

Hi, I'm a 19 year old male from London. I recieved a strong blow to my nose about 4 years ago causing it to be crooked and deviated. When I breathe, airflow only comes out of one nostril at any one time. This confuses me as throughout the day, the nostril which is 'working' will change between the left and the right. I have serious issues sleeping and wonder if it is my nose..When I feel my septum, it definatley follows the same pattern in which my nose is deviated to the left hand side. Thanks.

Doctor Answers 3

Deviated septum

The septum is the main supporting area of the middle of your nose.  It is not only a divider between the two sides but also a pedestal upon which rests the external portion of your nose.  Because of the 3 dimensional relationship it has when a blow to the nose occurs it is common for both an anterior and posterior deformity to occur on either side.  Imagine taking a piece of paper, end - on, and forming an S shape out of it.  It will bend to the right on the one side and the left on the other (front or back depending on which way you bend the S).  So it is very common for patient's to suffer bilateral obstruction.  The "switching" phenomenon that also occurs throughout the day and evening is a normal phenomenon called the nasal cycle which we all experience.  Typically, during the day, we have an aroused sympathetic nervous system which generically decongests our nose and allows us to breathe better.  At night, the parasympathetic system takes over and we lie flat increasing the blood flow to our nose...which creates a worsening of congestion.  With all this being said....these issues can absolutely create snoring and in some severe cases sleep apnea.  You may benefit from both a septoplasty and turbinate reduction to completely resolve the issues you experience.

Scottsdale Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Breathing difficult through nose since trauma

 Exactly...what you describe is the normal nasal cycle where for a couple of hours, the turbinates inside your nose swell on one side to warm and humidify the air.  This cycles to the other, side of the nose, and so on back and forth.  Since your nose was hit and you since have breathing issues, it's a good bet that part of your nasal septum is crooked and sticking out into one or both sides of your nose (nostrils) reducing the airflow space.  This can and should be confirmed using a nasal speculum and light to see inside each nostril.

 If crooked, a Septoplasty alone can be done to remove the crooked sections which will not change the external appearance of the nose.  This can also be combined, Septorhinoplasty, with a Rhinoplasty to make the nose more aesthetically attractive as well as fixing the crooked septum.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Deviated septum

quality of breathing alternating from side to side is a common observation of the "nasal cycle". It is caused by alternating swelling and shrinking of the turbinate tissue (spongy membrane on the sides of the nose) which are constantly reacting to environmental changes. Severe septal deviations create blockages which do not vary so much since they are due to a "fixed" obstruction-deviated bone or cartilage. It will be further exacerbated during the swelling of the cycle. 

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews
