Repair of a Deviated Septum (Septoplasty)
The nasal septum is the wall between the nostrils that separates the two nasal passages. It supports the nose and directs airflow. The septum is made of thin bone in the back and cartilage in the front. A deviated septum occurs when the cartilage or bone is not straight. A crooked septum can make breathing difficult. The condition also can lead to snoring and sleep apnea.
The septum can bend to one side or another as a part of normal growth during childhood and puberty. Also, the septum can be deviated at birth (congenital) or because of an injury, such as a broken nose. Very few people have a perfectly straight septum.
Surgery to straighten the septum is called septoplasty, submucous resection of the septum, or septal reconstruction. The surgery may be done along with other procedures to treat chronic sinusitis, inflammation, or bleeding, or to correct sleep apnea. Septoplasty also may be done to allow access into the nose to remove nasal polyps. In general, septoplasty is needed only when breathing problems or snoring do not get better without surgery. For more information on surgery to treat chronic sinusitis, see the topic Sinusitis.
Before surgery, the doctor may use a thin, lighted instrument (endoscope) to look at your nasal passages and to see the shape of your septum. In some cases, the endoscope may be used during surgery. You will receive local or general anesthesia for the 60- to 90-minute operation, which is usually done in an outpatient surgery center.
The septum and nasal passages are lined with a layer of soft tissue called the nasal mucosa. To repair the septum, the surgeon works through the nostrils, making an incision to separate the mucosa from the underlying cartilage and bone. The doctor trims or straightens the bent cartilage and then replaces the mucosa over the cartilage and bone.
What to Expect After Surgery
After surgery, you may have a nasal splint or pack placed in your nostrils to stop bleeding and keep the septum straight while it heals.
You probably will get instructions on how to care for your nose while it is healing. For example, you may be told not to blow your nose and to sneeze with your mouth open to avoid pressure changes.
All surgery has a small risk of infection or bleeding. Also, septoplasty carries a small risk of a hole (perforation) forming in the septum. A perforation rarely requires treatment. Additional surgery may be needed if the perforation causes discomfort or an infection develops.
Streptococcus and staphylococcus bacteria appear normally in some people. Packing the nose after surgery in people who have these bacteria increases the risk of toxic shock syndrome. Call your doctor immediately if you have any of the following symptoms:
- A fever of 101 F (38.3 C) or higher
- A headache
- A rash that looks like sunburn
- Signs of very low blood pressure, such as dizziness and fainting
Other Works Consulted
- Lund VJ (2009). Acute and chronic nasal disorders. In JB Snow Jr, PA Wackym, eds., Ballenger's Otorhinolaryngology: Head and Neck Surgery, 17th ed., pp. 557–566. Hamilton, ON: BC Decker.
- Shah SB, Emanuel IA (2012). Nonallergic and allergic rhinitis. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology—Head and Neck Surgery, 3rd ed., pp. 282–290. New York: McGraw-Hill.
- Spiegel JH, Numa W (2012). Nasal trauma. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology—Head and Neck Surgery, 3rd ed., pp. 265–272. New York: McGraw-Hill.