Patient education: Septoplasty (The Basics)

What is septoplasty? — 

This is surgery to change the shape of the septum. The septum is the wall separating the 2 nostrils of the nose. It is made up of bone and a rubbery material called "cartilage."

Doctors might recommend septoplasty to improve how you breathe through your nose. It can help treat problems with your septum. The most common problem is called a "deviated septum" (figure 1). This is when the septum is crooked. Many people have a slightly crooked septum that causes no problems. But if a deviated septum causes any problems, like stuffy nose or trouble breathing through the nose, surgery might help. Doctors do not recommend septoplasty for people whose crooked septum is not causing problems.

Doctors sometimes do a septoplasty for other reasons. For example, a deviated septum can make symptoms of obstructive sleep apnea worse. Septoplasty can sometimes help. In other cases, it is done as part of another procedure to treat nosebleeds or frequent sinus infections.

Usually, septoplasty is done by making small cuts (incisions) inside the nose. The surgeon might also use a thin tube with a tiny camera on the end called an "endoscope." It goes into the nose and sends pictures to a TV screen. The doctor can look at the screen to see inside the nose more clearly. In some cases, the doctor will remove the septum and reshape it before putting it back into the nose.

How do I prepare for septoplasty? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Before the procedure, your doctor will do an exam. They might send you to get tests, such as:

●Blood tests

●CT scan – This is a special kind of X-ray. It creates a picture of the structure of the nose.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●Any procedures you had on your nose in the past – This might include a previous septoplasty or rhinoplasty. (Rhinoplasty is surgery to change the shape of the entire nose, not just the septum.)

●Any recreational drugs you take – Cocaine and other drugs taken through the nose can damage the tissue inside the nose. People who use cocaine in the months before septoplasty are more likely to have problems after surgery.

You will also get information about:

●Eating and drinking – You might need to "fast" before surgery. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before surgery. Whether you need to fast, and for how long, depends on the procedure.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during septoplasty? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure you do not feel pain during surgery. Types of anesthesia include:

•Local – This uses medicine to numb a small part of your body so you don't feel pain.

•General – This makes you unconscious so you can't feel, see, or hear anything during surgery. You might get a breathing tube to help you breathe.

●You might get medicines to help control pain after surgery.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during surgery.

●They might flush the inside of your nose with fluid to decongest it.

●The doctor will make small incisions on the inside of your nostrils.

●They will remove parts or all of your septum to change its shape. They might reshape some of the parts they removed, and then put them back in. This is to make sure the structure of your nose is strong.

●They will close your incisions. They might also apply an antibiotic cream.

●They might put splints or gauze inside your nose to make sure it heals correctly.

●They might put gauze under your nose to catch any blood. If you have a lot of bleeding, they can pack your nose with gauze.

●The surgery usually takes 1 to 2 hours.

What happens after septoplasty? — 

You will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Usually, you can go home the same day.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of septoplasty? — 

Your doctor will talk to you about all the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●Blood clots forming in or around your septum

●A hole forming through your septum

●Scar tissue forming inside your nose, making it hard to breathe

●The surgery not fixing the problem

Septoplasty can also cause you to lose your sense of smell and taste, or make your upper teeth or lip feel numb or very sensitive. But these problems usually do not last long.

What else should I know? — 

Before you go home, make sure you know what problems to look out for and when to call the doctor. Make sure you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Septoplasty – Discharge instructions (The Basics)
Patient education: Deviated septum (The Basics)
Patient education: Obstructive sleep apnea in adults (The Basics)
Patient education: Obstructive sleep apnea in children (The Basics)
Patient education: Nosebleeds (The Basics)
Patient education: Chronic sinusitis (The Basics)

Patient education: Sleep apnea in adults (Beyond the Basics)
Patient education: Nosebleeds (epistaxis) (Beyond the Basics)
Patient education: Chronic rhinosinusitis (Beyond the Basics)