Septoplasty

Alternative names
Nasal septum repair

Definition

Septoplasty is an operation that corrects any defects or deformities of the nasal septum, which is the wall between the two nostrils.

See also Rhinoplasty (nose reshaping surgery).

Description

The goal of the surgery is to straighten out the nasal septum or to relieve obstructions or other problems related to deviation of the septum.

An incision is made internally on one side of the nasal septum. The mucous membrane is lifted away from the cartilage and bone, obstructive parts are removed or repositioned as necessary, and plastic surgery is performed as necessary. Then, the mucous membrane is returned to its original position. The tissues covering the septum are held in place by either stitches or packing.

Indications

The main conditions that call for nasal surgery are:

     
  • Nasal airway obstruction  
  • Septal spur headache  
  • Uncontrollable nosebleeds  
  • Nasal septal deformity in the presence of other intranasal surgery

Nasal airway obstruction is usually the result of a septal deformity that causes breathing by mouth, sleep apnea, or recurrent nasal infections. A septal spur headache is defined as a headache caused by pressure from the nasal septum on the inside of the nose (septal impaction) that is relieved by anesthetic applied directly to the septal impaction.

Other intranasal surgeries that may be modified to include septoplasty include the following:

     
  • Polypectomy (removal of a polyp)  
  • Ethmoidectomy (operation on the ethmoid bone at the top of the nasal cavity)  
  • Turbinate surgery (operation on the concha nasalis)  
  • Tumor removal

People who snort drugs such as cocaine in large quantities for long periods of time may require this surgery if drug use has damaged the septum.

Risks

     
  • Infection  
  • Excessive bleeding  
  • Relapse of the nasal obstruction requiring additional surgery

Expectations after surgery
The surgery can be done either under local anesthesia on an outpatient basis or under general anesthesia during a short hospital stay. After surgery, both sides of the nose may be tightly packed to avoid bleeding and serve as a splint to hold the mucosa in place. Packing is usually removed 24 to 36 hours after surgery.

Convalescence
To help the healing, it is recommended that you avoid blowing the nose or performing any Valsalva maneuver (for example, when you hold your breath and tighten your muscles while bearing down for a bowel movement) for a few days after surgery. Ice packs on the nose will enhance comfort.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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