Technique and Surgery Overview
The repair of a deviated nasal septum through surgical procedure is called septoplasty, but may also be referred to as septal reconstruction or submucous resection of the septum.
The entire operation is conducted through the nostrils so it is considered to be relatively non-invasive and is generally performed in an outpatient surgery center.
Before a patient undergoes septoplasty the physician will inspect the nasal passages with an endoscope, a lighted instrument that can be inserted into the nostrils.
In some cases, a CT scan of the area is also performed to fully assess the structure of the nasal passages. Once the shape of the septum has been determined the patient will receive local or general anesthesia in order to be prepared for the 60-90 minute procedure.
During the operation the surgeon will make an incision in the nasal mucosa and then separate the outer lining from the cartilage. Excess pieces of cartilage are removed in order to straighten the nasal septum.
The mucosa is then placed back over the cartilage and the septum is stabilized with sutures, splints or small plastic tubes. The nasal cavity may then be packed with gauze, or gauze may be taped beneath the nose to absorb blood.
Frequent or hourly changes of the gauze are normally the main postoperative care required for one or two days after surgery. Supports or stitches are typically removed a week to ten days after surgery.
Who Needs Septoplasty?
Septoplasty is recommended for a few conditions. Patients with nasal air passage obstruction that is severe enough to interfere with breathing might want to consider septal reconstruction.
Those suffering from sleep apnea may benefit from septoplasty in order to regain uninterrupted breathing and sleeping patterns. Chronic sinusitis and chronic nosebleeds may be treated with this form of nasal surgery.
Septoplasty may also be used to treat patients with headaches caused by septal spurs as well as to aid in polyp removal or tumor excision.
How Much will it Cost?
Septoplasty varies in cost by hospital and due to the varying amount of cartilage removal required. The national minimum for the procedure is around $3500 and the national maximum is about $6500.
The average cost of the entire procedure, including anesthesia, facility fee and surgeon expense is around $4500.
Recovery and Post Operation
Septoplasty is an outpatient procedure so it will be necessary to have someone to drive the patient home and stay with the patient for 24 hours.
Occasionally a surgeon may request to see the patient the morning after surgery for a post-operative check. For the first two days the gauze should be changed hourly and a cool compress may be desired for the area.
Ice packs should not be used. Saline rinses are recommended on the second day, especially before gentle blowing of the nose. To prevent bleeding, blood thinners like aspirin should be avoided during the first week after surgery.
Prescribed or general painkillers, like acetaminophen are recommended for treatment of pain and swelling. Patients should consider clothing that does not require being pulled over the head or face, such as button up shirts.
A cool mist humidifier may be beneficial during the healing time but is not mandatory. Patients are advised to take two full weeks of recovery time and not to blow the nose during that period if possible.
Side Effects & Risks
Septoplasty carries risks similar to other facial surgeries. Patients should expect postoperative swelling, bleeding, bruising or discoloration.
A few people experience allergic reactions to anesthetics. Septoplasty does not involve vital organs or major blood vessels so it is considered a low-risk operation.
In a small number of cases a hole may develop in the septum, but if no discomfort is experienced additional surgery is not required. In extremely rare cases, a cerebrospinal fluid leak could develop and then have to be treated with an injection.
Properly performed surgical procedures have a low risk of infection and antibiotics may be taken post operation for prevention of bacterial growth.
Does My Insurance Cover the Procedure?
Insurance coverage of septoplasty varies by the insurance carrier and the reason the surgery is being performed.
Patients having elective septoplasty in conjunction with rhinoplasty are unlikely to be covered. Experimental septoplasty or reconstruction after accidents is sometimes covered.
Necessary surgery to correct breathing problems, polyp removal and tumor excision is usually covered. Details change widely between insurance carriers and the patient should check with the insurance provider before proceeding with septoplasty.
What Results are Realistic to Expect?
Normal results for a septoplasty include improved airflow through the nasal passages and easier breathing. Most patients with sinusitis or sleep apnea have significant reduction of symptoms following surgery.
The outward shape and appearance of the nose may also be straighter than before surgery, depending on the severity of septal deviation. Results should be permanent, however cartilage can change and grow over time, possibly requiring additional surgery a decade after the initial operation.
Alternative Procedures
Depending on the condition behind symptoms, alternatives to septoplasty vary greatly. Patients suffering from sinusitis may want to attempt treatment via nasal sprays such as phenylephrine.
Long-term use of nasal sprays may damage the mucous lining of the nose and cause scarring so it is important to monitor results regularly with a physician. Patients diagnosed with sleep apnea have several alternatives, all of which are recommended before surgery is considered.
Sleep apnea sufferers should lose weight, attempt different sleeping postures and use specialized appliances that enlarge the airway. For those suffering from chronic nosebleeds, nasal packing should be tried and the source of bleeding should be identified prior to contemplation of surgery.
The advantage to alternative treatment is the possible removal of symptoms without surgery.
Am I a Candidate?
Candidates for septoplasty are patients suffering from breathing problems due to nasal obstruction, sleep apnea, chronic sinusitis, chronic nosebleeds, headaches due to septal spurs and those with polyps or tumors.
Individuals declared fit for surgery including anesthesia might undergo septoplasty as a form of treatment. Those with severe allergic reactions to anesthesia or have otherwise been declared unfit for anesthesia may not be candidates for septoplasty.
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