Septoplasty: Procedure Causes, Symptom and Recovery

The nasal septum is the wall present in the nose which separates the nasal cavity into the right and left cavities. The nasal septum is made of cartilage in the anterior region and bone in the posterior region. Though a slight deviation in the septum is normal finding, a greater extent of deviation in the septum results in soecific deviated septum symptoms by blocking a side of the nose causing breathing difficulties due to reduced airflow. Septoplasty is the surgical procedure which helps in straightening the deviated nasal septum. While performing septoplasty surgery, the surgeon may trim (cut and remove parts of septum), reposition (placing in the middle of the nose) and replace cartilage, bone or both. Deviated septum symptoms such as breathing difficulty, physical structure and features of the nose are taken into consideration before planning septoplasty.

The surgeon may recommend discontinuing certain medications such as aspirin, ibuprofen, and other blood thinners two weeks before the surgery as these medications may increase the risk of excessive bleeding during and after the procedure.

The surgeon will take pictures of the nose before and after the surgery. Comparing these pictures helps to understand the surgical changes made in the nose. Pre-operative surgical preparation for general anesthesia may include abstinence from eating and drinking in the night before the septoplasty surgery to reduce the risk of aspiration.

A septoplasty is carried under local or general anesthesia. The type of anesthesia used and the duration of the surgery depend on the complexity of the condition. The surgical procedure usually takes 30 to 90 minutes to complete.

The typical procedure is carried out in 4 steps;

Step 1: The surgeon will make an incision on one side of the nose to access the septum. The mucous membrane (the protective covering of the septum) is lifted from the septum on one side.

Step 2: An incision is made on the septum in front of the nasal deviation and the nasal mucosal lining is lifted away from the septum on the other side.

Step 3: Then, the deviated septum will be moved into the midline position. Barriers such as extra pieces of bone or cartilage, will be removed.

Step 4: The last step is the repositioning of the mucous membrane. This is carried out by various methods. One method is suturing the membrane and septum to hold them in place. However, packing the nose with cotton is sometimes enough to keep them in position.

Septoplasty is performed on an outpatient basis; therefore, the patient may be discharged on the same day after the anesthetic affect is worn off.

To promote healing and minimize swelling, physical activity should be limited for several weeks post surgery. Physical activities can increase blood pressure and lead to heavy nasal bleeding.

Tips for a quicker recovery include:

Elevating the head at night
Not blowing the nose for at least three days after surgery
Wearing clothing that may not require pulling over the head

Cartilage and other nasal tissues may take up to a year to fully settle into their new shape. Breathing will improve shortly after the procedure. The wound can be healed quickly.

Risks associated with surgery

Persistence of previous symptoms (difficulty in breathing), despite surgery
Excessive bleeding
A change in the shape of the nose
Septal perforation (An opening in the septum)
Anosmia (decreased sense of smell)
Septal hematoma (The collection of blood in the nasal space that would need to be drained)
Numb sensation