Septoplasty is a surgical procedure designed to reconstruct and improve the nasal septum shape and function. Septoplasty can correct any tissue deficit by adding cartilage or removing access tissue causing septal deviation which leads to nasal obstruction. The nasal septum works like a wall separating the two nostrils. The nasal septum is made of two main components: cartilage and bone.
Deviated nasal septum are caused either by congenital deformities (present from birth) or resulted due to a trauma or an injury. It is well known that any injury to nose causing nasal bone fractures will also involve a concomitant fracture of the septal cartilage as well. Therefore, correction of the septum by septoplasty is the first step to correct a deviated nose and dysfunctional nasal airway.
Minor deviated nasal septums that are not symptomatic do not require any surgical correction. However, symptomatic deviated nasal septums causing nasal obstruction require surgical intervention. Septoplasty can also be performed during cosmetic nasal surgery or rhinoplasty graft harvesting or correcting a crooked nose or dislocated septum.
Anatomy and function of the nasal septum have two purposes: nasal structural support and air flow regulation. Septoplasty is performed to improve the deformity of nose and also to improve airflow dysfunction caused by a deviated septum. During reduction rhinoplasty nasal septum is also reduced to improve shape of the nose.
During surgery, the patient’s own cartilage that has been removed can be reused to provide support for the nose if needed. This is called cartilage grafting. Internal nasal splints are inserted in the nostril to support the nasal cartilage and to reduce any chances of hematoma.
There are few symptoms and conditions that may be indications for septoplasty:
- Nasal air way obstruction due to deviated nasal septum
- Headaches caused by septal spurs
- Chronic nosebleeds
- Chronic sinusitis associated with a deviated septum
- Obstructive sleep apnea
Septal deviation could be the reason for a nasal airway obstruction. A nasal airway obstruction can cause mouth breathing at nights, obstructive sleep apnea, or chronic nasal infections. Septal spurs lead to severe headaches and facial pressure when these growths lead to increased pressure on the nasal septum. Large quantities of cocaine use over a long period of time can cause septal perforation which requires septoplasty to correct it.
Septal deviation is usually diagnosed by direct visualization of the nasal airway. Before performing a septoplasty, the surgeon will evaluate the difference in airflow between the two nostrils.
As with any other operation under general anesthesia, patients are evaluated for any physical conditions that might complicate surgery and for any medications that might affect blood clotting time. If a general anesthetic is used, then the patient is advised not to drink or eat after midnight the night before the surgery. In many cases, septoplasty can be performed on an outpatient basis using local anesthesia.
Septoplasty is performed as an outpatient procedure and the patients are home from the surgical center shortly after the surgery. Aftercare includes a list of detailed instructions that will be given prior to surgery.
The head needs to be elevated while resting during the first 24-48 hours after surgery. A small amount of bloody discharge is normal but excessive bleeding should be reported to the physician immediately. Most patients do not report significant discomfort, but those who do have some discomfort are given pain medications. Ice pack placement on the nose will reduce swelling and discomfort during the initial recovery period.