Septoplasty �sɛp.toˌplæ.sti(Etymology: L, saeptum, septum; Gk, πλάσσειν plassein – to shape), or alternatively submucous septal resection and septal reconstruction, is a corrective

surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

procedure done to straighten a deviated nasal septum – the

nasal septum The nasal septum () separates the left and right airways of the Human nose, nasal cavity, dividing the two nostrils. It is Depression (kinesiology), depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal ...

being the partition between the two

nasal cavities The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal c ...

. Ideally, the septum should run down the center of the

nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes th ...

. When it deviates into one of the cavities, it narrows that cavity and impedes airflow. Deviated nasal septum or “crooked” internal nose can occur at childbirth or as the result of an injury or other trauma. If the wall that functions as a separator of both sides of the nose is tilted towards one side at a degree greater than 50%, it might cause difficulty breathing. Often the inferior

turbinate In anatomy, a nasal concha (), plural conchae (), also called a nasal turbinate or turbinal, is a long, narrow, curled shelf of bone that protrudes into the breathing passage of the nose in humans and various animals. The conchae are shaped like ...

on the opposite side enlarges, which is termed '' compensatory hypertrophy''. Deviations of the septum can lead to nasal obstruction. Most surgeries are completed in 60 minutes or less, while the recovery time could be up to several weeks. Put simply, septoplasty is a surgery that helps repair the passageways in the nose making it easier to breathe. This surgery is usually performed on patients with a deviated septum, recurrent rhinitis, or sinus issues.

Procedure

The procedure usually involves a judicious excision/realignment of a portion of the bone and/or cartilage in the nasal cavity. Under

general A general officer is an Officer (armed forces), officer of highest military ranks, high rank in the army, armies, and in some nations' air forces, space forces, and marines or naval infantry. In some usages the term "general officer" refers t ...

local anesthesia Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It ...

, the surgeon works through the nostrils, making an incision in the lining of the septum to reach the cartilage/bone targeted in the operation. This may be performed using an endoscope or with open techniques. Sufficient cartilage and bone is preserved for structural support. After the septum is straightened, it may then be stabilized temporarily with small plastic tubes, splints, or sutures internally.

Skin graft Skin grafting, a type of graft (surgery), graft surgery, involves the organ transplant, transplantation of skin. The transplanted biological tissue, tissue is called a skin graft. Surgeons may use skin grafting to treat: * extensive wounding o ...

s can be placed internally to support the internal structures.

Indications

Apart from in patients with deviated nasal septum causing airway obstruction leading to difficulty with breathing, recurrent rhinitis, or sinusitis, septoplasty is done as an approach to

hypophysectomy Hypophysectomy is the surgical removal of the hypophysis (pituitary gland). It is most commonly performed to treat tumors, especially craniopharyngioma tumors. Sometimes it is used to treat Cushing's syndrome due to pituitary adenoma or Simmond' ...

. It is sometimes done as well to cure recurrent nosebleed (epistaxis) due to

septal spur In biology, a septum (Latin for ''something that encloses''; plural septa) is a wall, dividing a cavity or structure into smaller ones. A cavity or structure divided in this way may be referred to as septate. Examples Human anatomy * Interatr ...

Contraindications

Septoplasty should not be done in acute nasal or sinus infection. It should also be avoided if the person has untreated

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...

, severe

hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...

or bleeding diathesis.

Post-operation

Unless there are unusual complications, there is no swelling or discoloration of the external nose or face with septoplasty alone. Packing is rare with modern surgical techniques, but splinting the inside of the nose for a few days is common; the splints are not visible externally. One percent of patients can experience excessive bleeding afterwards — the risk period lasts up to two weeks. This could require packing or cautery, but is generally handled safely and without compromise of the ultimate surgical result. Septal perforation and septal hematoma are possible, as is a decrease in the sense of smell. Temporary numbness of the front upper teeth after surgery is common. Sometimes the numbness extends to the upper jaw and the tip of the nose. This almost always resolves within several months. The nasal tissues should mostly stabilize within 3-6 months post-surgery, although shifting is still possible for up to and over a year afterwards.

Complications of septoplasty

Nasal septum perforation A nasal septum perforation is a medical condition in which the nasal septum, the cartilage, bony/cartilaginous wall dividing the nostrils, nasal cavities, develops a hole or fissure. This may be brought on directly, as in the case of nasal body ...

due to the bilateral trauma of the mucoperichondrial flaps opposite each other. *Septal

hematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillary, capillaries. A he ...

and septal

abscess An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends b ...

. *Adhesions and synechiae between septal mucosa and lateral nasal wall. *

Saddle nose Saddle nose is a condition associated with nasal trauma, congenital syphilis, relapsing polychondritis, granulomatosis with polyangiitis, cocaine abuse, and leprosy, among other conditions. The most common cause is nasal trauma. It is characteri ...

due to over-resection of the dorsal wall of the

septal cartilage The nasal septum () separates the left and right airways of the nasal cavity, dividing the two nostrils. It is depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal septum is called the columella or col ...

. *Dropped nasal tip due to resection of the caudal margin.

References

External links

* A brief and concis
Septoplasty entry
on

MedlinePlus MedlinePlus is an online information service produced by the United States National Library of Medicine. The service provides curated consumer health information in English and Spanish with select content in additional languages. The site brings t ...

, a public health encyclopedia * A more in dept
Septoplasty and accompanying ''Turbinates'' entry
on the

American Rhinologic Society American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, pe ...

's website {{Respiratory system procedures Nose surgery