A deviated septum is a common problem in the general population, but degrees of severity vary. When the deviation causes snoring, difficulty in nasal breathing, constant respiratory diseases, frequent nosebleeds, and sinusitis, surgical intervention is recommended for correction – this is called a septoplasty.
How does septoplasty work?
The main purpose of septoplasty is to center the nasal septum — the part of the nose that divides the nasal cavity into two parts, consisting of mucosa, cartilage, and bone. In many cases, the surgery can be performed using a closed technique, without the need for external incisions.
Considered to be of low risk, septoplasty hardly requires the use of a pack in the postoperative period. In addition, hospitalization lasts a maximum of 24 hours and rest required is typically up to just 7 days. The procedure can also be associated with techniques for aesthetic correction such as a structured rhinoplasty, for example.
What is turbinectomy?
The association of septum correction with turbinectomy often optimizes the results of the procedure. This is because a turbinectomy, or turbinate reduction, is the surgery indicated for cases of nasal obstruction resulting from an increase in the nasal turbinates or nasal concha. Turbinate reductions may be necessary when treatment with medication does not bring results. This operation is often performed in cases where there may be associated rhinitis.
The turbinate structures, located on the lateral wall of the nose, can enlarge as a result of problems such as allergic rhinitis and thus obstruct the passage of air. In these cases, the correction is done through endoscopic surgery, that is, surgery without performing external cuts.
Turbinectomy is a low-risk treatment that can be done with either general or local anesthesia. The treatment takes about 30-60 minutes and is done with the help of an endoscope to visualize the interior structure of the nose.
The physician may choose to remove all or part of the nasal turbinates after determining the degree of hypertrophy, taking into account the danger of future hypertrophy and the patient’s history at the moment.
Although a turbinectomy ensures a long-lasting outcome, it is none-the-less an invasive procedure with a longer recovery time than a stand-alone spetoplasty, and it may incur the possibility of crust formation that must be removed by the doctor along with possible small nosebleeds.
The postoperative period of septoplasty is generally well tolerated, although there may be some discomfort in the first days, caused by nasal secretions and inflammation.
Recovery time is approximately one week, with little to no pain and only some nasal discomfort. After the surgery, it is necessary to keep some precautions, namely, not being exposed to high heat, not exercising, and doing proper nasal hygiene with saline water as prescribed by your surgeon.
Physical exercise is often limited the first two weeks. At the end of the third postoperative week, there are generally no longer any restrictions.
What to expect from surgery?
Despite being a very safe surgery nowadays, a septoplasty entails some risks and possible complications that should be taken care of. Some common complications are nosebleeds, infections, persistence of some degree of septal deviation, and septal perforations, among others.
Sometimes there is a question of whether the septum can deviate again after surgery. With the exception of nasal trauma (“bump in the nose”) which can cause anatomical changes that can cause the septum to deviate again, the alignment after surgery is definitive, that is, the septum will be well corrected in the midline for the rest of the patient’s life (provided the surgery is performed correctly and there is no issue in the immediate postoperative period).
Septoplasty and turbinectomy surgeries can help relieve symptoms and improve the patient’s quality of life. As an example, problems such as aggressive nasal obstructions, infections in the paranasal sinuses (sinusitis), headaches, snoring, and sleep apnea can be treated through these procedures.
Rahul K. Shah, Charles Patrick Davis, Deviated Septum Surgery and Turbinectomy (Septoplasty, Nasal Airway Surgery). November 2019.
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