Procedure for Endoscopic Septoplasty

The displacement of the wall between the nostrils is called deviated septum. It is a common condition though not always symptomatic. Instead of being in the centre the septum is shifted to one side of the nose thereby causing one nostril to be smaller than the other. Sometimes the deviation of the septum is so extreme it is plainly evident on the exterior.

The nasal septum is made up of bone and cartilage. Its main purpose is to:

• Support the nose
• Maintain its shape
• Support the mucous membranes lining the nostrils
• Regulate the air flow

Deviated Septum Symptoms

Deviated septum may be asymptomatic. However, sometimes the patient may experience the following symptoms:

• Frequent allergies
• Difficulty in breathing
• Wheezing sound
• Nasal congestion
• Nosebleeds
• Frequent sinus infections
• Facial pain
• Headaches
• Snoring
• Postnasal drip
• Ear pain and pressure symptoms
• Ear infections

Treatment

A surgical procedure called septoplasty is advised for the treatment of deviated nasal septum when all conservative treatments such as antiallergy, anti-inflammatory, antibiotics and steroids have failed Endoscopic septoplasty is the procedure when an endoscope is used to perform the procedure.

Pre Surgery Care

The patient undergoes a series of pre surgery care steps prior surgery which are as follows:

• Routine blood/urine exams are done
• X ray of the nose
• External examination

Procedure for Endoscopic Septoplasty

This procedure is performed usually under local or general anesthesia. It is a procedure that repositions the displaced septum to the center of nose so that both the nostrils are of the same size. This procedure can be combined with rhinoplasty to reshape the appearance of the nose.

The procedure involves the insertion of an endoscope into the nose to visually access the septum. A small incision is made in the most deviated area of the septum. The mucus membrane is lifted and the position of the underlying bone and cartilage are adjusted so as to bring the septum into the centre. If a spur or a polyp or a tumour is present which is causing the deviation, then they are excised. The mucosa is put back into place and the incision is sutured.

The procedure has a 90% success rate wherein the septum remains positioned in the midline but in 10% cases a repeat surgery may be needed. The severity of the deviation affects the result of the procedure. In a few weeks the patients show drastic improvement in their condition.

Some Statistical Data

Endoscopic Septoplasty surgery has 90% success rate and only in 10% of the cases a revision surgery needs to be performed. It is one of the top three ENT procedures to be conducted today.

How Long Hospital Stay is Required During This Surgery?

The patient is discharged the same day of surgery if no complications are present.

Indications for Nose Surgery

The following causes of deviated septum can indicate the need of a nose surgery :

• Trauma
• Birth defects
• Tumors
• Nasal spurs
• Polyps
• Unacceptable visual appearance.
• Sinusitis
• Persistent and recurrent rhinitis
• Fractures

Contraindication for Surgery

The procedure is not suitable in the following conditions:

• Paralysis
• Active infection
• Bleeding disorders
• Severely Immuno-compromised conditions

Risks/Complications Associated With Endoscopic Septoplasty

It is a relatively risk free surgery but the following complications might occur:

1. Immediate Complications may Include:
   • Septal perforation
   • Bruising
   • Swelling
   • Redness
   • Persistent pain
   • Bleeding
   • Infection
2. Delayed Complication may Include:
   • Failure of the corrective surgery
   • Scarring
   • Adhesions
   • Slight depression in the profile of the nose
   • Numbness

Post-Surgery Rehabilitation

Soon after the surgery completes, the patient might experience bleeding. Although the swelling subsides in fifteen days, there might be pain in the nose tip for some months. Hence, the patient must ensure to follow the below mentioned precautionary measures.

• Cold compresses on the nose will help reduce swelling if any.
• Anti-inflammatory, analgesics and antibiotics are given to treat swelling and pain and any possible infection
• Splints to support the nose are used only in conditions like severe trauma
• Nose blowing should be avoided.
• Extreme change of pressures should be avoided like traveling by aeroplane
• For a few weeks, strenuous activity should be avoided