Nasoseptal Reconstruction (Deviated Septum)
A nasoseptal reconstruction is a procedure that is used to correct a severely deviated nasal septum for functional and sometimes cosmetic purposes as well. It forms an important component of rhinoplasty surgery.
Where is my nasal septum?
The nasal septum is your dividing wall inside the nose that separates your two nasal cavities. The septum is made up of cartilage in the front of the nose and a thin sheet of bone toward the back of the nose, then covered by a thin layer of mucous membrane and skin on both sides.
How does a deviated septum occur?
A deviated septum can occur naturally or after trauma. When it occurs naturally it is often due to overgrowth. When the septal cartilage reaches the maximum amount of space available for it within it’s boundaries continued growth leads it to bend and eventually dislocate into one nostril. Trauma to the nose can bend, break or displace the nasal septum.
Does a deviated septum cause nasal congestation?
It is rare for someone to have a completely straight septum but more significant deviations of the septum can lead to vastly reduced air flow thus leaving the patient feeling congested. Small deviations of the septum for the midline can also cause nasal blockage.
What does septoplasty or nasoseptal reconstruction surgery involve?
If performed alone generally a septoplasty or nasoseptal reconstruction can be performed with all internal incisions within the nose. The skin and outer lining is gently elevated off the septal cartilage and bone which can then be carefully inspected. The cartilage and bone is carefully re-aligned and then internal dissolving sutures are used to secure everything back in place. Sufficient cartilage and bone is left to maintain the nasal dorsum and tip.
How long does a septoplasty surgery take?
Septoplasty surgeries can between 45-120 minutes. They are nt usually done as a singular procedure, it is generally combined with another surgery (for example a turbinoplasty) so it can vary between cases.
What kind of anaesthesia is used?
Generally septal surgery is performed under general anaesthesia.
Is nasal packing used during septoplasty?
No. Nasal packing is not used during a septoplasty.
Dissolvable stitches will be sewn into the septum to make sure it heals correctly. Sometimes a thin plastic splint is also used inside the nose to prevent scar band formation. The splint usually stays in one week after the operative and removed in your first post operative appointment. There is some variation in the products different surgeons use at the end of the procedure and new products become available every year.
Is septoplasty covered by Medicare and insurance?
Yes. A deviated septum causing airflow obstruction is covered by Medicare and private health insurance.
How long is the recovery?
Septoplasty is usually a 3 or 4 days but this procedure is often joined up with another surgery and generally takes about 7 days for a full recovery. 3 weeks off heavy exercise is recommended.
What are the risks of a septoplasty?
A septoplasty or nasoseptal reconstruction is a common procedure and complications are rare. Risks include bleeding, infection, recurrence of a slight bend and very rarely a chance that a hole (perforation) can develop in the septum during healing.
Can I have a nose job during my septoplasty?
Getting a septoplasty is an ideal time to have a rhinoplasty to reshape your nose. When undergoing rhinoplasty surgery the surgeon will often use portions of the septal cartilage to create the planned changes to the nose appearance. It is more difficult (for the surgeon) to have a rhinoplasty performed when a septoplasty or nasoseptal reconstruction has previously been performed.
What about having sinus surgery along with a septoplasty?
Sinus surgery is often combined with patients who are having septal surgery.
Can septoplasty help with my snoring or sleep apnoea?
Yes. A bad bend in the nasal septum interferes with nasal breathing during the night. There can be other causes for snoring and sleep apnoea that may also need to be treated.