Septoplasty & Turbinate Reduction
What is the Nasal Septum?
The nasal septum is the vertical wall that divides the nose into two nasal cavities. It is made up of cartilage. The nasal cavities and nasal septum are lined with a thin membrane of tissue called mucosa.
What is Septal Deviation?
At birth, the nasal septum is usually straight. However, as age progresses, there is a tendency for the septum to bend to one side or the other or for an irregular shelf of cartilage or bone to develop (septal spur). Often, there is no history of injury to account for the irregular septum. In some individuals the septum loses its midline position during the growth process rather than as the result of an injury. Few adults have a septum that is completely straight. Sometimes the septum is bent as a result of birth trauma. During childhood or adult life, trauma also plays a major factor in producing septal deviation.
What is Septoplasty?
Septoplsaty is an operation to correct a deformity of the nasal septum. The usual purpose is to improve nasal breathing, but it may also be performed to allow adequate examination of the inside of the nose for treatment of polyps, sinusitis, tumors, or bleeding. When the nasal septum is deformed, there is no medication that will cause it to be straightened, so surgery is the only solution to the problem.
How is Septoplasty done?
Septoplasty is performed under general anesthesia. It takes about 45 minutes and is usually done as an outpatient procedure. A small incision is made in the nose. The mucosal lining of the septum is detached from the cartilage and bones of the septum. The deviated portions of the septum are also detached from the cartilage and bones of the septum. The deviated portions of the septum are removed and straightened. The nasal lining mucosa membrane is replaced. Splints or packs are placed in the nose for 1-2 days. There are no external bruises or swelling of the eyes because the outer nasal bones are not broken or interfered with as they are in cosmetic nasal surgery.
What is a Turbinate?
In some patients, other structures in the nose may contribute to the blockage of airflow and your surgeon may advise that these be addressed as well. Occasionally, shelf like structures known as "turbinates" can be enlarged and block normal air movement through the nose. The function of the turbinates is to increase the surface area of the nose and to direct air through the nose. Surface area within the nose is important because the nose warms and humidifies air and removes small particles before the air reaches the lungs. When the turbinates are too large, however, they can disrupt air movement through the nose and may therefore need to be reduced in size. Your surgeon will discuss with you whether this is the case in your nose.
What are the benefits of Septoplasty?
The goal of the surgery is to restore normal airflow through the nose. Deviated portions of the nasal septum will be straightened or removed to improve airflow. Trimming or reduction of enlarged turbinates may also play a role in achieving this goal.
What are the complications of Septoplasty?
The possible complications may include:
- A hole in the septum
- Failure to completely improve breathing
- Very rarely, a change in appearance
- Permanent loss of sense of smell
All surgeries carry with them the risk of bleeding, infection, and pain. The risk of bleeding is increased by certain medications so you should review all medications. Lack of improvement or even worsening of the underlying condition and the need for re-operation are other risks inherent with any surgery. Surgery also carries the risk of anesthesia.
Taking antibiotics after the procedure will minimize the risk of infection. Most pain can be relieved by taking Extra Strength Tylenol or Ibuprofen and Tylenol combination.
What should I expect after surgery?
You should expect to have some nasal congestion from the swelling in your nose. This will last for 4-7 days. You may also have some bloody fluid oozing from the incision within your nose for 1-2 days following surgery. Scabbing or "crusting" may form along the incisions in your nose and it will be tender. You may want to take 4-7 days off from work/school following the surgery. There are no travel restrictions after the surgery but you will not want to swim until the healing of the incisions is complete, about 2-3 weeks.
Patients will be given an appointment 1-2 weeks after surgery.
What are the alternatives?
Medications to diminish the swelling of the lining of the nose may promote airflow but have drawbacks that you should discuss with your physician. If turbinate surgery is recommended, there are a number of methods to perform this portion of the procedure and may you wish to discuss these with your surgeon. This procedure is considered an elective surgery. As with any surgery, you should feel comfortable seeking a second opinion from another surgeon if you desire.