Nasal Obstruction

and Deviated Septum

What is nasal obstruction?

Nasal obstruction is difficulty passing air through one or both nostrils. It may be temporary, such as with a cold, or persistent due to a structural problem or an issue with the nasal lining.

The nasal septum is the wall dividing the nose into two sides; many people have a mild deviation with no symptoms at all.

What are the symptoms?

Difficulty breathing through the nose, on one or both sides
Mouth breathing, especially during sleep
Snoring or disrupted sleep
Dry mouth and throat on waking
Difficulty breathing during exercise
Occasionally, recurrent sinusitis

What are the causes?

Deviated septum: may be congenital or the result of a nasal injury.
Enlarged turbinates: ridges inside the nose that swell with allergy or inflammation.
Allergic rhinitis
Nasal polyps
Enlarged adenoids in children
Overuse of decongestant sprays
Weakness or collapse of the nasal side walls

How is it diagnosed?

The doctor asks about your symptoms and their duration, then examines the inside of the nose, sometimes using a small scope to view the deeper structures. Most cases don't need imaging, but the doctor may order it if a sinus problem is suspected or before surgery.

Important to know: having a deviated septum doesn't necessarily mean you need surgery. What matters is how much the obstruction affects your life and the examination findings.

What are the treatment options?

Treatment depends on the cause, and your doctor will determine what's best for you.

Medical treatment

When the cause is inflammation, allergy, or enlarged turbinates, nasal steroid sprays, saline rinses, and allergy treatment may be enough.

Surgical treatment

If the cause is structural and affects your life despite treatment, options may include:

Septoplasty: usually performed from inside the nose, without changing its external appearance.
Turbinate reduction: may be done together with septoplasty.
Occasionally, surgery to support the nasal side walls or functional rhinoplasty.

What can I do at home?

Rinse your nose with saline.
Use your steroid spray regularly if prescribed.
Elevate your head slightly during sleep.
Avoid smoking, smoke, and incense.
Don't use decongestant sprays for more than 3 days, as they can cause chronic obstruction that is difficult to treat.

When should I see a doctor?

If obstruction persists and affects your sleep or daily activity.
If the obstruction is on one side and gradually worsening.
If accompanied by bleeding or bloody discharge from one side.
If your sense of smell weakens.
If you notice snoring with breathing pauses during sleep.
If you depend on decongestant sprays daily.

When should I go to the emergency room?

After a nasal injury, if severe obstruction occurs with pain and swelling inside the nose, or bleeding that won't stop.

Remember

Nasal obstruction has many causes, not only the septum.
Many cases improve with medical treatment.
Surgery is an option when the cause is structural and symptoms are significant.
Persistent one-sided obstruction or bleeding needs examination.

This information is for health awareness and education, and does not replace a doctor's consultation or direct medical assessment.

Prepared by: Saudi Society of Otolaryngology–Head & Neck Surgery · Version 1.0 · Last reviewed: May 2026 · saudiorl.com