A deviated septum is typically caused by either birth-related factors or an injury to the nose. Here are the main contributors:

• Birth or congenital factors: Some people are born with a septum that is uneven or misaligned because of how the nasal structures developed in the womb. This can present at birth or become apparent as the nose grows. This is a common baseline cause in many individuals.

• Injury or trauma: The nose is the most exposed facial feature, and a blow to the nose from falls, sports, accidents, or physical impact can shift or bend the nasal septum. Even injuries that seemed minor at the time can contribute to a deviation over time. This is the most frequently cited cause in adults and children alike.

• Birth delivery-related trauma: In some cases, the birthing process itself (for example, prolonged labor or assisted delivery) can lead to septal deviation, which may be noticed later as the child grows.

• Aging and growth: As the nose grows and changes with age, minor shifts can become more pronounced, occasionally worsening a pre-existing deviation.

Notes:

• In a small number of people, a deviated septum can be mild and cause no symptoms, while in others it can contribute to nasal obstruction, recurrent sinus infections, or other breathing-related issues.

• Some sources also mention associations with certain connective tissue conditions or genetic factors, though these are less common and not the primary causes for most individuals.

If you’re experiencing congestion, nasal obstruction, or recurrent sinus infections and suspect a deviated septum, it’s a good idea to consult an otolaryngologist (ENT) who can confirm the diagnosis with a nasal exam and discuss treatment options, which may range from medical management to surgical correction (septoplasty) in appropriate cases.