What Can Be Done for Septum Pain and Deviation, and Enlarged Turbinates?

You may well have a deviated septum, and enlarged turbinates, but these conditions are not usually associated with pain unless you're having a sinus infection.

If you have a foul, off-colored, nasal discharge along with pain, then you could have sinusitis, and consultation with another ENT might help.



In our experience, the majority of people who suffer with nasal and sinus pain may have a variant of migraine. I agree that steroid nasal sprays will not improve your pain, but might help with your breathing.



I hope this was helpful, and best regards.

Pain of the septum has many causes, but the most common that I see is caused by dryness.  The septum can become chapped similar to your lips and this can cause significant irritation and pain.  There are obviously many other causes, but an in person exam is necessary.  Regarding the deviated septum and turbinate hypertrophy (IT), it is certainly possible you have neither, either or both.  A CT scan is not necessary in most cases to diagnose these conditions.  Europe may be different, but in the US, usually insurance will not cover septoplasty or IT reduction without a trial of nasal steroids.  I have seen patients who have a septum that completely occludes the nasal passages, and there is no physical way that nasal steroids will make a meaningful difference, but this does not change the insurance company's need to check off the box of "tried nasal steroids and failed".  Finally, having a deviated nasal septum can contribute to mucosal drying and irritation because the air flow through the nose is altered and changes from laminar flow to turbulent flow.  This is a frequent cause of nasal dryness.

If your septum is painful or deviated you should be examined intranasally with a speculum and a light source. The septum can be treated by removed the inner core of the septum and straightening the septum.  The turbinates are on each side of the nasal passage laterally and  may be enlarged for a variety of reasons such as allergies.  The treatment is turbinectomy in which a portion of the turbinates are removed.

While you may have a deviated septum and or enlarged turbinates, pain in the nose typically indicates and acute and active process usually involving an inflammatory and or infectious process.  This should be treated appropriately with antibiotics or anti-inflammatory medication.  Once the acute issues have been stabilized and if you  to indeed have a deviated septum or enlarged turbinates these can be addressed with surgery at a later date.

If one has septal or turbinate pain and discomfort and has inferior turbinate hypertrophy and deviation, this can be improved with septal reconstruction and turbinate submucosal resection and/or infracture. I would be very cautious about saying that it will guarantee pain relief. It may improve the nasal airway and breathing but may not always relieve the pain.