Deviated Nasal Septum

The nasal septum is the thin wall of cartilage and bone that separates the two sides of your nose. Ideally, it runs straight down the centre — but in many people, it’s slightly or severely bent. This is known as a deviated nasal septum, and it can lead to persistent nasal blockage, mouth breathing, snoring, and poor airflow during exercise or sleep.

Mr Patel offers detailed, physiology-guided assessment and tailored treatment, including modern, minimally invasive septoplasty techniques that focus on the areas most responsible for airflow obstruction.

• Congenital – present from birth
• Trauma or injury – often from childhood falls, sports, or accidents
• Developmental – may worsen with facial growth
• Post-surgical – re-deviation after prior nasal surgery

In addition to general deviation, septal spurs (sharp projections of bone or cartilage) may further narrow the airway and contribute to localised blockage.

Deviations are most problematic when they are anterior, near the front of the nose, as these affect the internal nasal valve — the narrowest part of the nasal airway and a critical site for airflow regulation.

• One-sided or alternating nasal blockage

• Difficulty breathing through the nose — especially at night

• Mouth breathing, leading to dry mouth or poor sleep

• Snoring or sleep disturbance

• Frequent nosebleeds or crusting

• Facial pressure or recurrent sinus infections

• Poor airflow during exercise or speech

Many people have a mildly deviated septum with no symptoms. But when it causes persistent nasal obstruction, sleep issues, or affects quality of life, treatment may be beneficial.

Mr Patel assesses whether the septum is truly the source of your symptoms, or if other causes (such as turbinate swelling or nasal valve collapse) are also contributing.

Evaluation includes:

• Nasal endoscopy – to visualise the deviation and assess airflow
• Review of symptom severity and lifestyle impact
• CT scan, if needed, to check for sinus involvement or complex anatomy

Medical management may relieve inflammation, but will not correct a physical deviation.

Surgical options include:

• Septoplasty – surgical straightening of the septum
• Endoscopic septoplasty – camera-guided, minimally invasive correction
• Turbinate reduction – often performed at the same time to improve space
• Nasal valve support or reconstruction, where internal valve weakness is contributing

These are performed as day-case procedures, with no external scars and typically a one-week recovery.

Not all deviated septums cause symptoms, and not all nasal obstruction is due to the septum. Mr Patel focuses on identifying the exact anatomical or physiological cause of airflow restriction — with a special focus on the internal nasal valve, the critical bottleneck in nasal airflow.

Mr Patel’s practice offers:

• Precise nasal airflow assessment, including:
  • Nasal endoscopy
  • NIPF testing both pre- and post-decongestion
• Differentiation of mucosal vs structural causes of nasal obstruction
• Careful mapping of the internal nasal valve, based upon one of Mr Patel’s published grading systems 
• Bespoke surgical technique – Mr Patel selects from a range of surgical manoeuvres based on the precise cause and location of septal deviation. The decision regarding mobilisation, resection, reconstruction, reinforcement, and fixation is tailored to the problem at hand — ensuring each patient receives the most appropriate operation for their septum
• Objective tracking of improvement using:
  • Pre- and post-operative NIPF scores
  • The NOSE Score, a validated Patient-Reported Outcome Measure
• Advanced techniques in both endoscopic, endonasal and open septoplasty
• Honest, data-driven advice when surgery is not the best option

All patients undergoing septal surgery under Mr Patel’s care are monitored using both objective airflow testing and patient-reported outcome measures. This allows for transparent, data-driven evaluation of results.

Nasal Airflow Improvement

Patients experience an average 41% increase in nasal airflow at 3 months following septoplasty, as measured by Nasal Inspiratory Peak Flow (NIPF) testing.

Note: All measurements are taken without nasal decongestants to reflect natural breathing capacity.

Symptom Reduction

On average, patients report a 74% reduction in nasal obstruction symptoms at 3 months post-operatively, based on NOSE scores.