Deviated nasal septum

Last revised by Frank Gaillard on 18 Jun 2024

Deviated nasal septums are a common, usually incidental, finding seen on brain and paranasal sinus CT studies. They are commonly seen with external nose deformities. 

Symptomatic patients can present with unilateral nasal obstruction or less commonly epistaxis, obstructive sinusitis, and/or pain/pressure symptoms 4

Nasal septum deviation can be congenital or acquired. The most common acquired cause is trauma from motor vehicle collisions, sports-related injuries, and altercations.

Deviated nasal septa are commonly associated with concha bullosa or turbinate hypertrophy with septal deviation being towards the contralateral side.

Unrecognised nasal septal deviations can contribute to failed rhinoplasty 3

Although a deviated nasal septum can be seen on plain radiography and MRI, it is best assessed with CT as part of a CT of the paranasal sinuses.

Nasal septal deviation can be C-shaped, reverse C-shaped, S-shaped or reverse S-shaped 3

If medical management fails, the most common surgical procedure performed is septoplasty 4,5

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