Nasoseptal Reconstruction (Deviated Septum)
Nasoseptal reconstruction — commonly known as septoplasty — is a surgical procedure to correct a significantly deviated nasal septum. It is one of the most commonly performed operations in ENT surgery and is a frequent component of rhinoplasty. The primary goal is to improve nasal airflow, though septal correction also plays an important structural role in rhinoplasty planning.
The Nasal Septum
The nasal septum is the internal dividing wall of the nose, separating the two nasal cavities. It is composed of cartilage in its anterior (front) portion and a thin sheet of bone further back, covered on both sides by a thin layer of mucous membrane. A perfectly straight septum is uncommon — minor deviations are nearly universal and do not require treatment. More significant deviations can substantially reduce airflow through one or both nasal passages.
How Does a Deviated Septum Develop?
- Developmental — as the septal cartilage grows and reaches the limits of the bony nasal cavity, continued growth can cause it to buckle and deviate into one nasal passage. This is the most common cause.
- Traumatic — a blow to the nose can bend, fracture, or dislocate the nasal septum from its midline position.
What Does the Surgery Involve?
Septoplasty is performed under general anaesthesia. All incisions are made inside the nose — there are no external scars. The procedure involves:
- A small internal incision inside one nostril to access the septum
- Careful elevation of the mucosal lining off the underlying cartilage and bone on both sides
- Repositioning, scoring, or partial removal of the deviated cartilage and bone — while leaving sufficient septal support to maintain the nasal dorsum and tip
- Securing the septum back in the midline using dissolving sutures. A thin internal splint may be placed inside the nose to prevent scar band formation during healing — this is removed at the first post-operative visit, typically one week after surgery.
Nasal packing is not routinely used at Dr Roth’s practice following septoplasty.
Frequently Asked Questions
| How long does surgery take? | Septoplasty alone takes approximately 45–120 minutes depending on the complexity of the deviation. It is often performed alongside turbinoplasty, sinus surgery, or rhinoplasty — combined procedures take longer. |
| What is recovery like? | Most patients take three to four days off work following septoplasty alone, or approximately seven days when combined with other procedures. Strenuous exercise should be avoided for three weeks. The nose will feel blocked during the healing period as swelling resolves. |
| Is it covered by Medicare? | A deviated septum causing documented nasal airflow obstruction is partly covered by Medicare and private health insurance where the applicable MBS item number criteria are met. Dr Roth’s team will assist in determining eligibility at consultation. |
| Can I have rhinoplasty at the same time? | Yes. Septoplasty and rhinoplasty are frequently performed together as a septorhinoplasty. Septoplasty provides access to septal cartilage for use as rhinoplasty grafts, and a single anaesthetic achieves both goals. Having a rhinoplasty after a prior septoplasty is more difficult, as septal cartilage availability may be reduced. |
| Can sinus surgery be combined? | Yes. Sinus surgery (FESS) is commonly performed at the same time as septoplasty in patients who have both a deviated septum and sinus disease. This avoids a second anaesthetic and allows comprehensive treatment of nasal obstruction in a single procedure. |
| Can it help with snoring? | A significantly deviated septum can contribute to nasal obstruction during sleep, which may worsen snoring and in some cases sleep-disordered breathing. Septoplasty may help where nasal obstruction is a contributing factor, though other causes of snoring and sleep apnoea may also need to be assessed. |
| What are the risks? | Septoplasty is a common procedure and complications are uncommon. Risks include bleeding, infection, recurrence of a slight bend, and very rarely a perforation (hole) in the septum during healing. These risks are discussed at consultation. |
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Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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