When to See an ENT for a Deviated Septum: Symptoms, Timing, and Treatment Options

When to See an ENT for a Deviated Septum: Symptoms, Timing, and Treatment Options

A deviated septum means the nasal septum—the wall of cartilage and bone between your nostrils—is off-center. For some people, that shift is mild and causes no real trouble. For others, it narrows one side of the nose enough to create nasal obstruction, making it harder to breathe comfortably, sleep well, and feel like yourself day-to-day.

This guide explains deviated septum symptoms, how to tell when timing becomes more important, and what to expect from an ENT visit—including today’s deviated septum treatment options from simple supportive care to septoplasty. Many people have some septal deviation and never need treatment; the difference is whether symptoms are persistent, disruptive, or complicated by infections or injury.¹

If you’d like a deeper primer on causes and symptoms, see our related article on deviated septum causes and symptoms: https://sleepandsinuscenters.com/blog/what-is-a-deviated-septum-causes-symptoms-and-when-to-see-a-doctor

What Is a Deviated Septum?

The nasal septum explained (simple anatomy)

The nasal septum is the internal “divider” between the left and right nasal passages. It helps support the structure of the nose and influences how air flows as you breathe in and out.

A helpful way to picture it: the septum is like the center wall in a two-lane tunnel. When that wall drifts into one lane, traffic (airflow) bottlenecks—especially when inflammation narrows the space even more.

How a deviation causes “nasal obstruction”

When the septum leans to one side, it can reduce airflow—sometimes noticeably—on that side. Many people notice that one nostril feels blocked more often, especially during colds or allergy seasons.

Another common piece of the puzzle is the turbinates (soft tissue structures inside the nose). If they become enlarged from inflammation, they can further narrow the airway—so even a moderate deviation may feel like severe chronic congestion.

Some patients describe it as: “I can breathe fine sitting up, but when I lie down, one side shuts off.” That pattern can be a useful clue to bring up during your visit.

Deviated septum vs. allergies vs. sinus infection

A deviated septum can feel a lot like allergies or recurring sinus problems because symptoms overlap: congestion, pressure, and reduced airflow. Sometimes, more than one issue is happening at once—structural narrowing plus inflammation.¹ That’s one reason an ENT evaluation can be helpful when symptoms keep returning.

When structure narrows one side, even small amounts of swelling can tip you from “fine” to “blocked”.

Common Symptoms of a Deviated Septum (and Why They Matter)

Breathing symptoms

Common deviated septum symptoms often center on airflow: ongoing nasal congestion, frequently worse on one side; trouble breathing through the nose, especially during exercise or when lying down; a persistent feeling of nasal obstruction that doesn’t fully clear. ¹

A practical example: you might notice you’re always choosing the same side to sleep on because the other side feels blocked, or you avoid certain workouts because you can’t catch your breath through your nose.

Sleep-related symptoms

When nasal airflow is reduced, many people compensate by breathing through the mouth at night. That can show up as mouth breathing and dry mouth; restless sleep or frequent waking; breathing problems at night that affect how refreshed you feel the next day.²

Even when symptoms don’t seem severe, nighttime breathing disruption can have an outsized impact on energy, focus, and mood.

Sinus and infection symptoms

Some people notice a pattern of sinus pressure or facial fullness; postnasal drip; recurrent sinus infections or symptoms that repeatedly return after treatment. ¹ ⁶

Not every sinus infection is caused by a deviated septum, but persistent blockage can be part of the overall picture.

Nosebleeds and dryness

Airflow through a narrowed passage can be turbulent and drying. Over time, that can irritate the lining of the nose and contribute to dryness or crusting and recurrent nosebleeds. ¹ ³

“Hidden” impact symptoms

Longstanding congestion and disrupted sleep can affect quality of life in less obvious ways, including fatigue, irritability, and difficulty concentrating. Patterns that persist, cluster, or affect sleep are clear signs to get checked.

When to See an ENT for a Deviated Septum (Timing Guide)

If you’re wondering when to see an ENT for a deviated septum, timing usually comes down to persistence, disruption, and patterns.

If symptoms are persistent (not just a bad week)

Occasional congestion during a cold is common. What tends to prompt evaluation is blockage that’s ongoing or keeps returning, and symptoms that don’t improve after reasonable self-care or over-the-counter approaches. ¹ ²

If you’re repeatedly planning your day around congestion, carrying tissues, or feeling stuck on one side, that’s meaningful information to bring to an ENT.

If you want to explore next steps, read about deviated septum relief: https://sleepandsinuscenters.com/deviated-septum-relief

If it’s affecting sleep or daily life

Sleep disruption is a clear signal for evaluation: waking due to breathing difficulty; frequent mouth breathing at night; trouble getting comfortable because one side feels consistently blocked. ²

For some patients using CPAP, nasal blockage can make therapy harder to tolerate—another reason an ENT assessment may help.⁵

If you’re getting frequent sinus infections

A pattern matters more than a single episode. With recurrent infections or symptoms that never fully resolve, an ENT can look for structural narrowing, ongoing inflammation, or other contributors.¹ ⁶

If nosebleeds are frequent or hard to control

Occasional nosebleeds happen for many reasons, but recurrent bleeding—especially alongside chronic blockage or dryness—deserves a closer look.³

If you’ve had nasal trauma (don’t “wait and see”)

After injury, breathing changes can be easy to dismiss as swelling. Seek timely evaluation if obstruction worsens rather than improves, the nose looks newly crooked or collapsed, or pain and swelling are significant or persistent. ⁴

When primary care or urgent care should refer you

If medical management doesn’t meaningfully improve airflow—or symptoms keep returning—referral to an ENT is a common next step.²

If symptoms are ongoing, disruptive, or repeating, it’s reasonable to book an ENT visit rather than wait.

Urgent Red Flags After Nasal Injury (Go to the ER or Urgent ENT Care)

Not every injury is an emergency, but some situations are urgent because delays can lead to complications.

Septal hematoma (medical emergency)

A septal hematoma is blood trapped within the septum. This is urgent because it can reduce blood flow to cartilage and potentially cause long-term structural damage if not addressed promptly.⁴

Uncontrolled nosebleed

If bleeding is heavy, difficult to stop, or repeatedly returns in a significant way, it may require urgent evaluation and treatment.² ⁴

Complex lacerations or suspected fracture

Significant deformity, severe swelling, escalating pain, or major breathing impairment after an injury may suggest a more complex problem needing prompt assessment.⁴

For more on injury-related timing: https://sleepandsinuscenters.com/blog/broken-nose-treatment-when-to-see-an-ent-specialist

After significant nasal injury, sooner evaluation is safer than a wait-and-see approach.

What an ENT Will Do at Your Appointment

History and symptom review

An ENT visit typically starts with how long symptoms have been present; whether blockage is one-sided or alternating; sleep quality and night breathing; frequency of infections and nosebleeds; any history of nasal trauma. Tip: note what makes symptoms worse (allergies, exercise, bedtime, dry air) and what you’ve tried (sprays, rinses, allergy meds).

Physical exam + nasal endoscopy (if needed)

A standard exam includes looking inside the nose with a lighted instrument. In some cases, a brief nasal endoscopy (a thin camera) helps visualize the septum’s shape, areas of swelling, and any drainage, crusting, or other concerns.

Imaging (only when appropriate)

Imaging such as a CT scan is usually reserved for certain situations—often when sinus disease is suspected or for surgical planning.¹

Rule out other contributors

An ENT may evaluate for allergic rhinitis, turbinate hypertrophy, nasal valve collapse, or nasal polyps.

A focused history, targeted exam, and—only when needed—imaging help pinpoint whether structure, inflammation, or both are to blame.

Treatment Options for a Deviated Septum (From Conservative to Surgical)

Your best plan depends on whether symptoms are driven mostly by structure, inflammation, or both.

Lifestyle + home care (symptom reduction)

Supportive strategies may help reduce irritation and improve comfort: saline sprays or rinses to reduce dryness and clear mucus; humidifier use at night in dry seasons; manage triggers that worsen swelling (dust or seasonal allergens). These steps won’t move the septum, but they can calm the lining and reduce swelling on top of structural narrowing.

Medications (when swelling is part of the blockage)

When inflammation amplifies obstruction, options may include steroid nasal sprays and allergy medications when allergic rhinitis is present. Medications don’t straighten a deviated septum, but reducing surrounding swelling can improve airflow.¹ ⁶

Septoplasty

Septoplasty is surgery to correct the position of the septum to improve nasal airflow.¹ It’s commonly considered when symptoms are significant—ongoing obstruction, sleep disruption, or repeated infections—or when conservative approaches haven’t provided enough relief.⁵ Learn more: https://sleepandsinuscenters.com/blog/deviated-septum-surgery-at-sleep-sinus-centers-of-georgia

Turbinate reduction (if needed)

When enlarged turbinates contribute to blockage, turbinate reduction may be discussed—often alongside septoplasty—to open the airway more fully.

When sinus procedures may be discussed

If chronic sinusitis or impaired drainage pathways are also present, an ENT may discuss sinus-directed procedures in addition to addressing the septum.

Medications calm swelling; septoplasty addresses structure—many people benefit from a tailored mix of both.

How to Know If Surgery Might Be Worth Discussing

Functional reasons (not cosmetic)

Many consider septoplasty for functional concerns: difficulty breathing through the nose most days; feeling limited during exercise; symptoms that disrupt sleep and quality of life. ² ⁵

Recurrent sinus infections tied to obstruction

Not every infection is caused by the septum, but persistent blockage raises suspicion that anatomy contributes—especially when infections are frequent or symptoms don’t fully clear.¹ ⁶

Failure of conservative management

If you’ve tried appropriate medical therapy consistently and still have significant obstruction, it’s reasonable to discuss structural treatment.² ⁵

Insurance/medical necessity considerations (brief)

Coverage often depends on documented symptoms, exam findings, and prior medical management. An ENT visit helps create a clear record of impact on breathing and daily life.

Consider surgery when function—not appearance—is the issue and medical therapy hasn’t been enough.

Lifestyle Tips to Breathe Easier While You Wait for Your ENT Visit

Nighttime strategies

Try side sleeping if one side tends to block more; slight head elevation may reduce the sensation of congestion.

Reduce nasal irritation

Avoid smoke exposure and strong fragrances; use humidity in overly dry environments when possible.

Safe decongestant guidance (brief caution)

Some topical decongestant sprays can cause rebound congestion if overused. If used longer than 3 days, certain sprays may worsen congestion when you stop. If you’re using them frequently, discuss safer long-term approaches with a clinician.

Small daily adjustments can improve comfort while you plan next steps with a clinician.

FAQs About Seeing an ENT for a Deviated Septum

How long should I wait before seeing an ENT?

If symptoms are persistent, keep recurring, or affect sleep and quality of life, many guidelines support scheduling an evaluation rather than waiting for months.² ³

Can a deviated septum cause snoring or sleep apnea?

A deviated septum can worsen nasal airflow and contribute to mouth breathing and snoring. Sleep apnea is often multifactorial; an ENT evaluation can help identify whether nasal obstruction is a meaningful contributor.

Will medications fix a deviated septum permanently?

No. Medications can reduce inflammation and swelling, but septal deviation is structural.¹

Do I need surgery if I have a deviated septum?

Not always. Many people do well with conservative care, especially if symptoms are mild. Surgery is typically discussed when symptoms are significant or medical therapy hasn’t helped enough.¹ ⁵

What should I do if I suspect a broken nose?

Because complications like septal hematoma can require urgent treatment, prompt evaluation after significant nasal injury is generally recommended.⁴

What happens if I ignore it?

Outcomes vary. Some people tolerate symptoms, while others experience ongoing congestion, sleep disruption, recurrent infections, or reduced quality of life over time.¹ ⁵

If in doubt, an ENT can help separate what’s structural from what’s inflammatory.

Conclusion: When It’s Time to Get Checked

Many people have a mildly deviated septum and never need treatment. But persistent nasal obstruction, chronic congestion, recurrent sinus infections, frequent nosebleeds, and breathing problems at night are all common reasons to consider evaluation—especially after nasal trauma or if symptoms are worsening.¹ ² ⁴

If you’re deciding when to see an ENT for a deviated septum, a helpful rule of thumb is this: when symptoms are ongoing, disruptive, or repeating in patterns that affect sleep and daily life, an ENT visit can clarify what’s driving the problem and which treatment options fit your situation—ranging from medical therapy to septoplasty.

To take the next step, explore deviated septum relief: https://sleepandsinuscenters.com/deviated-septum-relief —and if you’re ready, book an appointment with Sleep & Sinus Centers of Georgia at https://www.sleepandsinuscenters.com/

References

1. https://www.mayoclinic.org/diseases-conditions/deviated-septum/diagnosis-treatment/drc-20351716

2. https://www.ops4ent.com/information/ent-referral-guidelines-nose/

3. https://www.entdoctoroc.com/blog/deviated-septum-signs-that-indicate-its-time-to-see-a-doctor/

4. https://walterreed.tricare.mil/Health-Services/Hospital-Care-Surgery/Otolaryngology-Head-Neck-Surgery/Nasal-Trauma-Referral-Guidelines

5. https://www.houstonmethodist.org/blog/articles/2022/sep/what-is-a-deviated-septum-when-is-surgery-needed-to-fix-it/

6. https://wexnermedical.osu.edu/ear-nose-throat/sinus-care/deviated-septum

This article is for educational purposes only and is not medical advice. Please consult a qualified healthcare provider for diagnosis and treatment.