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A deviated septum occurs when the septum (the wall of cartilage and bone that divides the nose into two separate nostrils) moves to one side of the nose  . Some people are born with a deviated septum, whereas for others it might have developed due to an injury to the nose. People with this condition will have one nasal passage that is smaller than the other. This might result in breathing difficulties  . Surgical intervention is the only possible way to fix a deviated septum.
A septoplasty refers to the surgery for treating nasal blockage and to correct a deviated septum  . This surgery would straighten the septum, thus allowing for better airflow through the nose. Read on to know more about this surgical procedure.
What Is Septoplasty?
The primary reason behind performing a septoplasty is treating nasal blockages  . However, this surgical procedure can also be performed to treat long-term sinusitis, removal of nasal polyps and treating other conditions that block the nasal airway. In some cases, septoplasty can also be the chosen method for treating recurrent nosebleeds.
Septoplasty is ideally recommended only after your doctor has ruled out other treatments for nasal blockages. During septoplasty, the nasal septum is straightened and repositioned in the middle of the nose  . This procedure might require cutting and removing parts of the nasal septum before reinsertion in the proper position is done.
How To Prepare For A Septoplasty
Two weeks before the surgery, you might have to stop some of the prescribed medications, such as aspirin, ibuprofen and other blood thinners  . This step is essential to reduce the risk of excessive bleeding during and after the surgical procedure. Inform your doctor in case you have a history of bleeding issues.
Some people can have septoplasty under local anaesthesia (numbing the specific area to prevent pain)  . However, most of the people are advised to have this surgery under general anaesthesia (patient is in a sleep-like state during the procedure).
If general anaesthesia is the opted method, then you would be advised not to eat or drink anything after the night before the procedure. This ensures that you do not feel nauseated or vomit due to the anaesthesia during the surgery  .
Also, bring a friend or family member along who can be with you after the procedure. Photographs of your nose from different angles might be taken to serve as a reference before and after the surgery.
Risks Associated With Septoplasty
Septoplasty carries risks such as infection, bleeding and an adverse reaction to the anaesthetic. The following are some of the possible risks associated with septoplasty  :
- Excessive bleeding
- Persistence in previous symptoms despite surgery
- An opening in the septum
- A change in the shape of the nose
- A decrease in the sense of smell
- A temporary numb sensation around the upper gum region
- A collection of blood in the nasal space
The Septoplasty Procedure
The average time required for septoplasty is around 30 to 90 minutes. The exact time required depends on the complexity of the condition. The procedure involves making an incision on one side of your nose to access the septum  . The mucous membrane is next lifted. The mucous membrane is the protective covering of the septum. The deviated septum is then moved into the right position. Barriers in the form of extra pieces of bone or cartilage are removed. The last step involves repositioning the mucous membrane. Most of the time packing the nose using cotton after the surgery would be enough to keep the septum and membrane in place. In some rare conditions, stitches might be required  .
Care After Septoplasty
To decrease the chances of bleeding and swelling after surgery, your doctor would ask you to follow a few precautions at least for the first couple of weeks after the surgical procedure. The following are some of the guidelines that need to be followed  :
- Do not blow your nose.
- Avoid strenuous activities. This ensures that your blood pressure does not get elevated resulting in a nosebleed.
- Keep your head slightly elevated when sleeping.
- Do not pull clothing over your head. It is advisable to wear clothing that can be fastened at the front.
Results Of Septoplasty
The results are stable most of the time, however, tissue and cartilage may gradually reshape over time  . It would take about three to six months for the nasal tissues to relatively stabilize  . Most of the people say that septoplasty improves their symptoms such as difficulty breathing. However, the expected level of improvement may vary from person to person. In some rare cases, people might find their symptoms to continue even after the surgery  . In such cases, one can opt to undergo a revision septoplasty to further refine the nose and septum.
-  Kumar, L., Belaldavar, B. P., & Bannur, H. (). Influence of Deviated Nasal Septum on Nasal Epithelium: An Analysis.Head and neck pathology,11(4), 501–505.
-  van Egmond, M. M., Rovers, M. M., Hendriks, C. T., & van Heerbeek, N. (2015). Effectiveness of septoplasty versus non-surgical management for nasal obstruction due to a deviated nasal septum in adults: study protocol for a randomized controlled trial.Trials,16, 500.
-  Baumann I. (). Quality of life before and after septoplasty and rhinoplasty.GMS current topics in otorhinolaryngology, head and neck surgery,9, Doc06.
-  Dogan, R., Erbek, S., Gonencer, H. H., Erbek, H. S., Isbilen, C., & Arslan, G. (2010). Comparison of local anaesthesia with dexmedetomidine sedation and general anaesthesia during septoplasty.European Journal of Anaesthesiology (EJA),27(11), 560-964.
-  Daşkaya, H., Doğan, S., & Can, İ. H. (2014). Septoplasty: under general or sedation anesthesia. Which is more efficacious?.European Archives of Oto-Rhino-Laryngology,271(9), 2433-2436.
-  Dąbrowska-Bień, J., Skarżyński, P. H., Gwizdalska, I., Łazęcka, K., & Skarżyński, H. (2018). Complications in septoplasty based on a large group of 5639 patients.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery,275(7), 1789–1794.
-  Matthias C. (). Surgery of the nasal septum and turbinates.GMS current topics in otorhinolaryngology, head and neck surgery,6, Doc10.
-  Saharia, P. S., & Deepti Sinha (2013). Septoplasty can Change the Shape of the Nose.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India,65(Suppl 2), 220–225.
-  Kuduban, O., Bingol, F., Budak, A., & Kucur, C. (2015). The Reason of Dissatisfaction of Patient after Septoplasty.The Eurasian journal of medicine,47(3), 190–193.
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