects.
One can start to suspect a deviated septum if they start getting sinusitis, wake up in the middle of the night because they are out of breath, snore, sneeze again and again for no apparent reason, and experience difficulty with breathing. Nosebleeds and pain at or near the nose are also possible symptoms of a pathologic deviated septum.
In case the deviated septum needs medical intervention, but is not too severe, the treatment usually involves decongestants. This is because the deviated septum is only an additional factor to airway blockage, and the person would normally be fine without it. However, in more severe cases, a surgery called a septoplasty may be performed. This is a short procedure but is not a clinical procedure and should not be done outside of a hospital.
So now, if you are asked “What is a deviated septum?” you know how to answer them.