Septal Deviation of 5-6mm and Nasal Septal Spur: Severe Enough to Need Septoplasty?

A moderate to severe septal deviation documented on a CAT scan along with a history of symptoms that are unrelieved with medications is usually an indication for surgical intervention.  It is important to try medications first and make sure that they are not working prior to undergoing surgical intervention such as a septoplasty.  In addition, it is also important to address turbinates if they are hypertrophic and once lateralized can improve the airflow dynamics through the nose.  Chronic sinus infections are addressed through endoscopic sinus surgery if there are polyps located inside the sinuses.  This can all be done simultaneously.  

To better answer your question a thorough intranasal exam including a fiberoptic scope and a review of your actual sinus cat scan is necessary

Great question. A septoplasty is largely an elective procedure, thus its not really proper to suggest that anyone "needs" or must have a septoplasty. That being said, if you do not breathe well through your nose and there is some discernible obstruction of the nose by your septum then surgery is an excellent option for most patients. Simply put, if you want to breathe better through your nose, and you have a deviated septum, in my opinion there is no single treatment that will improve your breathing more than a well done septal surgery. Septopalsty is exceedingly well tolerated due to little or no pain, and nearly universally successful in improving breathing. Hope this helps.