The nose is first examined using a headlight which will also assess the external nose.  A rigid or a flexible telescope is then used to assess the inside of the nose including the back of the nose and sinus openings.  Investigations may then be required, for instance, a CT scan which will give further information about the nasal deviation and the structures around the middle of the nose e.g. sinuses.  The treatment is divided into medical and surgical.  In most patients, simple medical management will improve the symptoms. 

This can be normal Saline rinses or cortico steroid nose sprays.  Should these medical measures be unsuccessful, surgery is required.  The surgery is called a Septoplasty and may be done through the nose or via an external approach.  It may be also combined with a rhinoplasty should there be other associated deviations.  A simple Septoplasty done through the front of the nose with a headlight and a telescope will address the deviated segments.  These deviations can be removed or remodelled into a straight position. 

Silastic splints are often used to maintain the vertical position of the operated septum.  The lower turbinates are also often reduced in size as nasal allergy resulting in large turbinates can compound the nasal obstruction.  With a simple Septoplasty, the external shape of the nose should not change and there should be no bruising.  

Septoplasty: Patient Education