Sinusitis and a Deviated Septum: Can Rhinoplasty Help?
- Jan 27
- 5 min read
Updated: Feb 3
Many patients with recurrent or persistent sinusitis are told they also have a deviated septum. This often leads to a reasonable question:
“If my septum is deviated, would rhinoplasty or septorhinoplasty help my sinus problems?”
The answer is: sometimes — but not always. Understanding the relationship between septal deviation, sinus drainage, and nasal airflow is crucial before deciding on surgery.
How a Deviated Septum Can Contribute to Sinusitis
A deviated septum can affect the sinuses in several ways:
Narrowing of the nasal airway, reducing airflow
Impaired sinus drainage, particularly on the narrower side
Increased turbulence and drying of the nasal lining
Difficulty delivering nasal sprays effectively
In some patients, this creates an environment where sinus infections recur or fail to fully settle.
However, a deviated septum alone does not automatically cause sinusitis.
When Rhinoplasty or Septorhinoplasty Can Help Sinus Symptoms
Rhinoplasty (or more accurately, septorhinoplasty) may help sinus-related symptoms if:
The septal deviation is significantly obstructing airflow
One side of the nose is consistently blocked
Symptoms are worse on the narrowed side
There is associated nasal valve narrowing or collapse
Nasal sprays have been ineffective due to poor access
In these cases, straightening and stabilising the nasal framework can:
Improve airflow
Improve delivery of topical treatments
Reduce pressure and congestion
Improve overall nasal function
The aim is functional improvement — cosmetic change can also be prioritised if desired.
When Rhinoplasty Is Not the Right Answer
If sinusitis is driven primarily by disease within the sinuses themselves, correcting the septum alone may not be sufficient.
Examples include:
Chronic sinus inflammation
Recurrent acute sinusitis with mucosal disease
Blocked sinus drainage pathways (osteomeatal complex disease)
Nasal polyps
In these cases, endoscopic sinus surgery may be required — sometimes with septal correction, sometimes instead of it.
This is why proper diagnosis is essential.
Why a CT Scan Can Be Very Helpful
A CT scan of the sinuses is often the most useful investigation when symptoms are persistent or unclear.
It allows assessment of:
Sinus inflammation or blockage
Drainage pathways
Septal deviation severity
Turbinate enlargement
Whether symptoms are nasal, sinus-related, or both
This helps answer a critical question:
👉 Would septorhinoplasty alone help — or is sinus surgery needed as well?
If there is any doubt about sinus issues, I recommend CT scanning.
Cost of CT Imaging
A private CT scan of the sinuses typically costs around £500, for example when arranged through Medicana Winchester.
While this is an additional cost, it often prevents inappropriate surgery and ensures that the correct procedure is recommended from the outset.
It is also more helpful than nasendoscopy and therefore I tend to suggest this as a definitive investigation rather than having to pay for nasendoscopy and then again for CT.
Specialist Assessment Matters
Deciding whether rhinoplasty, sinus surgery, or a combination is needed requires specialist ENT input.
Assessment in Hampshire is provided by Mr Tim Biggs, a Consultant ENT & Rhinology Surgeon with expertise in:
Septal deviation and nasal obstruction
Functional septorhinoplasty
Chronic and recurrent sinusitis
Endoscopic sinus surgery
Combined nasal and sinus procedures
Consultations take place at Adnova Clinic, with patients attending from Portsmouth, Southampton, Winchester, and across the South Coast.
A Tailored Approach Is Key
Some patients benefit from:
Septorhinoplasty alone (undertaken at Adnova)
Sinus surgery alone (undertake at Medicana Winchester)
Or occasionally combined septorhinoplasty and sinus surgery (Undertaken at the Harbour private wing at the Queen Alexandra Hospital, Portsmouth)
The correct option depends on anatomy, symptoms, and imaging — not assumptions.
Summary
A deviated septum can contribute to sinusitis, but is not always the cause
Rhinoplasty or septorhinoplasty helps many, but not all, patients - the detailed assessment is key!
Persistent sinus disease may require sinus surgery instead
A CT scan (≈£500 privately) is invaluable in deciding the right treatment in those with a history of co-existing sinus pathology
Specialist ENT assessment ensures the correct surgery, first time
If you suffer from sinus problems and have been told you have a deviated septum, a structured assessment — occasionally including CT imaging — is the safest way to determine whether rhinoplasty will truly help.
To enquire or book an assessment:
📍 Adnova Clinic
More information:
Frequently Asked Questions: Deviated Septum, Sinusitis & Rhinoplasty
Can a deviated septum cause sinus problems?
A deviated septum can contribute to sinus problems, but it is rarely the sole cause. By narrowing one side of the nose, it may impair airflow and sinus drainage, making infections more likely or slower to resolve, but many people with a deviated septum never develop sinusitis.
Will rhinoplasty or septorhinoplasty cure my sinusitis?
Sometimes — but not always. Septorhinoplasty may help if nasal obstruction from septal deviation or valve narrowing is contributing to poor sinus drainage or spray delivery. However, if sinus disease is driven by inflammation or blockage within the sinuses themselves, septal surgery alone will not be sufficient.
When does septorhinoplasty help sinus symptoms?
Septorhinoplasty is more likely to help if:
One side of the nose is persistently blocked
Symptoms are worse on the side of the deviation
Nasal sprays do not reach properly
There is associated nasal valve narrowing or collapse
Airflow is clearly compromised
In these cases, improving nasal structure can significantly improve symptoms.
When is rhinoplasty not the right treatment for sinus problems?
Rhinoplasty or septorhinoplasty is unlikely to resolve symptoms if sinusitis is caused by:
Chronic sinus inflammation
Recurrent acute sinus infections with mucosal disease
Blocked sinus drainage pathways (osteomeatal complex disease)
Nasal polyps
In these situations, endoscopic sinus surgery may be required instead of — or occasionally in addition to — septal surgery.
How do you tell whether my symptoms are nasal or sinus-related?
The most reliable way is with a CT scan of the sinuses.
This allows assessment of:
Sinus inflammation or blockage
Drainage pathways
Septal deviation severity
Turbinate enlargement
Whether symptoms are nasal, sinus-related, or both
This avoids guesswork and inappropriate surgery.
Do I need a CT scan before deciding on rhinoplasty for sinus issues?
If there is any history of recurrent or persistent sinus symptoms, a CT scan is strongly recommended.
It answers the key question:
👉 Would septorhinoplasty alone help — or is sinus surgery needed as well?
How much does a private sinus CT scan cost?
A private CT scan of the sinuses typically costs around £500, for example when arranged through Medicana Winchester. Although this is an additional cost, it often prevents unnecessary or ineffective surgery.
Is a CT scan more useful than a camera test (nasendoscopy)?
Yes, for sinus disease. Nasendoscopy assesses the nasal cavity, but cannot reliably assess the internal sinus cavities. CT imaging provides a definitive anatomical roadmap and often avoids the need for multiple investigations.
Can septorhinoplasty and sinus surgery be done together?
Occasionally, yes.
Some patients benefit from:
Septorhinoplasty alone
Sinus surgery alone
Combined septorhinoplasty and sinus surgery
Combined procedures are sometimes undertaken at Queen Alexandra Hospital when appropriate.
Who should assess sinus problems with a deviated septum?
Assessment should be carried out by a specialist ENT surgeon with experience in both nasal structure and sinus disease.
In Hampshire, assessment is provided by Mr Tim Biggs, a Consultant ENT & Rhinology Surgeon with expertise in:
Septal deviation and nasal obstruction
Functional septorhinoplasty
Cosmetic septorhinoplasty & rhinoplasty
Chronic and recurrent sinusitis
Endoscopic sinus surgery
Combined nasal and sinus procedures
Consultations take place at Adnova Clinic.
What is the safest way to decide whether surgery will help?
The safest pathway is:
Specialist ENT assessment
Careful symptom correlation
CT imaging where sinus disease is suspected
A tailored surgical plan, if surgery is needed at all
Correct diagnosis ensures the right operation, first time.
Key takeaway
A deviated septum can contribute to sinus problems, but not all sinusitis is fixed by rhinoplasty. A structured assessment — often including CT imaging — is the most reliable way to determine whether septorhinoplasty, sinus surgery, or no surgery at all is the correct solution.
