Nasal Septal Reconstruction

Nasal septal reconstruction or nasal septoplasty is a procedure to straighten the nasal septum. The nasal septum is a wall that separates the two nostrils and nasal passages. It is slightly off center in most people. If the septum is severely deviated, it may result in problems, such as difficulty in breathing through the nose. The bend in the septum may be present at birth or could be due to an injury. This procedure is done if you have any of the following problems.

  • Deviation of the nasal septum.

  • Repeated infection of the sinuses (air-filled cavities in the skull).

  • Pain due to the deviated septum.

  • Loss of smell due to the deviated septum.

  • A blood clot in the septum that interferes your breathing.

  • Frequent nosebleeds.

If the outside of the nose is bent, it may have to be reconstructed by a surgery called rhinoplasty. Sometimes, this procedure may be combined with septoplasty.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies.

  • Previous problems with anesthetics.

  • History of bleeding or blood problems.

  • Any medicines that you are currently taking.

RISKS AND COMPLICATIONS

  • You may have a hole in the septum.

  • You may have a collection of blood in the septum.

  • You may develop loss of sensation in the upper lip or teeth.

  • You may develop an infection.

  • You may have bleeding.

  • The front portion of your nose may become flatter than what it was before the procedure.

  • You may develop a reaction to the anesthetic used.

  • You may have a recurrence of the nasal obstruction.

BEFORE THE PROCEDURE

  • Follow the instructions given by your caregiver.

  • Your caregiver may recommend x-ray and blood tests.

  • Your caregiver may advise you to stop smoking for at least 2 weeks before the procedure.

  • Your caregiver may advise you to stop taking aspirin and anti-inflammatory medications such as ibuprofen, 10 days before surgery, as these medicines can cause bleeding.

If the surgery is going to be under general anesthesia:

  • You may be advised to eat only a light meal, such as soup or salad the previous night.

  • You will be advised to avoid eating or drinking anything after midnight and also in the morning of the procedure.

PROCEDURE

If the procedure is being done under general anesthesia, you may be put to sleep. You will not feel the pain. You will not be aware of the procedure. It can also be done under local anesthesia with sedation where the area of the surgery is numbed. The surgeon then makes a cut on the inner lining of the septum. If there is a blood clot, it is drained. The bone and cartilage of the septum are reshaped. The straightened septum is held in place using plastic sheets or splints. Your nose is then packed with gauze to control the bleeding. The procedure may take one to one and a half hours. It generally does not cause bruising or black eyes.

AFTER THE PROCEDURE

  • You may be kept in the recovery room till the effect of the anesthesia wears off.

  • You may be then brought to your room in the hospital.

  • You may be asked to breathe through your mouth.

  • Your nose packing may need to stay in place for 3 to 4 days.

  • You may be given medicines for discomfort and nausea.

  • You may be given antibiotics.

  • You may be allowed to go home on the same day or have to stay in the hospital for a few days.

HOME CARE INSTRUCTIONS

  • Do not blow your nose.

  • Avoid doing heavy work and strenuous exercise for at least one week after the procedure.

  • Avoid pushing or moving your nose before it heals.

  • Avoid lifting weight and bending forwards.

  • Avoid using products that contain aspirin.

  • Keep your head raised while lying down.

  • Take the medicines as instructed by your caregiver.

  • Inform your caregiver if you have any problems after taking your medicine.

SEEK MEDICAL CARE IF:

  • You have a new symptom.

  • You have doubts regarding the procedure or its outcome.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop fever over 102° F (38.9° C).

  • You have severe difficulty in breathing.

  • Your nose continues to bleed even after you keep your head raised and apply ice to your forehead and nose for 10 to 15 minutes.