Can a deviated septum lead to sinusitis? I have a deviated septum which closes one side of my nose about 70%. I have visited five different ENTs for treatment of sinus problems. Only one doctor said surgery to correct the septum would help. He said the septum is preventing my sinuses from draining properly. My symptoms include chronic headaches between and above the eyes, puffiness around the eyelid area, stuffiness, pressure around the eyes, yellow nasal discharge. The symptoms have gotten much worse over the past five years (I'm 32 now). Two CT scans revealed no sinus disease, only the deviated septum. I have had a few sinus infections over the past few years. The other doctors said straightening the septum would not help my problems. They think I suffer from migraines. I don't think so. I also have allergies, which I am being treated for with shots. My condition has not changed, however. Any insight would be helpful. Would surgery for the septum help my condition? Thank you.
Reply: ----------------------------
If you have already seen 5 different ENT physicians and have received different answers then it is very unlikely that I would be able to offer any additional insight into your problem. Suffice it to say that it is certainly possible for a deviation of the nasal septum to interfere with the normal drainage of a sinus. It is also possible to have a deviation of the nasal septum that does not interfere with the normal drainage of a sinus. The best objective assessment as to whether a nasal septal deviation may be involved with recurring sinusitis is with the combination of nasal endoscopy and a CT scan. Here one is looking for the relationship between the normal sinus pathways and the septum itself. For example, if one visualizes a bony spur of the septum that protrudes directly into the middle meatus between the middle and inferior turbinates after application of a topical decongestant into the nasal passages, then it is reasonable to consider the possibility that the septum itself may be responsible for obstructing the sinus. It is therefore also reasonable to anticipate that surgery to correct the septal deviation may have benefit in reducing sinus problems when other appropriate non-surgical measures have failed. On the other hand, if such anatomic relationships are not visualized, then I would recommend septoplasty be considered only when chronic nasal airway obstruction is the predominant symptom and standard non-surgical measures to treat it are ineffective.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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