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Deviated Septum

Septoplasty – Deviated Septum Treatment

Deviated Septum

A deviated septum is a common condition in which the thin wall between nostrils- the nasal septum– is twisted and displaced.  This makes one or both of the nasal passages smaller.  A nasal passage with half the normal size creates a 16 fold drop in airflow.  It is estimated that more than 50% percent of people have some level of deviated septum.  When a deviated septum is severe, it can cause significant breathing problems and require treatment.


Many septal deformities result in no obvious symptoms.  However, the most common symptoms of a more significantly deviated septum are nasal congestion and difficulty breathing.  This may be more noticeable with a cold or allergy that causes nasal passages to swell and narrow even more.  People will often adapt to their blocked nose, unaware that their “mouth breathing” is really a sign of a deviated septum.

Other symptoms include:

  • Nosebleeds
  • Facial pain
  • Headache
  • Postnasal drip
  • Loud breathing and snoring during sleep
  • A preference for sleeping on a particular side
  • Sleep apnea (in certain cases)


A deviated septum can be:

  • Present at birth.
  • The result of an injury to the nose.  Trauma to the nose most frequently occurs during contact sports, active play or automobile accidents.
  • Worsened over time as part of the normal aging process that impacts nasal structures.


See your doctor if you experience:

  • Blockage in one or both nostrils that doesn’t respond to treatment
  • Recurrent sinus infections
  • Frequent nosebleeds
  • Inability to breathe well through the nose


The septum is examined in our office using a long, thin tube equipped with a light and video camera, called an endoscope. We pay particular attention to the structure of the septum and how it interacts with other nasal structures to impede the passage of air through the nose. We also take a full personal history to understand how the deviated septum may be impacting your life.


For those with a significantly deviated septum, whose symptoms do not respond to medical and allergy treatment, surgery may be recommended.  A septoplasty is the surgical means of repairing a deviated septum.  It is important to note, that while septoplasty can be combined with sinuplasty and other sinus procedures, it is not, on its own, a direct treatment for sinus problems.

A septoplasty involves a small incision just inside the nostril to open the nasal membrane covering the septum.  Crooked and irregular cartilage and bone is removed while preserving the overall bone and cartilage framework.  The membranes septum are then sewn together with the septum now straight.


Dr. Agrama, ENT, has extensive experience in this area, having performed more than 2,000 septoplasty procedures in his career.  This level of expertise has allowed him to perfect a method that uses both traditional and endoscopic techniques to precisely take care of the problem with minimal risk.

Thanks to recent endoscopic advancements, our practice is now able to perform some septoplasty procedures in our office, rather than requiring a patient to go to a hospital or surgery center.  Dr. Agrama frequently combines septoplasty and other nasal procedures with balloon sinuplasty, when indicated, as an awake office procedure.

Advantages of an in-office awake procedure include:

  • Faster recovery
  • The avoidance of general anesthesia
  • The avoidance of sedatives or “Level 2 Anesthesia.”
  • Less risk of bleeding
  • Less risk of infection
  • Less out-of-pocket cost

As a result of his meticulous technique, Dr. Agrama is able to avoid the use of splints or packing.  This makes the recovery process both quicker and easier.  Patients can often notice an immediate difference in their breathing, but will generally have nasal blockage and congestion for a few days after the procedure.

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