What is septoplasty?
Septoplasty is a surgery to correct a deviated nasal bone.
The septum, which is about 7 cm long in adults, is made up of cartilage and bone. It divides the inside of your nose into two. A deviated nasal bone can block one or both nostrils and restrict airflow. Your septum can develop from an injury or from birth.
What are the causes of nasal bone curvature?
Ideally, the left and right nasal cavities are of equal size. Injury or trauma to the nose can cause a curvature. However, curvature can occur even in people with normal growth and development and no history of injury, trauma, or broken noses.
What are the symptoms of nasal bone curvature?
The most common symptom of nasal bone curvature is difficulty breathing through the nose, usually more intensely on one side. In some cases, the curvature can block sinus drainage and cause recurrent sinus infections. The curvature can also cause:
- Noise bleeding
- Noisy breathing during sleep in infants and young children
- Mouth breathing during sleep in adults. This can cause insomnia.
Are there other conditions that accompany nasal deviation?
The following conditions may accompany the deviation:
- Enlargement of the lower turbinate, which is the structure that warms and moistens the air in your nose (inferior turbinate hypertrophy).
- Formation of a large air bubble in one of the turbinates next to your sinus openings (medial turbinate bullosa).
- Collapse of the nasal valve
- Sinusitis
- Headaches
- External nasal deformity (change in the shape of the nose)
- Decreased sense of smell
When is septoplasty performed?
A deviated septum is common. It is estimated that 80% of people have a deviated nasal bone. However, when this deviated septum is severe, it can block the nose and reduce airflow. Your doctor may also recommend septoplasty for the following purposes:
- Remove nasal polyps
- Treat chronic sinusitis
- Stop recurring (chronic) nosebleeds
- Relieve other conditions that block your nasal airway
If your symptoms are affecting your quality of life, surgery may be the right decision for you.
Are there any risks to septoplasty surgery?
As with any surgery, septoplasty carries risks. These risks include bleeding and infection.
Other risks specific to septoplasty include:
- Non-relief of nasal congestion
- Changes in the shape of the nose
- Perforation of the septum (septal perforation)
- Loss of sense of smell
- Blood clotting in the nasal cavity that needs to be drained
- Temporary loss of sensation in the upper gums, teeth or nose
- Poorly healing surgical incisions
- Cerebrospinal fluid leak (extremely rare)
What is the pre-septoplasty process like?
- During your pre-septoplasty consultation, your doctor will: takes your medical history, examines your nose and skin, requests necessary blood and imaging tests, may take pre-operative photographs, and explains what to watch out for before surgery.
- You should stop taking medications such as aspirin or ibuprofen before and after surgery due to the risk of bleeding. Only use medications approved or prescribed by your surgeon.
- Smoking increases your risk of having problems during and after surgery. It can also slow down the healing process.
How is septoplasty surgery performed?
Septoplasty is a surgical procedure performed through the nostrils. Therefore, there is generally no bruising or external surgical scars. However, each case is different and special techniques may be required for each patient. The surgery takes approximately 1-1.5 hours. This period will be longer if combined with different procedures.
Local anesthesia was also preferred in the past, but due to developing technological applications, general anesthesia is used more frequently today for the comfort of the patient.
The procedure takes place entirely inside your nose. Your surgeon creates an incision on one side of your nose and removes the mucosa (a thin membrane that covers and protects the septum). This procedure allows your surgeon to reshape the bone and cartilage of the septum.
During the surgery, the severely deviated parts of the septum can be completely removed or readjusted and repositioned in the nose. Then, your doctor places the mucosa back on the septum. The nasal bone is not broken during the surgery.
How is postoperative packing used?
Your surgeon will place packings in your nose after the procedure. The application of a nasal packing varies depending on factors such as the type of surgery, the postoperative period, and the surgeon’s preference. The packing plays a critical role in ensuring stability, healing, and comfort after surgery. The functions of a nasal packing are as follows:
- Controls bleeding after surgery.
- Supports nasal tissues during healing.
- Preserves stitches and the shape of the nose.
Traditional nasal packings can be uncomfortable. For this reason, modern alternatives such as silicone gel sheets, tubes, or nasal splints are often used.
If a sponge packing has been used, it is removed from the nose within 1-3 days. Since silicone packings have a lower risk of infection, they can sometimes be removed after 5 days.
What should I watch out for after septoplasty?
Although the process varies from patient to patient, your surgeon may ask you to take the following precautions for a few weeks to reduce the possibility of bleeding and swelling:
- Sleep on your back with your head elevated.
- After the operation, sneezing and coughing should be done carefully so as not to disturb the nasal structures.
- Do not blow your nose for at least a few weeks.
- Wear clothes that tie in the front. Do not put on and take off clothes such as shirts or sweaters over your head.
- Avoid strenuous activities such as heavy lifting, aerobics and running for up to 6 weeks. This is because the increase in your heart rate and blood pressure can cause additional bleeding, pain and swelling.
- Use medications prescribed by your surgeon to relieve pain when necessary.
When should you see your doctor?
If you recently had septoplasty, you should call your doctor if:
- Difficulty breathing
- Heavy, uncontrollable nosebleeds
- Pain that doesn’t get better with medications and gets worse
- High fever
- Chilling
- Headaches
- Disorientation
- Stiff neck
What is recovery like after surgery?
Your surgeon will give you a list of instructions to help you manage pain, bleeding, and swelling after septoplasty, and will tell you when to return to your normal routine.
After 3 to 6 months after surgery, the tissues in your nose will likely have stabilized somewhat. It’s still possible for the cartilage and tissue to move or change shape over time. Some changes may occur up to a year or longer after surgery.
Many people find that septoplasty improves their breathing difficulties. However, results vary from person to person.
Some people report that their symptoms continue after surgery. In this case, a second septoplasty may be necessary.
Should rhinoplasty and septoplasty surgery be combined?
If patients with nasal deviation want to improve the appearance of their nose, and if the patient’s health condition allows, it may be more logical to perform the two surgeries simultaneously rather than one after the other because:
- The rhinoplasty performed after septoplasty is much more complicated because the septum cartilage is no longer present. Instead, cartilage grafts will need to be taken from the ear.
- Combining the procedures makes the surgery much easier to perform.
- Since patients do not undergo two separate surgical procedures, their recovery time is more comfortable.
After the combined septoplasty and rhinoplasty procedure, patients may experience:
- Improved breathing
- Decreased/ending snoring
- Increased sleep quality
- Reduction in facial pain
- A more aesthetic appearance
FREQUENTLY ASKED QUESTIONS ABOUT SEPTOPLASTY
Is septoplasty a major surgery?
No. Septoplasty is a minor, low-risk procedure. Recovery usually takes a few days, with an average of one week of recovery. However, like any surgery, septoplasty carries some risks, including bleeding, infection, and numbness.
Can children have septoplasty?
In most cases, septum surgery can be performed on children as young as 6 years old. However, if necessary, septum surgery can be performed on younger children.
What surgeries can septoplasty be combined with?
The surgery can be combined with rhinoplasty, turbinate reduction, and sinus surgery.
Can Septoplasia be performed with local anesthesia?
Your doctor will decide which anesthesia method will be applied according to your condition. Although local anesthesia was often preferred in the past, general anesthesia is generally preferred for the comfort of the patient thanks to safer anesthesia techniques today.
Is Septoplasty painful?
Septoplasty is a comfortable operation, but you can expect mild to moderate discomfort afterwards. Some pain and pressure may occur around the eyes, forehead, cheeks and upper teeth. These side effects are normal and usually disappear within a few days.
Can Septoplasty be performed without nasal packing?
Yes, but this depends on the patient’s condition. Surgeons sometimes make decisions based on the risk of bleeding.
Which type of tampon is most commonly used in septoplasty?
The most commonly used tampons are silicone ones. These are breathable and supportive tampons. They remain in the nose for 3-5 days, sometimes longer. While sponge tampons completely block breathing, silicone tampons can provide good airflow if nasal sprays are used regularly.
Is there any pain when removing the tampon during nose surgery?
Silicone tampons cause slight discomfort when removed, but they are not painful. Since sponge tampons do not stick, they cause minimal discomfort during the removal process. The nasal tampon removal process takes a very short time and breathing comfortably relaxes the patient.
Is septoplasty the same as rhinoplasty?
No. Rhinoplasty focuses on changing the external appearance of your nose or the structural support of your nose, while septoplasty targets the structures inside your nose. Rhinoplasty is usually a cosmetic surgery procedure, while septoplasty restores function.
Septoplasty itself does not change the shape of your nose. If you want to change the shape of your nose in addition to straightening your deviated septum, your surgeon may combine septoplasty with rhinoplasty.
Sources:
- mayoclinic.org
- ncbi.nlm.nih.gov
- hopkinsmedicine.org
- clevelandclinic.org
- enthealth.org