What is Septoplasty?

Septoplasty is a surgical procedure, for straightening the bone and the cartilage that divides the space between the two nostrils (septum). If your septum is not straight or curved. It is known as a deviated septum. Having a deviated septum can cause you to have breathing problems and increase the risk of sinus infections due to poor drainage. 

A deviated septum is very common, but in more severe cases it can block one of the noses, reducing the airflow and making it difficult for you to breathe through one side or both sides of the nose.^1,2

How do you know if you need a septoplasty?

Septoplasty is commonly performed in teenagers and adults and is not recommended for young children. But in more severe cases your child may need septoplasty.³

Most people may need septoplasty for breathing problems, such as:

• Nasal Obstruction - a deviated septum
• Chronic Sinusitis
• Septal Trauma
• Cosmetic Concerns
• To stop chronic nosebleeds
• Removing nasal polyps

Preoperative assessment for septoplasty

Before the actual surgery, generally, the doctor will ask you a few questions and do a physical exam of the nose.

Patient Evaluation⁴

• Medical history

A complete detailed history of your nasal symptoms should be given to your doctor, including any allergies and your doctor may ask you if you smoke regularly. The doctor may also ask you if you take any additional medications or any recreational drugs.

• Physical examination

After the doctor asks you about your medical history, they will do a physical exam. A full neck and head exam and a rhinoscopy with a nasal speculum, for the doctor to check for any sign of sinus, inflammation, perforations and dislocations. An external exam is also made for checking any other deformities.

Diagnostic tools⁵

• Nasal Endoscopy - a tool that uses a thin, flexible tube with a camera to look at nasal passages. It is painless when a numbing spray is given to you 
• Imaging Studies (CT Scans) - would help the doctor to better look at and study the nose

Surgical procedure 

What happens during the procedure?⁶

Septoplasty is performed on an outpatient basis, which means the patient will go home on the day of the surgery. You will be given a general anaesthetic, which means you will be asleep during the procedure, or a local anaesthetic, which only numbs the area that is targeted for surgery. These options will be discussed with you by your doctor. 

The doctor will make a cut on one of the sides of your nose and lift the mucosa (membrane covering the septum). This will allow your surgeon to reshape the septum bone and the cartilage. In some cases, they can also remove areas of the bone and the cartilage and then reposition and reshape the structure of the nose. The mucosa is then put back into place covering your septum. 

Your surgeon will then insert splints and soft packing to hold the nasal tissue. This will prevent nosebleeds and reduce the risk of scar tissue. The splints will usually stay in for a week. The procedure itself will last between 30 to 90 minutes. 

Recovery and postoperative care¹

After your procedure is done, the medical team will keep an eye on you for a while until the anaesthesia wears off. When you are awake and well, you are able to go home. 

Your doctor will provide you a list of post-operative instructions for you to follow, which will help you to manage the pain, swelling and bleeding. It is advised to avoid exercising and lifting during your recovery time. The reason for this is because exercising will increase your heart rate and the blood pressure can lead to additional bleeding, swelling and pain. Your doctor will tell you when you can go back to your normal routine. 

Expected outcomes²

Septoplasty will improve the airflow in your nasal passage, which can have various benefits, such as:

• Improvement in Nasal Breathing
• Treating breathing problems caused by deviated septum
• Reduces or stops snoring, giving you a better night's sleep
• Makes sure your sinuses are drained better 

Risks and complications⁷

Just like any other procedure, there will be some complications and risks:

• Infection
• Bleeding
• Changes in Sensation
• Numbness
• Septal Perforation
• Cartilage migration
• Hyposmia

Are there any other alternatives to Septoplasty?^4,7

A curved or bent nasal septum will not do any harm unless very severe, so you can leave it alone if you want to. The only way to straighten a deviated septum is with surgery, you may need to go to the doctor if you are not able to breathe properly. Decongestants and nasal sprays can shrink the lining of the nose and can help relieve blockage of the nose. 

Summary

Septoplasty is a small surgery that can benefit many people. It opens the nasal passages which can improve your breathing drastically. Being a common procedure, it is important that it is the right choice for you. So, if you have difficulty in breathing, your doctor should conduct a thorough examination and understand why this is happening. Symptoms such as deviations or nasal polyps and sinuses can be treated by septoplasty, which can improve your quality of life.