Septoplasty

Overview

Septoplasty, a surgical procedure designed to correct a deviated septum, involves the straightening of the wall of bone and cartilage that separates the two nostrils. This partition, known as the septum, can become misaligned, making it difficult to breathe through the nose. The surgery entails repositioning the septum to its central location within the nose, which may involve the removal and subsequent replacement of sections of the septum. The result of septoplasty is improved nasal breathing, providing relief to individuals with a deviated septum.

The septum, typically about 7 centimeters long in adults, comprises both cartilage and bone, dividing the nasal passages into two chambers or nostrils. A deviated septum, which can be present from birth or develop due to injury, is characterized by its crooked or bent shape, often obstructing one or both nostrils and impeding the normal flow of air through the nasal passages.

Prior to undergoing septoplasty, individuals should consult with a surgeon to gain a clear understanding of the expected outcomes and potential benefits of the procedure.

Reasons for undergoing the procedure

Septoplasty is a surgical procedure primarily recommended for individuals with a deviated septum causing nasal obstruction, and it may also be advised for purposes like removing nasal polyps, treating chronic sinusitis, addressing recurrent nosebleeds, or managing other conditions that impede nasal airflow. This procedure is most commonly performed in adolescents and adults, although exceptions exist for certain cases in young children. During septoplasty, the surgeon straightens the septum by modifying cartilage, bone, or both, while sometimes recommending turbinate reduction to reduce the size of nasal structures. It serves as an effective solution for enhancing nasal airflow and relieving symptoms impacting one’s quality of life.

Risk

Like any major surgical procedure, septoplasty is associated with certain risks. These potential risks include:

• Bleeding: There is a risk of bleeding during or after the surgery.
• Infection: Infections can occur as a result of the surgical procedure.
• Adverse reaction to anesthesia: Some individuals may experience adverse reactions to the anesthesia used to induce unconsciousness and alleviate pain during surgery.

In addition to these general risks, septoplasty carries specific risks, including:

• Persistent symptoms: There is a possibility that you may continue to experience symptoms such as nasal congestion and obstruction after surgery.
• Severe bleeding: In some cases, serious bleeding can occur during or after the procedure.
• Altered nasal shape: Septoplasty can potentially lead to changes in the shape of the nose.
• Septal perforation: There is a risk of developing a hole in the septum, the partition between the nostrils.
• Reduced sense of smell: Some individuals may experience a diminished sense of smell following the surgery.
• Blood clots: Clots of blood may form in the nasal space, necessitating drainage.
• Temporary numbness: Short-term loss of sensation in the upper gum, teeth, or nose may occur.
• Poor wound healing: Surgical incisions may heal inadequately, resulting in poor scar formation.

It’s important to note that in some cases, additional surgery may be required to address these health issues or to achieve the desired results from septoplasty. Before undergoing septoplasty, it’s crucial to discuss these specific risks with your surgeon to fully understand the potential outcomes and make an informed decision.

Before the procedure

Before your septoplasty, it’s essential to meet with your healthcare provider and adhere closely to the preoperative instructions provided. You must inform your provider about all the medications you are presently using, including over-the-counter drugs, dietary supplements, and herbs. In preparation for surgery, it is advisable to discontinue the use of medications such as aspirin, ibuprofen, naproxen, and specific herbal supplements that can impede blood clotting. Additionally, it’s crucial to disclose any allergies or bleeding issues to your healthcare provider.

During the procedure

Septoplasty is typically performed as an outpatient procedure, allowing most patients to return home on the same day of the surgery. The procedure can be done under general anesthesia, which means you will be unconscious during the operation. Alternatively, local anesthesia, which numbs the specific area to be treated, may also be considered.

The entire procedure takes place within the nasal passages. Your surgeon will make an incision on one side of your nose and gently lift the mucosa, a thin protective membrane covering the septum. This provides access to reshape the bone and cartilage of the septum. In some cases, portions of the bone and cartilage may be removed, reshaped, and repositioned to improve the structure of your nose. Following this, the mucosa is carefully placed back over the septum. It’s important to note that your nose is not broken during this surgery. The entire operation typically lasts anywhere from 30 to 90 minutes.

After the procedure, your surgeon may insert splints or soft packing materials to support the nasal tissues, minimize the risk of nosebleeds, and reduce the potential for scar tissue formation. These splints are usually left in place for about a week. Alternatively, your surgeon may opt for dissolvable stitches that will naturally disappear over time.

After the procedure

After a septoplasty, your medical team will closely monitor you as you wake up from anesthesia. Once you’re alert and stable, you can go home. Your surgeon will provide postoperative instructions to help you manage pain, bleeding, and swelling. It’s important to avoid strenuous activities and heavy lifting during your recovery, as they can increase bleeding, pain, and swelling. Your surgeon will guide you on when it’s safe to resume your normal routines.

After septoplasty, you can expect mild to moderate discomfort, similar to a sinus infection. This discomfort typically includes pain and pressure around the eyes, forehead, cheeks, and upper teeth, but it usually diminishes within a few days.

Outcome

Recovery from septoplasty typically involves an initial one-week healing period, followed by ongoing bone and cartilage healing over several months to a year. Here are some key recovery guidelines:

• Activity: Rest at home for several days post-surgery. Light activities can resume after one week, while strenuous physical activity should be avoided for a month.
• Nasal care: Avoid nose blowing and sneeze with your mouth open for the first week. If your nostrils have splints, keep them dry in the shower and they will be removed after about a week. Without splints, you can bathe the day after surgery.
• Diet: Resume your normal diet as tolerated.
• Pain management: Use over-the-counter pain relievers like acetaminophen and ibuprofen as needed. Alternating these medications every three hours can help control discomfort.
• Fever: If you have a low-grade fever (101 degrees or less), take acetaminophen. For high fever (over 102 degrees) lasting more than two days, contact your healthcare provider.
• Antibiotics: Take prescribed antibiotics starting on the day of surgery and complete the full course.
• Surgical dressing: Leave gauze under your nose for 48 hours after surgery or until drainage stops. Change gauze as needed. Contact your provider if there’s excessive bleeding requiring hourly changes. Soft splints or packing in the nose will be removed at your first follow-up visit.
• Nasal hygiene: Rinse the inside of your nose with saline, as instructed by your provider. If crusting occurs around your nostrils, gently clean with a cotton swab dipped in diluted hydrogen peroxide.

Follow your surgeon’s specific postoperative instructions for a comfortable and successful recovery.