Septoplasty- Who Can Opt For It?

Why is nasal septoplasty surgery performed?
Many people have a deviated septum, and it often causes no noticeable issues. However, if your septum is severely deviated, it can block one side of your nose and reduce airflow. You may have trouble breathing through one or both sides of your nose, and you may also develop other issues such as snoring, sleep apnea, an impaired sense of smell or taste, or frequent sinus infections –as a result.
In addition, you may also experience crusting or bleeding due to the additional exposure of a deviated septum to the drying effect of airflow through the nose.
Septoplasty straightens the nasal septum by trimming, repositioning, and replacing cartilage, bone, or both. It’s done entirely through the nostrils, so no skin on the outside of your nose is cut.

The goals of nasal airway surgery include the following:

1. Improve airflow through the nose
2. Control nosebleeds
3. Enhance visualization of the inside of the nose (to identify other nasal problems)
4. Relieve nasal or sinus headaches associated with swelling of the inside of the nose
5. Promote drainage of the sinus cavities

Who is a candidate for septoplasty?
If a deviated septum is severe, it can block one side of the nose, impeding the flow of air through one or both nasal passages. For some people, it can cause problems such as snoring, frequent sinus infections, snoring, sleep apnea, and respiratory complaints.

Usually medications such as decongestants and antihistamines can be used in an effort to alleviate symptoms. But in some cases, they can cause troubling side effects such as elevated blood pressure (decongestants) and drowsiness (antihistamines). They also may not provide enough relief. If your symptoms are significantly affecting your life, you should consider a septoplasty surgery in order to achieve long-lasting relief.
 
What is involved in nasal septoplasty surgery?
Before planning the surgery, your doctor will discuss your medical history with you, as well as any medications you may take. A physical examination will be conducted, and your doctor may use an endoscope (a thin, lighted instrument) to examine your septum. You’ll also be able to learn about your expected results if surgery is a recommended option.

Septoplasty requires local or general anesthesia, depending on the surgeon’s preference and the complexity of the surgery. It usually lasts about 60 to 90 minutes and is often performed in an outpatient surgery center.
To repair the septum, the surgeon works through the nostrils rather than from the outside of the nose. An incision is made to separate the mucosa (a soft layer of tissue that lines the septum and nasal passages) from the underlying cartilage and bone. The doctor trims or straightens the bent cartilage and then replaces the mucosa over the cartilage and bone.

The incision is closed with an absorbable suture, and soft splints and a bandage-like material may be used to support the septum and prevent bleeding. After a recovery period, you’ll likely be able to go home the same day.
 
What are the benefits of nasal septoplasty surgery?
The benefits of this type of surgery include:

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, but also reduces or eliminates snoring and/or sleep apnea and improves the overall quality of your sleep.
3. Fewer sinus infections: Opening the airways can allow mucus to drain normally from sinuses that were previously narrowed or partially blocked.
4. Improved senses: For patients that previously had an impaired sense of smell or taste due to the effects of a deviated septum, this surgery may improve both senses

What are risks and complications of deviated septum surgery (septoplasty) or turbinectomy?
Some people will need a second surgery if they’re unsatisfied with the results. Other risks associated with a septoplasty are rare, but they can include:

1. Bleeding
2. Scarring
3. Perforation of your septum, which happens when a hole forms in your septum
4. An altered nose shape
5. Discoloration of the nose
6. Decreased sense of smell

Excessive bleeding and infection are possible risks of any surgery. Keeping your nose clean and washing your hands frequently can reduce these risks. 

Nose Surgery and Septal Perforations! 

Overall, a septoplasty is considered a safe procedure. Although it is commonly performed, it is also a very delicate surgery, which requires numerous skills. Occasionally, a septoplasty procedure can result in a complication and, in rare instances, cause a septal perforation. It is important to note that a septal perforation is generally more likely to occur in the case of a revision surgery (a secondary septoplasty) or when a patient suffers from a severe deviated septum.

If a septal perforation does occur after surgery, it is important to have it evaluated and treated. If left untreated, a septal perforation can worsen and become more complicated to repair. A variety of treatments are available, depending on the location, size, and severity of the septal perforation. Minor septal perforations may respond to therapeutic treatments, such as emollients, and may not need to be repaired. Some surgeons may recommend plugging the perforation with a silicone prosthesis called a septal button. However, these buttons can irritate the lining around the perforation, leading to further complications and, for that reason, are not recommended by Drs. Solieman and Litner. For more complicated cases, surgery may be necessary to close the perforation.

Although a septal perforation can be the result of complications from nose surgery, such as a septoplasty, the overall risk of developing one is low. If your doctor determines that your septal perforation needs repair, it is better to address it than not have it treated. The risk of inaction can outweigh the risk of treatment. However, be sure to see a surgeon who has a track record of successfully treating patients with septal perforations.
If you suspect you have septal perforation or have already been diagnosed with one, it is best to have your nose fully evaluated and treated by surgeons with expertise in septal perforation repair. If you wish to discuss about any specific problem, you can consult an ENT specialist.