15 W. Dry Creek Circle 6169 S. Balsam Way; Suite 290
Littleton, CO 80120-4427 Littleton, Colorado 80123
Phone: (303) 798-1309 Fax: (303) 798-2319
Ear, Nose & Throat Center
Specialists of the Ear, Nose and Throat / Head and Neck Surgery / Facial Plastic Surgery
Evaluation of Dizziness & Vestibular Disorders
For more information see us at our web site ! http://www.ENT Center.Net
Nasal Congestion Due to a Deviated Septum
What is a septoplasty ?
A septoplasty is a surgical procedure in which the nasal septum is straightened.
What is the nasal septum?
The nasal septum is the part of the nose that divides the right nasal cavity from the left nasal cavity (see diagrams). The septum usually lies directly in the center of the nose and rests on a bony ridge called the maxillary crest. The septum is made up of several layers. In the front, the central portion of the septum is cartilage, a relatively soft material that is fairly flexible. More posteriorly, the central septum is made up of thin bone. Lying on top of the bone and cartilage is the lining of the nose, called the mucosa. This picture shows the internal structure of the nasal shows septum viewed in cross section. The front of the nose is to the left. The cross-hatched region is made up of cartilage. Towards the back, the septum is made up of thin bone.
When and why is a septoplasty done?
A septoplasty is done if the septum is so crooked that it interferes with breathing or causes other problems. Few people actually have a perfectly straight septum, but in most cases the amount of bending is not large enough to be noticed. This image shows the nose viewed from below. In this case the septum is deviated to the patient's right side. In some cases the front part of the septum is in the proper position, but the rear portion has the deviation. The most common symptom from a badly deviated (crooked) septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and sometimes actually occur on the side opposite the bend. In some cases the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections. The septum may also need to be straightened in individuals undergoing sinus surgery just so that the instruments needed for this operation can be fit into the nasal cavity.
I have stuffy breathing. Does this mean I need a septoplasty?
It is important to remember that the nose goes through a natural cycle in which the nasal line on one side and then the other slowly expands and contracts. These cycles occur every several hours and may lead to the perception of nasal obstruction. If you have persistent difficulty breathing through your nose, you should see an Otolaryngologist for a complete exam.
Should I use nasal sprays to improve breathing through my nose?
You should NOT use any over-the-counter nasal sprays for more than a few days without contacting your doctor. Many of these products have ingredients that produce rebound nasal swelling when they are stopped. As a result, the user is required to keep using the spray in order to keep his or her nose clear. Long term use like this can cause injury to the lining of the nose. There are some sprays that can be used for a long time without side-effects; ask your doctor which spray is best for you.
How is a septoplasty done?
The basic principle in a septoplasty is to straighten the crooked portions of the septum. The operation is almost always done through the nose, without an external incision (there may be an incision if a rhinoplasty is also done at the same time). Badly deviated portions of the septum may be removed entirely, or they may be removed, readjusted, and reinserted into the nose. The operation takes about 1-1.5 hours, depending on the complexity of the deviation. It can be done with a local or a general anesthetic, and is usually done on an outpatient basis. In many cases nasal packing is placed for one to several days. There almost never is any bruising on the skin for just a septoplasty, though there can be bruising if a rhinoplasty is also done at the same time.
What are the potential complications of a septoplasty?
If the operation is done under a general anesthetic, there are the usual risks with any general anesthesia. Bleeding is a possible risk, which may require nasal packing. Much more rare is the risk of a hole developing in the septum after the operation. This may cause nasal crusting or interfere with breathing through the nose. An even rarer complication is postoperative infection of the septum, which could cause the front portion of the nose to bend inward. This would require a second operation to correct the deformity.
How do I know if I need a septoplasty?
It is best to have a good nasal exam by an Otolaryngologist. There are some medical treatments that can reduce nasal swelling.
What is otolaryngology-head and neck surgery ?
Otolaryngology-Head and neck surgery is a specialty concerned with the medical and surgical treatment of the ears, nose, throat and related structures of the head and neck. The specialty encompasses cosmetic facial reconstruction, surgery of benign and malignant tumors of the head and neck, management of patients with loss of hearing and balance, endoscopic examination of air and food passages, and treatment of allergic, sinus, laryngeal, thyroid and esophageal disorders. To qualify for the American Board of Otolaryngology certification examination, a physician must complete five or more years of post-M.D. specialty training.
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