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Definition

Septoplasty is the surgical straightening of a deviated septum (also called septal deviation). The septum is the wall dividing the left and right nasal cavities. It is made of cartilage and bone and is lined with a thin mucous membrane. A normal septum is relatively straight and in the center of the nose; a deviated septum is bent or significantly off-center. Septal deviation may occur during prenatal development, during birth, as your nose grows, or after a traumatic injury to the nose. Septoplasty is often done at the same time as other nasal surgery like rhinoplasty.

Parts of the Body Involved

Nose

Reasons for Procedure

Septoplasty is considered if a deviated septum obstructs your nasal passages and causes impaired nasal breathing, chronic sinus infections , obstructive sleep apnea , or a chronic runny nose. A deviated septum may also need to be corrected with septoplasty if it causes severe nosebleeds or chronic headaches.

Deviated Nasal Septum

Risk Factors for Complications During the Procedure

Taking certain medications, including blood thinners, aspirin, and nonsteroidal anti-inflammatory drugs such as ibuprofen
Uncontrolled high blood pressure
Medical problems such as cardiac disease
Abnormalities in the blood causing exceeive bleeding, such as low platelets, or hemophilia
Cocaine use

What to Expect

Prior to Procedure –

Before septoplasty your doctor may do a CT scan of your nose to look for other causes of nasal obstruction (if the septal deviation is a result of a traumatic injury) or to evaluate the condition of your sinuses.

To prepare for surgery, follow any instructions provided by your doctor.

You may be asked to discontinue the use of medications that increase your risk of bleeding, such as blood thinners, aspirin, and nonsteroidal anti-inflammatory drugs (eg, ibuprofen).
Tell your doctor about any medications including vitamins, herbs, or dietary supplements that you take.
If you are having local anesthesia for the procedure, it is likely that no other special preparation is needed. If you will be having general anesthesia, your doctor will give you additional instructions, including when to stop eating and drinking prior to surgery.

Anesthesia –

Septoplasty can be done using local or general anesthesia. The decision is based on the patient’s and surgeon’s preference.

Description of the Procedure –

The surgeon will make an incision inside the nose. He or she will then remove the mucous membrane lining the septum, straighten the bent bone or cartilage by moving it or cutting off the bent piece, and replace the membrane over the top of the septum. The surgeon may put gauze in the nose to soak up any blood. He or she may also insert a plastic splint to keep the septum in place while it heals.

After the Procedure –

If nasal packing is used, it is removed 1-2 days following the surgery. The splint remains in the nose for up to a week.

How Long Will It Take –

1-1 ½ hours

Will It Hurt?

Anesthesia will minimize pain during septoplasty. Following surgery, your nose may be tender or mildly painful. Ask your doctor about medications to help with the pain. Call your doctor if the pain is excessive.

Possible Complications –

Numbness in the tip of the nose or upper front teeth
Bleeding
Infection
Septal perforation (a hole in the septum)
No improvement in nasal breathing
Saddle nose deformity
Drooping of the nasal tip

Average Hospital Stay –

This procedure is done on an outpatient basis. Most patients leave the hospital or surgery center 3-4 hours following septoplasty.

Postoperative Care –

After the surgery, do the following to ensure a smooth recovery:

Try to breathe through your mouth for the first few days.
Do not blow your nose.
Keep head elevated when lying down for the first 1-2 days.
Apply ice packs to the nose to reduce pain and swelling.
Do not take aspirin products for pain.
Your doctor may want to see you for a follow-up visit to monitor the healing or to remove the gauze packing or splint.

Outcome

In the majority of cases, septoplasty successfully repairs the septum and improves nasal breathing.

Call Your Doctor If Any of the Following Occurs

Heavy bleeding
Severe pain
Signs of infection, including high fever and chills
Difficulty breathing

RESOURCES:

American Academy of Otolaryngology–Head and Neck Surgery

http://www.entnet.org

The American Rhinologic Society

http://www.american-rhinologic.org

CANADIAN RESOURCES:

BC Health Guide, British Columbia Ministry of Health

http://www.bchealthguide.org

Canadian Society of Otolaryngology

http://www.entcanada.org

References:

Beers MH, Berkow R, Burs M, eds. The Merck Manual of Diagnosis and Therapy . Whitehouse Station, New Jersey: Merck Research Laboratories; 1999.

Fact sheet: deviated septum. American Academy of Otolaryngology–Head and Neck Surgery website. Available at http://www.entnet.org/healthinfo/sinus/deviated-septum.cfm . Accessed September 9, 2005.

Ferguson BJ. Septoplasty and turbinate reduction. The American Rhinologic Society website. Available at http://american-rhinologic.org/patientinfo.septoplasty.phtml . Accessed August 31, 2005.

Way L, Doherty G, eds. Current Surgical Diagnosis and Treatment , 11th ed. New York: Lange Medical Books; 2003.

Last reviewed March 2007 by Elie Rebeiz, MD, FACS

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Septoplasty