I was curious as to the symptoms of a deviated septum... I have chronic (every day at some point) allergy symptoms, runny nose, breathing problems (within nasal passages), burning eyes and sinus headaches. On a daily basis I go to bed with a stuffed nose, and awake with one, usually having some sort of sneezing attack concurrent with the other symptoms. There seems to be nothing this specifically relates to and is not seasonal. Sometimes it occurs after I've crawled into bed, sometimes a weather change triggers it, going from air conditioning to outside often sets it off, or even just being tired can bring on the symptoms I've described. Also, most decongestents (like Sudafed) don't seem to work, though some stronger antihistamines releive at least the incredible clogging of my nasal passages. Someone recently said to me that it might be possible I have a deviated septum. What do you think?
Answer -------------------------
The symptoms described certainly could be partially due to a deviated septum, but it is unlikely that they are all caused by a simple anatomical problem. In fact most of your symptoms suggest allergy. The common symptoms of allergy include itchy water eyes, nasal itching, nasal stuffiness, watery nasal drainage, sneezing, ear pressure, throat irritation, etc. Allergies may be a perennial phenomena particularly if significant allergens include dust, mold, animal dander, feathers, or foods to name just a few. In other words, allergic symptoms need not be limited to seasonal symptoms. Antihistamines would not improve symptoms due to a nasal septal deformity, but would improve symptoms caused by allergy.
The nasal septum is a structure that divides your nasal passage into two and is composed of cartilage and thin bone. It is unusual to have a perfectly straight septum. Occasionally, the septum has significant deviation or deformity which results in obstruction to normal airflow through the nasal passageway. Such abnormalities may be congenital or they may be related to nasal trauma (with or without an actual fracture of the nose). Severe nasal septal deformities can result in rhinitis or inflammation of the nasal membranes resulting in chronic post-nasal drainage. Severe deformities can also cause chronic sinus problems including chronic or recurrent sinus infection. Frequently however, severe septal deformities cause only nasal airway obstruction that is chronic and typically consistently worse on one side or the other. The nasal airway obstruction caused by a septal deformity is typically worse at night because the nasal mucous membranes are rich in blood vessels which engorge by the effects of gravity when one reclines to a supine position, thus making the airway obstruction worse.
A careful nasal examination (possibly endoscopic) as well as a screening allergy evaluation would be an appropriate initial step in defining the cause of your symptoms.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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