Anatomy
The
nasal septum is the dividing wall
between the two sides of the nose.
The septum is composed of both
cartilage and bone. The front (or
anterior) part of the septum
supports the tip of the nose; and
like the tip of the nose, is
composed of flexible cartilage. The
back (or posterior) portion
of the septum is composed of bone.
Very
frequently, the bony and
cartilaginous portions of the septum
can become crooked or deviated.
This deviation can block one or both
sides of the nose. These deviations
in the septum are commonly caused by
trauma to the nose. Other times,
the life-long growth of cartilage
eventually exceeds the bony space
that contains it, causing the septum
to buckle and block the nasal
passage.
Procedure
Surgery to correct a septal
deviation is called septoplasty.
This procedure is usually performed
under general anesthesia, but it can
be performed under local anesthetic
for select cases. Septoplasty is
usually performed as a day-surgery
procedure.
This
procedure involves making an
incision on one side of the septum
inside the nose, raising the
membranes that cover the cartilage
and bone of the septum, and then
removing the deviated portions of
cartilage and bone. Once the airway
has been opened, the incision is
closed and the membranes are sewn
down onto the cartilage. Then,
plastic splints are placed on each
side of the nose to help the septum
to heal properly. These splints are
removed in the office about one week
after your surgery.
Following surgery, patients are
observed for a few hours. If the
patient meets certain criteria, then
he or she can go home. Patients
will be seen within one week
following surgery.
Risks
-
Change of appearance of the
nose. The cartilage of the
septum supports the front,
flexible part of the nose. If
too much of this cartilage is
removed, then there might be a
sagging of the nasal tip, thus
changing the appearance of the
nose.
-
Septal perforation. The
membranes that cover the
cartilage and bone are the blood
supply to these structures. If
these membranes are damaged,
then the blood supply to the
corresponding cartilage
underneath becomes disrupted.
This cartilage will die, and a
hole in the septum might occur.
The symptoms of such a hole can
include crusting or a whistling
sound when breathing through the
nose. Nasal septal perforations
can be repaired.
-
Infection. You will be placed
on antibiotics to prevent the
occurrence of infection.
-
Pain. Septal surgery is not
particularly painful. Headache
and nasal congestion can occur
following septoplasty and are
usually due to septal splints
that are placed inside the
nose. You will be given mild
narcotic pain medication to
relieve your pain.
-
Numbness of palate. Some
numbness of the palate can occur
due to bruising of the nerves to
the palate during removal of
parts of the bony septum. This
numbness will resolve with time.
Postoperative Instructions
-
Expect some bloody drainage from
your nose. Wear a cotton gauze
pad under your nose for the
first few days following surgery
to absorb nasal drainage.
-
Due to the splints in your nose,
your nose will feel congested or
blocked. Occasionally, patients
experience headaches due to the
splints. Once the splints are
removed, these symptoms will
resolve.
-
DO NOT remove your splints.
-
DO NOT blow you nose. Instead,
sniff secretions back into your
throat and spit them out through
your mouth.
-
DO NOT do any strenuous
activities, such as lifting
objects greater than 10 pounds
or bending over, for 10 days
after your surgery.
-
Your physician will prescribe
pain medications and
antibiotics. Please take these
medications as prescribed.
-
Call your physician, (713)
795-0111, if you develop severe
bleeding, requiring you to
change the drip pad more than 6
times in an hour; or severe pain
not relieved by your pain
medication.
