Septoplasty

About the Procedure

Septoplasty (also known as a deviated septum) is a procedure to straighten the nasal septum, the cartilage partitioning the two nasal cavities, when it is causing a partial or total blockage of one or both cavities. It may be performed as an adjunct to another surgical procedure such as rhinoplasty (cosmetic nose alteration), polypectomy, epistaxis (chronic nosebleeds), or to access other areas of the head, e.g., brain, pituitary gland. Patients requiring a septoplasty may experience significant breathing problems, chronic sinusitis, snoring, and sleep apnea. The origin of the displacement may be from a birth injury, a developmental process, a congenital malformation, or an external injury to the nose.

The ninety minute procedure is performed by a plastic surgeon, an otolaryngologist, or a head and neck surgeon. It is done at an out-patient facility using either general or local anesthesia. After numbing the inside of the nose and roof of the mouth, the surgeon enters the nostril to access the septum. The parts of the cartilage which are obstructing the breathing passages are excised and the septum is aligned. The cartilage is sutured and/or splinted, and possibly packed with gauze. The patient is observed for a few hours prior to discharge.

What to Know Before the Procedure

The nasal and sinus cavities are vascular areas in close proximity to the eyes and brain. Caution must be taken to keep bleeding under control and to avoid nasal perforations which can injure the eyes or brain. Other possible complications are scarring and an undesirable change in the shape of the nose. The results of a septoplasty depend on the severity of the deviation and the expectations of the patient. The long-term success of a septoplasty is not guaranteed as the septum may start to curve again.

Preparation for this procedure is similar to other operations. A health assessment, blood work, a review of current medications, especially those which prevent blood clotting, and pre-operative instructions on food and water intake will be done days before the surgery. A CT scan is often obtained for prior analysis and for guidance during surgery. Plan in advance for a ride at discharge as post-operative pain medications may cause drowsiness. Assistance for the first day is recommended since pain and tiredness are the chief complaints during recovery.

What to Know After the Procedure

In an uncomplicated surgical procedure patients are discharged the same day. They are advised to breathe from the mouth and elevate their head for 24 to 48 hours. Internal swelling, bruising and feeling congested can be reduced by applying ice packs, and pain is easily relieved by medication. Activities which put pressure on the nose, e.g., heavy lifting, playing sports, nose blowing, pulling clothes over the head, and vigorous tooth brushing, should be avoided for two to three weeks. The doctor will discuss the use of a nasal spray to keep the tissues inside the nose moist. Patients whose jobs do not require strenuous activity can return to work in under a week but may find a full day's work tiring. Those with more strenuous jobs should seek the advice of their doctor.

If you Need to Travel Outside of your Local Hospital

Since this surgery is on the face, choosing a qualified, experienced surgeon is a major factor in being satisfied with the relief of symptoms as well as the outward appearance of the nose. Therefore, selecting the right doctor will affect where the surgery will take place. Travelling for this medical procedure is an option provided there will be adequate time for the patient to rest and elevate their head for two days following surgery. The doctor should be consulted regarding post-operative travel restrictions before making a decision.