Otorhinolaryngology focuses on the ear, nose, and throat. Learn about the diagnosis and treatment of hearing loss, sinusitis, tonsillitis, and voice disorders.
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Before any treatment can be planned, an accurate diagnosis is essential. You might suspect you have a deviated septum based on your symptoms, but a medical professional must confirm the condition and assess its severity. The diagnostic process involves a combination of discussing your history, physical examinations, and sometimes advanced imaging. This thorough evaluation ensures that the breathing problem is indeed caused by the septum and not by other issues like polyps, allergies, or enlarged turbinates.
This section outlines what you can expect during your consultation with an ear, nose, and throat specialist. We will explain the tools they use to look inside your nose and the different tests that measure how well you breathe. Understanding these diagnostic steps removes the mystery of the medical appointment and helps you prepare to provide the information your doctor needs to help you.
The diagnostic journey begins with a standard physical exam. The doctor will ask about your medical history, focusing on any past nasal injuries, breathing difficulties, and sleep habits. After this talk, they will check your nose for any external deviation or nostril collapse when you breathe.
Next, the doctor uses a bright light and a handheld instrument called a nasal speculum to gently widen the nostrils. This allows them to look into the front part of the nasal cavity. They can visually check the position of the septum and the size of the nasal turbinates (structures on the side of the nose). Often, a severe deviation is visible right at the entrance of the nose during this simple exam. This step is painless and takes only a few moments, but it provides the initial confirmation needed to proceed.
The doctor will perform a nasal endoscopy to see deeper into the nose, beyond what the handheld light can reveal. This is the gold standard for diagnosing internal nasal problems. An endoscope is a thin, flexible, or rigid tube with a tiny camera and light on the end. The doctor inserts this tube gently into the nose to view the back of the septum and the openings of the sinuses.
Before the scope is inserted, the doctor may spray a decongestant and a mild numbing medication into your nose. This minimizes discomfort. The scope provides a magnified, high-definition view of the entire nasal passage on a monitor.
Endoscopy allows the doctor to see deviations located deep in the nose that might be missed otherwise. It also helps identify other sources of blockage, such as nasal polyps, This may be due to swollen tissue or an infection in the sinus drainage pathways. It is a critical step for planning any potential surgery.
In some cases, visual inspection is not enough, especially if sinus issues are also suspected. The doctor may order a Computed Tomography (CT) scan. A CT scan uses X-rays to create detailed cross-sectional images of your head. Unlike a standard X-ray, a CT scan shows the soft tissues, bone, and air pockets with high precision.
A CT scan is typically ordered if the patient has a history of chronic sinus infections or if the surgery will affect the sinuses as well as the septum. It serves as a “roadmap” for the surgeon.
The images will show the exact shape and position of the septum, the health of the sinus cavities, and the presence of any fluid or inflammation. It allows the surgeon to measure the severity of the deviation accurately and check for anatomical variations that could affect surgery.
While the structural exams show what the nose looks like, airflow tests measure how it functions. One common test is acoustic rhinometry. This test uses sound waves to map the internal space of the nasal cavity. It helps identify exactly where the narrowing is occurring. Another test is rhinomanometry, which measures air pressure and the rate of airflow while you breathe.
These functional tests provide objective data. They can prove that the deviation is causing significant resistance to airflow, which is often required for insurance approval. They also provide a baseline measurement so the doctor can compare your breathing ability before and after treatment to quantify the improvement. These tests are non-invasive and simply require you to breathe into a specialized mask or tube.
Since allergies can mimic or worsen the symptoms of a deviated septum, ruling them out or managing them is part of the diagnosis. The doctor may recommend allergy testing, which can be done via skin pricks or blood tests. If you have significant allergies, your nasal lining will be swollen regardless of whether your septum is straight or crooked.
Understanding the role of allergies is crucial for the treatment plan. If allergies are the primary cause of blockage, surgery on the septum might not fully resolve the issue. Often, doctors treat the allergies first to see how much breathing improves. If blockage persists despite allergy management, then the structural problem (the septum) is confirmed as the primary issue. This comprehensive approach ensures that surgery will only be performed when it is truly beneficial.
To get the most out of your diagnostic appointment, preparation is helpful. You should write down a timeline of your symptoms, noting when they started and if anything makes them better or worse. List the OTC nasal sprays, antihistamines, or strips you’ve tried and how well they worked.
It is also important to mention any previous nose injuries, even if they happened years ago in childhood. Inform the doctor if you snore or if someone has told you that you stop breathing at night. Being honest about your lifestyle, such as smoking habits, is also vital. This information helps the doctor distinguish between a purely structural problem and other contributing factors, leading to a more accurate diagnosis and a better treatment plan.
Send us all your questions or requests, and our expert team will assist you.
Most patients feel pressure or a “weird” sensation, but it is rarely painful. The numbing spray used beforehand helps make it quite tolerable.
A CT scan shows the sinuses and deep structures that cannot be seen with the eye alone. It ensures no other hidden problems are contributing to your symptoms.
A general doctor can suspect it during a basic exam, but an ENT specialist is needed to confirm the diagnosis and determine if surgery is required.
Modern sinus CT scans use very low doses of radiation. The risk is minimal and is generally considered safe for diagnostic purposes.
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