Septoplasty

Overview of Septoplasty | ENT Specialist

What is septoplasty?

Septoplasty is a surgical procedure that straightens the bone and cartilage that separates the space between the two nostrils (septum). When the septum is curved, it is called a deviated septum. A deviated septum makes breathing through the nose difficult and increases the risk of sinus infections due to inadequate drainage.

During a septoplasty, your nasal septum is placed in the center of your nose. Your surgeon may need to cut and remove parts of your nasal septum before reinserting them into the correct position.

Some people are born with a deviated septum, but it can also be caused by an injury to the nose. Most people with a deviated septum have one nasal passage that is much shorter than the other. May cause shortness of breath. Other symptoms of a deviated septum can often include a runny nose and facial pain. Surgery is the only way to repair the deviated septum.

Septoplasty is a surgical procedure to correct a deviated septum. Septoplasty straightens the septum, allowing better airflow through the nose.

Once the septoplasty heals, breathing feels easier. Your surgeon can discuss what a septoplasty can accomplish for you.

Why is septoplasty necessary?

Septoplasty is the only way to correct a distorted septum, which makes breathing through the nose difficult and forces breathing through the mouth. Oral breathing causes dry mouth. The inability to breathe through the nose is a major problem at night and prevents sleep.

Sometimes septoplasty is part of other medical procedures, such as sinus surgery and removal of nasal tumors. Also, if the septoplasty does not change the shape of the nose, it is called a septorhinoplasty with nose shape surgery.

Finally, each patient must decide whether to undergo a septoplasty to straighten the deviated septum. This condition does not bother anyone who can tolerate the symptoms.

Risk factors for septoplasty

As with any major surgery, septoplasty carries risks such as bleeding, infection, and an adverse reaction to a medication. Other specific risks of septoplasty:

  • Symptoms such as nasal obstruction persisted
  • Excessive bleeding
  • A change in the shape of your nose.
  • A hole in the septum
  • Decreased sense of smell
  • Blood clots in the nasal area
  • Temporary numbness in the upper gums, teeth, or nose

You may need additional surgery to treat some of these problems. You may also need additional surgery if the septoplasty result does not match your expectations. Talk to your doctor about your specific risks before surgery.

Preparing for septoplasty

Your doctor may ask you to stop taking certain medications two weeks before surgery. These medications may include aspirin (bufferin), ibuprofen (Advil), and other blood thinners. This is done to reduce the risk of excessive bleeding during and after the procedure. Tell your doctor if you are allergic to certain medications or if you have a history of bleeding problems.

In some cases, people will have a septoplasty under local anesthesia, which will numb the area to prevent pain. However, most people have surgery under general anesthesia, which means that they fall asleep during the procedure.

If you are going to be under general anesthesia, do not eat or drink anything after midnight before the procedure. This can help prevent vomiting and nausea if you feel nauseous from the anesthesia during surgery.

Bring a family member or friend who can drive you home after septoplasty. Drowsiness after the general anesthesia procedure. You should not drive until the effects have completely worn off.

Your doctor may take pictures of your nose before the procedure. Comparing photos before and after the procedure can help you see how your nose has changed.

Septoplasty procedure

A septoplasty can take 30 to 90 minutes to complete, depending on the complexity of the condition. You will be under local and general anesthesia and you and your doctor will decide what is best for you.

In a simple procedure, the surgeon will make an incision in the side of your nose to access the septum. Then they lift the mucous membrane, which is the protective shield of the septum. The deviated septum is then moved to the correct position. All obstructions, such as extra pieces of bone or cartilage, are removed. The final step is the establishment of repositioning of the mucous membrane.

You may need stitches to hold the septum and membrane. However, covering the nose with cotton is sometimes enough to keep them.

What can you expect

Septoplasty straightens the nasal septum by trimming, repositioning, and replacing cartilage or bone. The surgeon works through incisions inside the nose. Occasionally a small incision is necessary between the nostrils.

If the nasal bones are twisted and pushing the septum to one side, it may be necessary to cut the bones of the nose to reposition them. Spreader grafts are small strips of reinforcing cartilage that can be used to help correct a deviated septum when the problem is along the bridge of the nose. Sometimes these are necessary to effectively straighten the septum.

During the procedure

The procedure can be performed under local or general anesthesia. The type of anesthesia used depends on the complexity of the surgery and what you and your surgeon prefer.

Local anesthesia. This type of anesthesia is limited to the nose. Your doctor injects a pain reliever (anesthetic) into your nasal tissues. If you will also be sedated, this is done with intravenous medication. The medicine leaves you groggy but not completely unconscious.

General anesthesia. Under general anesthesia, you inhale an anesthetic agent or receive an anesthetic through an IV. This type of anesthesia affects your entire body and induces a temporary state of unconsciousness.

Talk to your doctor beforehand about what type of anesthesia is best for you.

During surgery, the incision is closed with absorbable suture. Soft silicone splints can be inserted into each nostril to support the septum. To prevent postoperative bleeding, your doctor may place a bandage-like material on your nose (tamponade).

After surgery, you are transferred to a recovery room, where the staff monitors you and watches for complications. This procedure is usually done on an outpatient basis, so you will likely be able to go home the same day. However, you will need someone to drive you home.

After the procedure

To further decrease the chances of bleeding and swelling, your doctor may ask you to follow these precautions for several weeks after surgery. Depending on the extent of your surgery, you may not need to do all of these:

  • Elevate your head when you sleep.
  • Don’t blow your nose for several weeks.
  • Wear clothing that fastens in the front; do not pull clothing, such as shirts or sweaters, over your head.
  • Avoid strenuous activities, such as aerobics and jogging, for up to five weeks to avoid causing a nosebleed.

Recovering from a septoplasty

Septoplasty is usually performed as an outpatient procedure unless major complications arise. This means that you’ll be able to go home on the same day as the procedure, once the anesthesia has worn off. Your nose will be swollen, painful, and packed with cotton to control bleeding. The packing can be removed a day or two after surgery. Your doctor will also prescribe pain medication as needed.

Your doctor will likely ask you to avoid aspirin, ibuprofen, and other drugs that thin the blood. This is done to lower the risk of bleeding problems after the procedure.

You should also limit your physical activity for several weeks after surgery to minimize swelling and promote healing. This includes most forms of intense exercise, such as running, lifting weights, and playing contact sports. These activities can increase your blood pressure and lead to heavy bleeding.

Tips for a quicker recovery include:

  • Elevating your head at night to keep the swelling down
  • Not blowing your nose for at least three days after surgery
  • Wearing shirts that button up in the front so you won’t have to pull clothing over your head

Results

Between three and six months after surgery, your nasal tissues will be relatively stable. It is still possible for cartilage and tissue to gradually move or reshape over time. Some changes can still occur for up to a year or more after surgery.

Most people find that septoplasty improves their symptoms, such as shortness of breath, caused by a deviated septum. The level of improvement you can expect with septoplasty varies from person to person.

Some people find that their symptoms continue even after surgery and choose to undergo a second septoplasty to further refine the nose and septum.

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