Septoplasty

Internally the nose is divided into two passages by a wall of cartilage and bone in the midline, called the nasal septum.  If the septum is deviated to one side it can cause nasal blockage.

A septal deviation can be corrected by an operation called a septoplasty, which is performed under a general anaesthetic.  Septoplasty is often performed together with surgery to reuce the size of the inferior(lower) turbinates).

Before surgery

  • Report a personal or family history of bleeding problems
  • Declare if you take medications to thin the blood (eg aspirin or warfarin; these will need to be stopped prior to surgery
  • Do not eat or drink 6 hours before surgery

Surgery

Surgery will take one to two hours under a general anaesthetic. A small incision is made over the septum just inside the nose. There will be no visible scars. The septum is straightened surgically. The turbinate size is reduced. Most of the time the procedure is performed as daystay surgery and you will return home 2-3 hours after surgery.

After Surgery

What to expect and look out for:

  • The nose will feel blocked after surgery. This is a normal reaction of nasal tissue to surgery. It will clear over the following 2-3 weeks
  • There may be temporary numbness of the upper teeth and lips
  • The nose does not change its shape; all incisions are on the inside of the nose
  • Expect to drain blood stained mucus or even a few drops of blood from your nose for a week or two which is normal. If it becomes a constant flow of fresh blood get in touch with your GP, surgeon or the emergency department.
  • Pain will be minimal and may last for a few days
  • start saline rinse from day 2 after surgery and continue for 6 weeks
  • A follow up visit will be arranged 2-3 weeks after the operation. You may need 2-3 follow-up visits.
  • Healing will be complete 3 months after surgery
  • Keep your mouth open when sneezing to reduce pressure in the nose.
  • Only wipe your nose during the first week after surgery and blow it gently during the second week
  • Rest and avoid strenuous activity for two weeks after surgery. Have 5-7 days off work or school


Complications

Overall, postoperative complications are uncommon.

Haemorrhage

Heavy bleeding may require packing of the nose, or rarely, return to the operating room.

Infection

Increasing pain, redness, flu-like symptoms, increasing nasal blockage may be signs of infection requiring antibiotics.

Septal haematoma/abscess

This is a collection of blood between the cartilage and lining of the septum and symptoms are similar to those of infection. Contact your surgeon immediately if you suspect you have this.

Septal perforation

A septal perforation is a through and through hole in the septum that may develop if the healing is impaired. This may occur in up to 2% of patients. This will usually be asymptomatic and will not need to be repaired

Intranasal adhesions (scar tissue)

Scars may form inside the nose neween the septum and the lower turbinates. These scars are called adhesions. They may cause recurrent nasal obstruction. These adhesions are usually treated in the office under local anaesthetic.

Persistent symptoms

There may be minimal or no improvement in symptoms in up to 10% of patients. In this case there may be benefit from a second operation (revision septoplasty).