Whenever people talk or hear about nose surgery, they immediately think of a cosmetic procedure to enhance or change the appearance of a person’s nose. In general, nose surgery can be a cosmetic procedure, a reconstructive procedure or both. Rhinoplasty is one of the most popular cosmetic procedures performed today. There are a number of people who want to change the look of their nose to be more symmetrical to the shape of their face, a nose may be too large or too small. There may also be congenital defects in the nasal passageways or a deviated septum. The shape of the nasal cavity can be a cause of chronic sinusitis and other breathing issues.
The Nasal Septum
The nasal septum is the wall that separates the two nasal cavities into two halves. The nasal septum is composed of a central supporting skeleton that are covered by mucous membranes. The front portion of the septum is mostly cartilage and covered in skin with a good supply of blood vessels. In general, the ideal nasal septum is exactly midline and separates the left and right sides of the nose into equal passageways.
It is estimated that 80% of all nasal septums are not centered but are unnoticeable. A deviated septum happens when the septum is severely shifted away from the nose’s midline. One of the most common symptoms of a misaligned septum is breathing difficulty. Symptoms are sometimes worse on one side, but it can also occur on the opposite side of the bent septum. There are also cases where the bent septum can hinder sinus drainage which results in repeated sinus infections. Breathing issues can also be due to enlarged turbinate or nasal tissue. These issues can be corrected through Septoplasty (for a deviated septum) and turbinectomy (for enlarged nasal tissues). The surgery may be done with other surgical procedures in treating chronic sinusitis, bleeding or inflammation or in correcting sleep apnea. Symptoms of a deviated symptom include, nasal congestion, frequent nosebleeds an sinus infection, blockage on one nostril or both, postnasal drip, headaches, facial pains; for infants, noisy breathing during sleep.
A trained specialist like an EENT or an experienced plastic surgeon in treating nasal issues can properly diagnose and treat a deviated septum or enlarged nasal tissues. They will be able to determine the cause and provide the proper treatment during a patient consultation. After discussing the symptoms, the physician will asks if there were any accidents or if the patient has ever incurred severe trauma or a previous nose surgery. Examinations of the overall appearance of the nose will be made, including x-rays, a bright light and nasal speculum t to check the position of the nasal septum and inspect the interior of each nostril. Surgery will be performed if the deviated septum is causing frequent nosebleeds or recurrent sinus infections.
Septoplasty is performed entirely through the nose. The procedure can be combined with rhinoplasty where the external appearance of the nose is enhanced or altered. The procedure usually involves realignment and making judicious excision of a portion of the cartilage or bone cavity. The patient is put on general or local anesthesia. The surgeon will work through the nostrils by making an incision in the septum lining to reach the cartilage targeted in the operation. Sufficient cartilage is left and preserved for structural support. Once the septum is re-aligned and straightened, it is then temporarily stabilized using flexible splints, small plastic tubes and internal sutures. The surgery can last from 60 minutes up to 90 minutes, depending on the severity of the deviated septum of enlarged nasal tissues.
Just like any surgical procedure, Septoplasty or turbinectomy will have some form of risks. It can be an infection, bleeding or a hole forming in the septum although perforation rarely needs treatment. But if the perforation causes discomfort, then further treatment will be needed to prevent infections.
Post Surgery Care
Scheduled post surgery check up should be followed and the doctor will let the patient know when the scheduled check up is and when the packs and the splints should be removed. Once the packing and splints are removed, the patient can breathe through the nose, but will be prevented to blow or sneeze too hard through the nose. Light blood-tinged drainage is normal for several days. If bleeding occurs, apply an ice pack and the patient needs to lie down with the head elevated. Nasal irrigation using a nasal saline spray is very important after surgery because it will prevent crust from forming in the nose. The patient needs to use irrigation until the doctor instructed them to stop. Failure to properly irrigate the nose may cause the surgery to fail.
Septoplasty and tubinectomy are outpatient procedures. Proper post surgery should be taken to ensure that the surgery will be a success and there will be no need to have a repeat surgery. Any issues that may be out of the normal after surgery should be relayed to your doctor immediately.