What is a Deviated Septum?
When the bone and cartilage dividing your two nostrils are displaced, it is known as a deviated septum. A deviated septum may be caused by injury or trauma to your nose, or you may have been born with it; whichever the case, it can result in difficulty breathing and/or affect the physical appearance of your nose. Additional symptoms may include:
- Facial pain
- Snoring, or in some cases sleep apnea, which causes you to stop breathing altogether
- Postnasal drip, in which excess mucus runs from your nose into your throat
In many circumstances, a deviated septum can be treated with medications, but when the symptoms are severe and affect the quality of your life, septoplasty may be required.
What is Septoplasty?
Septoplasty is a surgical procedure that straightens and repositions your nasal septum to improve your breathing.
Septoplasty involves making small incisions on the inside of your nose to remove, relocate and replace bone or cartilage; in some cases, an incision between your nostrils may be required.
Septoplasty may also be used to remove nasal polyps (common noncancerous growths in your sinuses or nasal passages).
Determining the Need for Septoplasty
Before septoplasty, your ENT (ear, nose and throat specialist) will talk with you about the benefits and risks of the surgery.
Benefits of septoplasty may include improved breathing, a lessening of allergy problems and nosebleeds, and the correction of sleep apnea.
As with any major surgery, risks include infection, bleeding and possible adverse reaction to the anesthetic. In addition, the following may occur:
- Change in your nose’s shape
- Decreased sense of smell
- Persistence of your previous symptoms, despite surgery
- Need for additional surgery
In evaluating your suitability for septoplasty, your surgeon will a take a detailed medical history, conduct a physical exam and look into your nasal passages with a slim lighted instrument called an endoscope, which may also be used during the surgery. Photographs may also be taken.
It is important that you and your doctor discuss your expectations of what septoplasty will accomplish.
If you and your physician determine that you are a good candidate for septoplasty, local or general anesthesia will be used, depending on your and your surgeon’s preferences and on the complexity of the surgery.
Local anesthesia means that a pain-numbing medication is injected directly into your nasal tissues; this often includes a drug for sedation injected through an IV (intravenous line) during the procedure, making you groggy, but not unconscious.
If general anesthesia is used, you will either inhale a painkilling agent or receive one through an IV; this will affect your entire body and induce a temporary state of unconsciousness.
Discuss with your doctor beforehand which kind of anesthesia is best for your case.
What Happens During Septoplasty?
Septoplasty is usually an outpatient procedure, taking anywhere from 60 – 90 minutes.
The lining of the passages of the septum and nasal cavity are layered with a soft tissue known as the nasal mucosa. Working through incisions within the nose, your surgeon will separate the mucosa from the cartilage and bone, both of which are trimmed, relocated, and replaced as required.
In some cases, additional measures such as a small incision between the nostrils might be necessary to straighten the septum effectively. If your nasal bones are uneven and the septum pushed to one side, cuts in the bone might be required to relocate them. Should the problem be along the bridge of your nose, spreader grafts (small, reinforcing strips of cartilage) might be applied.
When the septoplasty is complete and the incision closed with absorbable sutures, your surgeon may use silicone splints in your nostrils to support the septum, along with a dressing to prevent bleeding.
Before you go home, your physician will provide you with instructions to minimize the chances of bleeding and swelling; make certain that you follow these to avoid complications.