Septoplasty (straightening of the nasal septum) and turbinoplasty (reduction of the inferior turbinate bone) is the most common procedure for nasal obstruction.
Septoplasty requires carefully lifting up the inner lining of the nose and removing or straightening the bent cartilage. It requires a small cut on the inside of the nose that can’t be seen. There is no bruising or swelling to the face. It requires a general anaesthetic and takes approximately 60 minutes.
It is usually performed in combination with the reduction of the turbinates. These bones sit on the lateral side of the nasal cavity and can be easily seem through the nostril. A variety of conditions can cause them to swell, in particular allergic rhinitis. They are reduced by carefully lifting the lining of the bone and removing the bone.
The procedure is not generally painful and can be perfomed as a day surgery. A small amount of bleeding is common for throughout the first week and settles spontaneously. You will need to use a salt water rinse (saline douche) for approximately 6 weeks after the procedure to allow it to heal. The operation is more than 90% effective for significantly improving nasal obstruction.
Before the procedure
Prior to the procedure an accurate assessment of the nose needs to be performed which relies on a thorough clinical history and physical examination. This will invariably also include examination of the posterior nasal airway with a vdeonasendoscope. Nasal airflow studies (rhinomanometry) is also routinely performed for those patients undergoing nasal septal / turbinate surgery.
A comprehensive discussion of the proposed surgical plan in addition to what to expect during the post-operative course will be undertaken before your operation.
During the procedure
The procedure is performed mostly through incisions on the inside of the nose although occasionally an external incision on the nasal columella (in between the nostrils) is required, particularly if the deviation of the septum is anteriorly placed. Once the deviated segment has been resected and any cartilage grafts positioned the incisions are closed and the nasal septum secured in the midline. Nasal splints made of silicon are occasionally used to help support the reconstruction.
The inferior turbinates are reduced in size using an endoscopic shaving instrument and dissolvable packing is often used to help prevent excessive bleeding. This is rinsed with saline douches in the weeks after surgery to help ensure the best healing possible.
Post procedure recovery
Following the surgery most people are able to be discharged on the same day without having to stay in hospital overnight. Depending on the splints and packing used antibiotics are often used for at least 5 days postoperatively. If splints have been inserted these are removed after 1 week then a further follow up appointment approximately 4-6 weeks later.
Bleeding during the 1st week following the operation is common but excessive bleeding necessitating readmission to hospital is rare. Pain is generally mild and well controlled with simple analgesic medications such as panadol and ibuprofen.
Following the procedure and recovery the initial nasal obstruction necessitating the operation should be relieved. Occasionally postoperative rhinomanometry is conducted to assess nasal airflow objectively.