What is Septoplasty Surgery for Deviated Septum?
Septoplasty is surgery inside the nose to straighten a deviated septum. The septum, about 7 centimeters long (2.5 to 3 inches) in adults, is made of cartilage and bone. It separates the inside of the nose into two chambers or nostrils.
What is a deviated septum?
A septum is deviated if it is crooked or bent instead of straight. A deviated septum can block one or both chambers of the nose and interfere with airflow. A septum can become deviated from an injury, but it can also grow that way naturally.
How is a deviated septum diagnosed?
A doctor will examine the inside of the nose, possibly by performing a nasal endoscopy, which involves inserting a tube with a camera on the end. A computed tomography (CT) scan can also detect a deviated septum, but it is usually unnecessary. After the diagnosis, the doctor will discuss treatment options, including septoplasty.
Are there other causes of nasal obstruction?
Yes. Allergies and polyps can cause nasal blockages. Also, turbinates – long ridges of bone and tissue inside the nose that protrude into the nostrils – can obstruct if they are too large. Steroid nasal sprays can reduce swelling in turbinates, and adhesive nasal strips can provide temporary relief.
Why is septoplasty necessary?
Septoplasty is the only way to correct a deviated septum, which can make breathing through the nose difficult and force breathing through the mouth. Mouth breathing can cause dry mouth. Inability to breathe through the nose is even more of a problem at night and can inhibit sleep.
Sometimes septoplasty is part of other medical procedures, including sinus surgery and the removal of nasal tumors. Also, although septoplasty itself does not change the nose’s shape, it can be combined with nose-shaping surgery called septorhinoplasty.
Ultimately, it is up to each patient to decide whether to undergo septoplasty to straighten a deviated septum. The condition will not hurt anyone who can tolerate the symptoms.
How does a patient prepare for septoplasty?
The doctor must know of all medications — including nonprescription drugs, supplements and herbs — the patient is taking. Before surgery, the patient should stop taking drugs like aspirin, ibuprofen, naproxen and certain herbal supplements, which make it harder for blood to clot. The doctor should also know if the patient has allergies or bleeding problems.
How is septoplasty performed?
Septoplasty is usually performed on an outpatient basis, so most patients go home the day of the surgery. In most cases, the patient is placed under general anesthesia and is asleep during the operation. Local anesthesia, which numbs the part of the body targeted for surgery, might be an option.
The procedure takes place entirely inside the nose. The doctor cuts a wall on one side of the nose and lifts or removes the mucosa, a thin membrane that covers and protects the septum. This allows the doctor to reshape the septum’s bone and cartilage. Sometimes parts of the bone and cartilage are removed, then reshaped and repositioned. Afterward, the mucosa is placed back over the septum. The nose is not broken during surgery. The operation takes between 30 and 90 minutes.
Afterward, the doctor may insert splints or soft packing to hold nasal tissue in place, prevent nosebleeds and prevent the formation of scar tissue. Usually, the splints stay in one or two weeks and packing remains in the nose between 24 and 36 hours. Sometimes, the doctor might leave only dissolving stitches, which disappear on their own over time.
Are there risks or complications with septoplasty?
Risks or complications are rare and unlikely. One risk is that bleeding may become excessive during surgery, especially if the patient did not stop taking blood-thinning medications beforehand. If this happens, the doctor may decide not to go ahead with the operation.
Infection is possible because the inside of the nose is not sterile. Toxic shock syndrome is an unusual and life-threatening infection, mostly related to packing being placed, which is rare. Symptoms include change in blood pressure and heart rate, fever and skin discoloration. If symptoms appear, notify the doctor or surgeon immediately.
What can I expect after septoplasty?
Since the operation is done through the nostrils, patients do not have to worry about facial scars or black eyes. However, they can experience pain or tenderness on the front of the nose, stuffiness due to swelling and nasal drainage of blood and-or mucous. Swelling from surgery may last two to three days, and drainage might continue for two to five days. Usually, over-the-counter medications will suffice for pain, although the doctor may prescribe a pain reliever. The doctor might have the patient use saline sprays or irrigation treatments to clear nasal congestion. However, if packing is in the nose, the patient will have to breathe through the mouth until the material is removed. It may take up to three months for the nose to achieve maximum clearness.
