A deviated septum is not an uncommon problem. It occurs when the nasal septum, which is the thin wall of bone and cartilage separating the two nostrils, is displaced to one side. In most individuals, the end result is one nasal passage that is smaller than the other. When the deviation is severe, airflow can be reduced, leading to swelling of the sinus tissues, difficulty breathing, dry nasal passages, nosebleeds and, in certain cases, sinus infections. Fortunately, there is a procedure known as septoplasty that can correct this problem.
What is Septoplasty?
Septoplasty is a type of corrective surgery designed to straighten a crooked or deviated nasal septum. The surgery is usually performed on an outpatient basis, unless a hospital is recommended by your surgeon. Treatment is not associated with major risks.
Septoplasty straightens the wall that separates the nostrils by trimming cartilage and placing it in a more appropriate position. In certain cases, specific parts of the nasal bone are trimmed and repositioned as well.
Why Have a Septoplasty Procedure?
Most people have some degree of deviation of the septum. However, in moderate to severe cases, one side of the nose may become completely blocked, causing a variety of unpleasant side effects, including labored breathing, loud snoring, sinus infections, and blocked or swollen nasal passages. This is the reason most patients seek treatment. Fortunately, in most cases, these problems are eliminated when septoplasty is successfully completed.
The surgeon begins the procedure by making incisions inside the nose. During this time, the patient is usually under general anesthesia, although in certain cases local anesthesia is sufficient. During surgery, the Dr. Walton will remove pieces of cartilage. In some cases, small sections of bone are removed as well. The septum is then realigned, with an ultimate goal of ensuring that each nasal cavity and both sinuses have equal airflow.
Sufficient bone and cartilage are preserved for structural support, and after the surgical straightening is complete, the Dr. Walton may temporarily stabilize the area with small, plastic splints, tubes or sutures. Incisions are closed with absorbable sutures. In most cases, nasal packing is not required.
After the procedure, the patient is typically transported to a recovery area, where licensed staff members monitor his or her condition and observe for any potential complications. In most cases, the patient can leave the facility the same day, although in certain instances, a one night stay is recommended. This will depend on the individual’s health history and the extent of surgery required to treat the condition.
Prior to having the procedure completed, Dr. Walton will discuss possible outcomes and what each patient should expect from the surgery. For example, before the surgery is scheduled, patients may be told to discontinue certain medications, stop smoking or use a saline rinse for a few days prior to the surgery. However, these preoperative instructions may vary from one patient to the next.
Who is a Good Candidate?
Good candidates for septoplasty include those who are generally healthy and have a properly functioning immune system. Those who have had symptomatic nasal blockages and complications from swollen nasal passages or difficulty breathing usually enjoy meaningful improvement after the procedure. Therefore, such individuals make the best candidates for treatment. In addition, patients with constant nosebleeds from dry nasal passages and those who have difficulty sleeping or suffer from sleep apnea related to a deviated septum may also be ideal candidates for the surgery.
There are also certain individuals who are not good candidates for septoplasty. These include those who smoke cigarettes on a regular basis. This is because smoking damages the nasal passages and sinus tissues and delays healing. This can increase the risks for complications.
Other conditions that make someone a poor candidate for septoplasty include poorly controlled high blood pressure, untreated diabetes mellitus or bleeding diathesis, which is a type of bleeding disorder.
How long will the procedure last?
The majority of septoplasty surgeries are completed in 1-2 hours depending on the level of deviation and the steps required to straighten the septum and secure parts.
The results of the procedure should last indefinitely, if the surgery was successful. However, it may take the tissue and cartilage up to six months to completely heal. This is normal, and one can expect his or her nasal tissues to become relatively stable within three to six months following the procedure. In some cases, changes may occur for up to twelve months after the surgery, although this is much less common.
What can I expect after the procedure?
Virtually all individuals find that septoplasty improves the symptoms that previously troubled them, such as difficulty breathing, nosebleeds, dry nasal passages, and sinus infections. However, the degree of improvement one experiences varies considerably from one patient to the next.
In rare cases, certain individuals find that their symptoms are relatively unchanged following the procedure and opt to undergo a revision septoplasty to further refine the septum and nose.
Fortunately, this is uncommon and one’s surgeon can typically predict if more than one procedure may be necessary. Therefore, patients are not usually taken by surprise if this is the case.
Barring rare or unusual complications, there is generally little discoloration or swelling to the external nose area following septoplasty, as the majority of the surgery is completed on the inside of the nose. Nasal passages may feel a bit sore, and the sensation of a sinus headache is often present for a few days following the procedure. However, Dr. Walton will prescribe medication to make you feel more comfortable.
Temporary numbness of the front upper gum is also common. This symptom may sometimes extend to the tip of the nose and jaw, but virtually always resolves itself within three to four weeks after the surgery.
Are There Risks?
As with any major surgical procedure, there are specific risks associated with septoplasty. These may include infection, bleeding, and an adverse reaction to local or general anesthesia. Other potential risks include the following:
- Decreased sense of smell
- Septal hematoma–blood clot in the nasal passage that requires draining
- Septal perforation–undesired opening in the septum
- Undesired change in the shape of the nose
- Persistence in previous symptoms
- Permanent numb sensation in upper gum area
Although most of the aforementioned complications are rare, it is possible that they may occur and additional surgery may be needed to treat them, depending on the specific problem. It is important for each patient to discuss risks with a surgeon before scheduling septoplasty.
How Soon Can I Return to Work?
Strenuous activity must be avoided for several weeks following the procedure; therefore, the time frame concerning going back to work varies considerably among patients. Those with sedentary jobs can return to work in a few days, although many patients prefer to take a week off for their procedure. The splints placed inside the nose are usually removed after 10-14 days. Prior to that time, the nose may be “stuffed-up” creating a nasal quality to the speech. Patients may prefer to remain out of the mainstream of social interaction until the splints can be removed. Those whose jobs are physical in nature must take several weeks off for this surgery or make arrangements with their employer to perform less strenuous work during their recovery period.
Anyone with symptoms such as difficulty breathing through their nose, loud snoring, nosebleeds, dry nasal passages or other problematic issues associated with a deviated septum should consider speaking to Dr. Walton about septoplasty. Although no surgeon can guarantee perfect results, a successful septoplasty procedure leads to a better quality of life for many individuals.
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