Septoplasty

Septoplasty is a surgical procedure that is done to correct deviated nasal septum. It is a structure made up of bone and cartilage present in the middle of the nose separating two, nasal cavities. An ENT surgeon performs this procedure. It helps in better airflow through the nose, and it becomes easier to breathe after the surgery.

 

1. Improved breathing – overall breathing function is greatly improved since the nasal passages are opened up.
2. Better sleep quality – reshaping a crooked septum not only improves airflow while you're awake,
3. But also reduces or eliminates snoring and/or sleep apnea and improves the overall quality of your sleep

1. Septoplasty is the only solution to fix a deviated septum. The severely deviated nasal septum can lead to dry mouth due to chronic mouth breathing.
2. Congestion in your nasal passages
3. Septoplasty raises the nose and aligns it in the centre.
4. It is also done for other medical procedures like sinus surgery and the removal of nasal tumours.
5. Deviated nasal septum shows symptoms like:
6. Breathing difficulty
7. Recurrent infection of the sinus 
8. Obstruction in nose
9. Crooked nose
10. Snoring
11. Headache[3]

A septoplasty procedure comprises the following steps:

Step 1

The surgeon administers anaesthesia to numb the pain during the surgical procedure. The anaesthesia can be intravenous or general anaesthesia depending on your health condition. Your doctor will tell you the best choice for you.

Step 2

In septoplasty, the incisions are usually made within the nasal cavity or across your columella,  the anterior part of the nose.

Step 3

The nasal mucosal lining is then separated from the septum on one side. This is an important step that must be carefully performed since the lining is delicate, which may cause a tear or hole. Similarly, the mucosal lining is lifted from your septum.

Step 4

The deviated septum (bone and/or cartilage) is removed. Only the nasal lining of your nose is left behind. 

Step 5

Once your septum is in the midline position and is straightened by the surgeon, it is sutured back together.

Step 6

Your reconstructed septum is stabilised with the help of silicone splints or packing. Internal sutures are absorbable.

 

What to expect before the surgery?

 

First, your doctor will discuss with you the risks and benefits of the surgery, which includes:

Medical history: The surgeon will ask you about any health conditions you have  in the present or past. 

Physical examination: The surgeon will examine both inside and outside your nose.

Photograph: The photographs of your nose will be clicked as a reference for before and after the septoplasty.

The surgeon will ask you to run some basic blood tests and X-ray.

You will be asked to stop taking blood thinners like aspirin, as they increase the chance of bleeding and painkillers like ibuprofen.

The doctor will prohibit you from smoking as it interferes with healing.

Based on your test reports, the date of your surgery is fixed.

The doctor will decide the type of anaesthesia to administer to you, local or general.

You will be prohibited from eating anything before surgery for at least 6 hours.

You won't be able to drive home after surgery, so you will need a family member to take you home.

If you have any queries, ask your surgeon.

What to expect on the day of surgery?

The faculty will ask you or your family members to sign the consent form for the procedure.

The procedure usually takes about 30-90 minutes, depending upon the severity of your nasal septum deformity. 

What to expect during surgery?

 

You will be appropriately positioned for the procedure with your head slightly above, to monitor your vitals.

You’ll be administered the type of anaesthesia suggested by your surgeon. Primarily general anaesthesia is given so that you remain unconscious during the surgery.

Sometimes, local anaesthesia is also given, which means the part of your nose is numb to the pain.

Your surgeon will reconstruct and replace your septum and make it straighter. 

Sometimes, your doctor may need to cut the bone to fix it.

You may also get silicone splints or soft packing to keep your septum supported. This helps in preventing bleeding.

What to expect after surgery?

1. Since it is usually an outpatient surgery, you will be sent home after the procedure.
2. You may have splints or packing, which your surgeon removes within 24-48 hours during your first follow up.
3. If packing is present, you will have to breathe through your mouth till it is removed.
4. You will have only dissolving sutures, which will be absorbed.
5. There are only internal incisions, so there will be no scarring. 
6. Your nose will have swelling for 2-3 days and drainage of blood or mucus for up to 5 days.
7. You may experience pain or tenderness on the front of the nose and stuffiness due to swelling.
8. You will be advised not to blow your nose or rub it, bathe for the first 24 hours after the surgery, and not lift heavyweights.
9. You should stay away from dusty or smoky places.

First follow-up appointment

1. The first follow-up is usually within 24-48 hours for removing silicone splints or soft nasal packings.
2. If you don't have any nasal packing, your follow-up is usually after 5-10 days.
3. If you observe any unusual signs like bleeding, excessive swelling, consult your doctor. 
4. If your suture does not dissolve on its own, you should visit your doctor.

When to consult a doctor?

1. Consult a doctor if you experience: 
2. Trouble in breathing
3. Excessive nosebleed
4. Pain that worsens and is not relieved by medications
5. High fever and chills
6. Headaches
7. Disorientation
8. Neck stiffness

 

As soon as you face any of the complications mentioned above, you should immediately reach out to your doctor.