Whenever I hear someone say the they have a deviated septum, or that their deviated septum is the cause of their headaches, sinusitis, and even their crooked nose, I chuckle quietly inside to myself.  This is because technically, everyone has a crooked, or deviated nasal septum. No one has a perfectly straight nasal septum. It’s also common for people to blame their deviated septum to some kind of nasal trauma in years past. 

The term septum is used to describe a wall or a partition between to body cavities. The nasal septum is a midline wall that separate the left and right nasal cavities. The frontal sinus has one and the heart has one too. In some people the septum is abnormally crooked. This can happen spontaneously, or after major trauma. One old theory is that as the nose gets crushed during the trauma of childbirth, the septum becomes crooked. Now that’s been debunked, as even C-section babies can have deviated septums.

What’s more important than how crooked you septum is is how big are your turbinates, and how flimsy are your nostrils. Your turbinates are wing-like structures that attach to the side-walls of your nose. Essentially, they look and behave like airplane wings. They help to warm, smooth and humidify air that you breathe in. Normally, one side swells and the other side shrinks, and this reverses every few hours. This is normal and it’s called the nasal cycle. 

However, if your turbinates are more swollen (due to colds, allergies or weather changes), and your septum is slightly crooked, then you’ll feel like you have a stuffy nose. 

In some people, the nostrils are naturally flimsy and can cave in even with a little bit of inhalation. This can also occur years after rhinoplasty, when the cartilaginous support structures are weakened, so the nostrils collapse inward as you breathe in. So if your nostrils are slightly weakened and your septum is crooked and your turbinates are swollen due to allergies, then your nostrils will cave in at a certain point as you inhale. These are the people that may benefit from nasal dilator strips, more commonly known as Breath-Rite Strips.

One last reason for having a crooked septum is how your jaws develop. As I describe in my book and in various articles, modern humans have smaller jaws compared with our ancestors. One common feature of having smaller jaws (and dental crowding) is what’s called a high arched palate. This means that the center of the roof of your mouth is pushed upwards, literally into your nasal cavity. This pushes on the bottom of your septum, making the septum buckle to one side or the other, or slide off the middle of the nasal floor completely.

Since the side-walls of your nose follows what happens to your upper jaws, they’ll be more narrow, closer to the septum. If you add all this together, the perfect situation is created that sets you up for a stuffy nose. 

How many of you have a deviated septum and if so, do you have a stuffy nose?

One Response to “The Deviated Septum Myth”

1. Bob Quinn on August 29th, 2009 11:44 am

   For me, yes, and yes. I also have been told by ENT’s that my turbinates are unusually swollen, most likely due to my allergies. My recessed jaw has narrowed, and I have moderate sleep apnea, now being treated with varying success by both CPAP and oral appliance. I also am doing the tongue/throat exercises used by the Brazil group to reduce apnea symptoms (I may take up clarinet once again). I am considering turbinate reduction and septum straightening, if I can get convinced that likely benefit will outweight the hassle. As with most of us, I need to think well to do my job, so I’m throwing everying at the problem that seems to have been demonstrated to be effective.

   I’ve enjoyed reading your stuff– very informative and clearly written. I usually come away from a sleep center consulation with more questions than answers (eg, should we be focusing not on AHI but on percentage of slow-wave sleep, if the latter is responsible for most symptoms?).

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