• Septoplasty

    Definition

    Septoplasty is a surgery to straighten a deviated septum . The septum is the wall dividing the left and right nasal cavities. It is made of cartilage and bone and is lined with a thin mucus membrane.
    A normal septum is relatively straight and in the center of the nose. A deviated septum is bent or significantly off-center. Septal deviation may occur during development in the womb, during birth, as your nose grows, or after a traumatic injury. Septoplasty may be done at the same time as other nasal surgery, like rhinoplasty .

    Reasons for Procedure

    Septoplasty is considered if a deviated septum obstructs your nasal passages. The obstruction can cause impaired nasal breathing, sinus infections , obstructive sleep apnea , recurrent nose bleeds , or a runny nose. A deviated septum may also need to be corrected with septoplasty if it causes chronic headaches.
    Deviated Nasal Septum
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    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have a septoplasty, your doctor will review a list of possible complications, which may include:
    • Numbness in the tip of the nose or upper front teeth
    • Bleeding
    • Infection
    • Septal perforation (a hole in the septum)
    • No improvement in symptoms
    • Poor cosmetic outcome
    Some factors that may increase the risk of complications include:
    • Smoking
    • Bleeding disorders
    • Medical problems, such as cardiac disease
    • Cocaine use
    • Prior nasal surgery with excessive scarring
    • Taking certain medicines

    What to Expect

    Prior to Procedure

    To prepare for surgery, follow any instructions provided by your doctor.
      Talk to your doctor about your medicines, including vitamins, herbs, or dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
      • Aspirin or other anti-inflammatory drugs
      • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
    • If you are having local anesthesia for the procedure, it is likely that no other special preparation is needed. If you will be having general anesthesia, your doctor will give you additional instructions.

    Anesthesia

    Septoplasty can be done using local or general anesthesia. Local anesthesia will numb the area. General anesthesia will put you to sleep.

    Description of the Procedure

    An incision will be made inside the nose. The lining of the septum will be removed. The bent bone or cartilage will be straightened by moving it or cutting off the bent piece. Once the repair is done, the lining will be replaced over the top of the septum. Gauze may be placed in the nose to soak up any blood. A plastic splint may also be inserted to keep the septum in place while it heals.

    How Long Will It Take?

    About 1 to 1-½ hours

    How Much Will It Hurt?

    Anesthesia will minimize pain during surgery. Following surgery, your nose may be tender or mildly painful. Ask your doctor about medicine to help with the pain.

    Average Hospital Stay

    Most patients leave the hospital or surgery center after 3-4 hours.

    Postoperative Care

    If nasal packing is used, it is removed 1-2 days after the surgery. The splint remains in the nose for up to a week. After the surgery, do the following to ensure a smooth recovery:
    • Try to breathe through your mouth for the first few days.
    • Do not blow your nose.
    • Keep your head elevated when lying down for the first 1-2 days.
    • Apply ice packs to your nose to reduce pain and swelling.
    • Do not take aspirin products for pain.
    • Your doctor may want to see you for a follow-up visit to monitor healing or to remove the gauze packing or splint.
    • Be sure to follow your doctor's instructions .

    Call Your Doctor

    After you leave the hospital, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
    • Heavy bleeding
    • Packing from your nose falls into the back of your throat, causing discomfort
    • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital (Vomit may be bloody or the color of coffee grounds from mixing with stomach juices.)
    • Pain that you cannot control with the medicines you have been given
    • Cough, shortness of breath, or chest pain
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Academy of Otolaryngology http://www.entnet.org/

    The American Rhinologic Society http://www.american-rhinologic.org/

    CANADIAN RESOURCES

    Canadian Society of Otolaryngology http://www.entcanada.org/default.asp

    Health Canada http://www.hc-sc.gc.ca/index-eng.php

    References

    Beers MH, Berkow R, Burs M, eds. The Merck Manual of Diagnosis and Therapy . Whitehouse Station, New Jersey: Merck Research Laboratories; 1999.

    Fact sheet: deviated septum. American Academy of Otolaryngology website. Available at http://www.entnet.org/healthinfo/sinus/deviated-septum.cfm . Accessed September 9, 2005.

    Ferguson BJ. Septoplasty and turbinate reduction. The American Rhinologic Society website. Available at http://american-rhinologic.org/patientinfo.septoplasty.phtml . Accessed August 31, 2005.

    Way L, Doherty G, eds. Current Surgical Diagnosis and Treatment . 11th ed. New York, NY: Lange Medical Books; 2003.

    6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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