Alternative Names nasal septoplasty, nasal septal reconstruction
Definition A septoplasty is a form of plastic surgery used to straighten the nasal septum. The septum divides the nasal cavity into 2 sections. The front part of this wall is made of cartilage. A thin, bony plate forms the back part. If the septum deviates into one or both nasal cavities it can cause problems such as airway blockage.
Who is a candidate for the procedure? A septoplasty is generally done to correct a deviated nasal septum, or one that is not in its normal position. A septum that deviates to one side can narrow that nasal cavity, decreasing the airflow. A septum deviated toward the front of the nose can become dry and cracked as air runs across it. This can cause the nose to bleed. If frequent bleeding occurs, then straightening of the septum is recommended.
A septoplasty may also be recommended if the septum deviates into a deeper part of the nasal cavity. This can affect sinus drainage and lead to chronic sinusitis. Surgery may be done in an individual whose septum tightly contacts other structures inside the nose, causing chronic headache, facial pain, or a poor sense of smell.
How is the procedure performed? A septoplasty can be performed under general anaesthesia, in which the person is put to sleep for the procedure. It may also be done under local anaesthesia, with numbing only of the area involved in the surgery.
An incision is made in the septum to reach the cartilage and bony structures beneath its lining. A small strip of cartilage is usually removed from the lowest part of the septum. This helps to free it from the bone beneath. The remaining crooked portions of the septum are then removed. To hold the straightened septum in place, small plastic sheets, splints, or packing may be used.
A septoplasty may be combined with other procedures if there are other problems. Opposite the septum are bony structures called turbinates. If the septum deviates to one side, the turbinates on the opposite side will enlarge. It may be necessary to push these out of the way or reduce their size. Doing this will improve the airway on both sides.
What happens right after the procedure? After surgery, the person is taken to the surgery recovery room until the anaesthesia wears off. The nose may have packing in place. The person may be anxious at first, and feel he or she is not getting enough air. The individual will be instructed to breathe through his or her mouth. Medication will be available to decrease the discomfort and nausea. The person will be taken to his or her hospital room to recover once the anaesthesia has worn off. Occasionally, the individual may go home the same day.
What happens later at home? Following a septoplasty, it is important to reduce the risk of bleeding. The individual should avoid strenuous exercise, nose blowing, and products containing aspirin. An antibiotic may be given to prevent infections. If there is packing in the nose, it will usually be removed the next day.
What are the potential complications after the procedure? Rarely, a hole may appear in the septum as a result of a septoplasty. A septal haematoma, which is a collection of blood, can also develop. This may cause pain, pressure, nasal blockage, and infection. If infection occurs and spreads into the sinuses, it can be life threatening. Any new or worsening symptoms should be reported to the doctor.
Author: Mark Loury, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 12/06/2005 Contributors Potential conflict of interest information for reviewers available on request
