Septoplasty is a surgical procedure performed entirely through the nostrils, resulting in no external bruising. The surgery might be combined with a rhinoplasty, in which case the external appearance of the nose is altered and swelling/bruising of the face will be present. Septoplasty may also be combined with sinus surgery.
The time required for the operation averages about 45 minutes to one and a half hours, depending on the deviation. It can be done with a local or a general anesthetic, and is usually done on an outpatient basis. After the surgery, silicone intranasal splints are often inserted to prevent excessive postoperative bleeding and shifting of the septum during the early healing. During the surgery, badly deviated portions of the septum may be removed entirely, or they may be readjusted and reinserted into the nose.
The nasal septum is the wall dividing the nasal cavity into halves; it is composed of a central supporting skeleton covered on each side by mucous membrane. The front portion of this natural partition is a firm but bendable structure made mostly of cartilage and is covered by skin that has a substantial supply of blood vessels. The ideal nasal septum is exactly midline, separating the left and right sides of the nose into passageways of equal size.
Estimates are that 80 percent of all nasal septums are off-center, a condition that is generally not noticed. A "deviated septum" occurs when the septum is severely shifted away from the midline. The most common symptom from a badly deviated or crooked septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and sometimes actually occur on the side opposite the bend. In some cases the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.
Septoplasty is the preferred surgical treatment to correct a deviated septum. This procedure is not frequently performed on minors, because the cartilaginous septum grows until around age 18. Septal deviations commonly occur due to nasal trauma.
A deviated septum may cause one or more of the following:
In some cases, a person with a mildly deviated septum has symptoms only when he or she also has a "cold" (an upper respiratory tract infection). In these individuals, the respiratory infection triggers nasal inflammation that temporarily amplifies any mild airflow problems related to the deviated septum. Once the "cold" resolves, and the nasal inflammation subsides, symptoms of a deviated septum often resolve, too.
Patients with chronic sinusitis often have nasal congestion, and many have nasal septal deviations. However, for those with this debilitating condition, there may be additional reasons for the nasal airway obstruction. The problem may result from a septal deviation, reactive edema (swelling) from the infected areas, allergic problems, mucosal hypertrophy (increase in size), other anatomic abnormalities, or a combination. The surgeons at Michigan ENT & Allergy Specialists are experts in diagnosing and treating ear, nose, and throat disorders. We can determine and treat the cause of your chronic sinusitis and nasal obstruction.