Septoplasty for Deviated Nasal Septum

Septoplasty is a procedure that can help straighten a deviated nasal septum. It can help improve airflow for those struggling with nasal congestion. Recovery after septoplasty is now much better than it used to be in the past. Most patients having septoplasty do not need nasal packing or nasal splints after surgery.

What is septoplasty?

Septoplasty is a surgical procedure to treat a deviated nasal septum.  The septum is the wall in the middle of the nose.  It separates the right side of the nose from the left side.

No one has a “perfectly straight” septum.  There are natural little curves and bends in the septum almost everyone has.  For most people, these little curves don’t cause any real nasal problems.  The nose usually functions just fine even if the septum is not perfectly straight.

A deviated septum refers to a septum that is crooked. This means that it is bent, curved, or pushed to one side.  A deviated nasal septum can make the inside of the nose narrow.  A deviated septum can make it hard to breathe properly through the nose.  Sometimes, just one side of the nose feels congested.  In many cases, though, both sides are congested.

A septoplasty procedure helps to correct narrowing caused by a deviated septum.  An ENT doctor will work through the inside of the nostrils to perform surgery.  Most patients have surgery under anesthesia at a surgery center or hospital.

How is septoplasty performed?

To perform the surgery, the doctor looks inside the nose using a light or using a little camera.  Then, the doctor can see the deviated parts of the septum.  The septum is made of cartilage and bone. There is a mucous membrane on the surface of the cartilage and bone. This membrane is similar in some ways to the skin we have on the outside of the body.

The surgeon makes an incision inside the nostril and lifts the membrane from the cartilage and bone. The surgeon can then look at the crooked portions of the cartilage and bone. Different types of surgical tools are then used to carve and sculpt the misshapen cartilage and bone. After the carving and reshaping is complete, the mucosa is laid back into its natural position.  Some dissolvable stitches are then placed at the edge of the septum. In our practice, Dr. Goyal does not have to place nasal packing or splints after correcting a deviated septum.

What is the recovery like after septoplasty?

After septoplasty, most patients have a lot of stuffiness and nasal drainage.  After surgery inside the nose, the areas will have some swelling as they heal.  This is what leads to stuffiness.  The stuffiness is usually most severe in the first 4-5 days.  The congestion usually starts to improve slowly after the first week.

The drainage is usually a combination of mucus, some blood, and some clots.  Since Dr. Goyal does not use nasal packing, the nose will tend to drain a bit more.  The drainage can be a bit annoying, but this is typically still much easier than having packing in place.  After surgery, we will ask that you use a sinus rinse to clean some of the drainage from your nose.  As the swelling comes down and as the body heals, the drainage becomes better.  The first week is usually when the drainage is most significant.

Most patients have septoplasty under anesthesia, so they do feel fatigued from the anesthesia after surgery.

Most of our patients don’t have much pain after surgery.  Our patients typically use some Tylenol as needed to manage pain after nasal surgery.

What types of symptoms does septoplasty usually help?

Most patients having septoplasty surgery have problems with nasal congestion.  So, one of the main goals of septoplasty is to improve airflow through the nose.  With better nasal breathing, many patients are more comfortable during many different types of activities.  Many patients find that they can breathe more comfortably during exercise when their nose is functioning better.  Better nasal airflow can also improve sleep quality for patients who struggle with night time congestion.

What are the risks of surgery?

As with any surgical procedure, there are risks of surgery. Some of the risks of septoplasty are things like infection, bleeding, scar tissue formation, some numbness along the top of the mouth, and persistent congestion.  Less common risks include things like a septal perforation, injury to the skull base, leakage of spinal fluid, and a decreased sense of smell.  There are other possible risks, so please ask your doctor for more information if you have questions about risks of surgery.

I feel congested at night.  Is that from a deviated septum?

Night time congestion can be from a deviated septum.  It can also be from enlarged turbinates.

Many people also notice that their congestion switches from one side to the other.  Typically, if they are laying on their side, that side of the nose feels plugged.  The other side may open up, but is often not open enough to allow them to breathe comfortably through the nose.  This is fairly common, and can be related to a combination of a deviated septum and enlarged turbinates.  When that is the case, correcting the deviated septum and shrinking the enlarged turbinates together can help improve the breathing.

Does medical insurance cover the cost of septoplasty?

Insurance usually covers surgery for a deviated septum when a deviated septum is affecting the function of the nose.  Insurance usually does not cover the cost of surgery if they do not find it to be medically necessary. Each insurance plan is different, so please check with your insurance company about which benefits are covered.

For patients having surgery through our practice, we will obtain authorization from your insurance company before surgery.

Other questions?  Want to schedule an evaluation?

If you have other questions about a deviated septum or surgery to correct a deviated septum, we would be happy to evaluate you at our office.  

Please contact us if would like to have an evaluation for nasal and sinus issues at our office.  You may request an appointment by calling, sending us a text message, or by requesting an appointment online.  Our office staff is available Monday – Friday, from 8:30 AM to 4:30 PM.

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