This article is on Septoplasty, a common surgical procedure in Otolaryngology. It is intended to help inform patients, relatives of patients and health professionals. The information in the grey boxes is more technical and intended more for Health professionals that are reading this article.

 

Nose Anatomy

The septum is made up of both bone and cartilage. It sits between and separates the two nostrils. The front part of the septum is a common location for nose bleeds or Epistaxis.

Studies have shown that up to 80% of people have a slightly bent septum but most do not have any symptoms.

 

What is a Septoplasty?

Septoplasty is a surgical procedure to straighten a deviated septum. The surgery is completed under a General Anaesthetic (an Anaesthetist will explain to you how this process will happen).

The procedure can be completed with an Endoscope (a telescope with a camera and light) or directly with a head light. It is completed through your nose and there are no cuts made to your skin.

 

What are the indications for a Septoplasty?

The main indication for completing a septoplasty is for significant nasal obstruction caused by a deviated septum. Another indication is to improve access during Endocopic Sinus Surgery.

 

What happens before surgery?

You cannot eat or drink anything from 6 hours before your surgery. The anaesthetist will see you either in clinic days before the operation or on the day of surgery. You may be asked to have routine blood tests taken prior to your surgery.

If you take regular medication, some of them, in particular blood thinners may need to be stopped prior to your surgery.

 

How long is the surgery?

The operation will take around one hour to complete but could be longer if it is completed with additional procedures (Turbinoplasty or Endoscopic Sinus Surgery). The entire process which includes pre-operation checks, anaesthesia and recovery can take several hours.

 

What are the risks?

Your ENT Surgeon will explain all the risks of surgery and answer any questions during your consultation. The most common complication after surgery is bleeding. While small amounts of bleeding is expected in the first few days after surgery, occasionally it can be more severe. In some cases, your surgeon may need to cauterize or pack the nose.

Scarring can sometimes form in the nose and requires dividing when you see your ENT Surgeon in clinic.

Complications:
1. Haemorrhage
2. Septal hematoma
3. Septal perforation
4. Adhesions
5. Structural deformity
6. Hyposmia
7. Infection

 

Are there alternative options?

Recommendations will depend on the indication for surgery. Your Surgeon will discuss all alternative options with you. The final decision to proceed with surgery is made by the patient.

The option of not having surgery is always available.

 

How long is the recovery?

Patients commonly stay one night in hospital after the procedure. However, it can be completed as a day case surgery also.

It is important to avoid physical contact with the nose, blowing your nose or any heavy physical activity in the first 2 weeks after surgery. You will be given a prescription for routine pain relief. It is normal to have small amounts of bleeding through the nose for the first few days after surgery.

On average, expect 1-2 weeks off school or work after surgery.

 

Further reading:

1. Mayo Clinic – Septoplasty – Mayoclinic.org
2. Cleveland Clinic – Septoplasty – Clevelandclinic.org

 

References:
1. Dabrowska-Bien J, Skarzynski P, Gwizdalska I et al. Complications in Septoplasty based on a large group of 5639 patients. 2018. European Archives of Oto-Rhino-Laryngology. 275:1789–1794
2. Egmond M, Rovers M, Tillema A, Heerbeek N. Septoplasty for nasal obstruction due to a deviated nasal septum in adults: a systematic review. 2018. Rhinology. 56:3, 195-208.

 

Author + Affiliation:
Dr Johnny Wu, Department of Otolaryngology, Waikato Hospital.
Reviewed by Dr , Otolaryngologist, Waikato Hospital

Date of Publication +/- Review:
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