Septoplasty

INTRODUCTION:

Septoplasty is the operation to straighten the central wall within the nose. This wall is a ‘jigsaw puzzle’ of 4 pieces of bone and one piece of cartilage. Displacement or buckling of these pieces is a very common consequence of injury. The result is nasal blockage and, sometimes, visible external deformity.

REASONS FOR SURGERY:

Dr Wallace recommends Septoplasty for the following reasons:

  • Blockage to breathing causing snoring, mouth breathing and possibly sleep apnoea
  • Chronic sinus infections with nasal or post-nasal discharge
  • Recurrent ear infections and/or Eustachian tube blockage
  • As part of a Rhinoplasty operation to correct nasal deformity

RISKS OF SURGERY:

This surgery is associated with a low risk of complications. The specific risks of Septoplasty of which you should be aware are:

  • Bleeding from the nose or epistaxis is normal for several days after surgery, Late or ‘secondary’ bleeding is unusual and management of this problem is not difficult
  • Infection is rare but almost all patients feel as though they have contracted an head cold. True infection is associated with throbbing pain and red swelling of the nasal tip. A fever may develop. Antibiotics would then be necessary. Contact Dr Wallace promptly if any of this happens.
  • Incomplete straightening of the nasal septum is very common but rarely compromises the desired improvement of the nasal airway. Incomplete straightening is usually due to the difficulty in the removal of a cartilage twist where the cartilage needs to be a strong support for the nasal bridge. ‘Breaking’ the twist could cause the bridge to subside.

ANAESTHESIA:

General Anaesthesia is the routine for this operation. Anaesthetic sleep is approximately 30-60 minutes followed by 45 minutes in the Recovery Room

THE OPERATION:

Dr Wallace performs the Septoplasty via an incision inside the nostrils. The septum is straightened and the incision closed with dissolving stitches. The septum is then supported with plastic splints that are stitched internally. They are not visible. Normally no other dressings or packing within the nose is used and so some nasal breathing is possible.
Septoplasty surgery may involve an overnight hospital stay but more commonly is done as ‘Day Surgery’, going home a few hours after the procedure.

AFTER SURGERY:

Dr Wallace visits at the hospital early the following morning. There should be no external swelling or bruising and little or no pain. An office appointment with Dr Wallace is scheduled for one week later and most patients take this week off work. The cost of this appointment and a review at 6 weeks is included in the surgical fee.
At your first post-op visit to the office, the splints will be removed and your breathing will be immediately much improved. It takes 6 weeks for your nose to fully heal and about 12 months for you to get used to the new patterns of nasal airflow.

COMBINED OPERATIONS:

The operation of Septoplasty is often combined with other procedures. The most common combination is with Nasal Turbinate Cautery to deal with the effects if hay fever or rhinitis. Other commonly combined operations include Rhinoplasty for nasal re-shaping and Sinus Surgery for sinusitis treatment.

RESULTS:

The vast majority of patients will be very glad that they put themselves through the minor discomfort of a Septoplasty. Within 4- 6 weeks breathing will be easier and sleep should be more refreshing. However, you must remember that the nose is there to slow down the inflow of air for air-conditioning and we do most of our breathing through one nostril at a time. This ‘Nasal Cycle’ changes over approximately every 3 hours. It is more prominent than usual in the first year after surgery.