What is deviated septum treatment
What is deviated septum treatment
The septum is a structure that separates the left and right airways of the nasal cavity. It is made up of cartilage and bone. No septum is perfectly flat. An ideally positioned septum divides the parts of the nasal cavity into two equal volume nostrils.
What is deviated septum treatment
This makes them perfectly passable. If this is the case, we only experience nasal obstructions in case of a severe cold or during allergy season. It is estimated that approx. 70–80% of individuals have some degree of nasal septum deviation, however, most do not suffer from any serious consequences.
Issues that make septoplasty worth considering: difficulty breathing through the nose (if the septum is off-centre enough to cause such problems), including when lying on one side for extended periods of time; obstructive sleep apnoea – pauses in breathing occur, it may be noticed that the person cannot breathe for extended periods during sleep (such people often breathe louder, snore, and wake up tired); recurrent sinusitis (a deviated septum can block the sinuses); frequent epistaxis (nosebleeds); in nasal fractures where the nasal septum is so badly deviated that adjusting the bone fragments is impossible without prior surgery; rhinologic headaches (a headache that originates in the nasal structures): because of a significantly deviated septum where the deviation comes into contact with the lateral nasal wall structures, the headache is usually confined to the forehead, the area above the sinuses, or the eye area.
What causes a deviated septum?
What causes a deviated septum?
Congenital (inherited) deviated septum (i.e., the septum has been compressed since birth) after a microscopically small injury during the newborn's passage through the birth canal; a deviated septum can also result during rapid growth, specifically due to the uneven development of the individual parts of the septum, and sometimes, the actual cause may even remain unknown.
When to consider septoplasty
When to consider septoplasty
In case of nasal breathing issues (i.e., when the septum is off-centre enough to cause such problems). Also, when laying on your side for extended periods and with the appearance of apnoea. Apnoea is a serios breathing disorder during sleep. It is characterised by alternating episodes of interrupted breathing, which the sleeping person is unaware of, impairing the quality of sleep, and as a result, of living.
When to consider septoplasty
Recurrent sinusitis (inflammation of the nasal cavities) is caused by a deviated septum that blocks the sinus cavities.
Nosebleeds (epistaxis) which occur in nasal bone fractures, when the nasal septum is deviated to such an extent that bone fragment adjustment is not possible without prior septum surgery.
Rhinologic headaches (a headache that originates in the nasal structures) resulting from a severely deviated septum, where the deviation comes into contact with the structures of the lateral nasal wall. The headache is usually confined to the forehead, the area above the sinuses, or the eye area.
Anaesthesia
Deviated septum surgery is most common performed under local anaesthesia. If at all possible, the surgery is conducted endoscopically, through the nose. This allows us to target the deviated septum and cause minimal trauma. Furthermore, this method facilitates recovery.
Before the procedure, the patient is administered a sedative tablet (midazolam) and painkillers. Sometimes, surgery is also conducted under general anaesthesia.
Preoperative instructions
Before the surgery, do not drink or eat for at least 6 hours. If you take medicine regularly, please take it with a sip of water and also let us know. Do not take antihyperglycemic agents levels unless instructed otherwise.
Do not take Aspirin or other blood thinning agents (Marevan, etc.). Do not take alternative medicine substances such as ginseng and ginkgo biloba, which prolong the duration of the bleeding. If unable to discontinue these medications, a consultation at least a week before surgery is advised
After admission, a nurse will insert a venous catheter needed for the medications administered during the operation. The nurse will remove the catheter before discharge.
Nasal septum surgery is known as septoplasty. It is a relatively safe elective operation to fix a crooked, or deviated, septum. It lasts about 1 hour. The surgery improves nasal breathing.
Possible complications
Bleeding, inflammation, persistence or recurrence of underlying issues, nose shape change, which is extremely rare, poor wound healing with risk of scarring or even hypertrophic scarring, blunt sensation in the upper teeth or upper lip area including possible transient swelling, respiratory or sleep disturbances, snoring, cerebrospinal fluid leakage, orbital blood, haematoma or abscess of the nasal septum, etc.
Postoperative complications
In up to 5%, bleeding requires intervention. This occurs most often on the first day after surgery; however, bleedings may occur for up to 2 weeks post-surgery. Occasionally, a haematoma (blood under the mucous membrane) develops between the septal cartilage and the overlying perichondrium. There is a risk of infection, leading to an abscess (pus collection), which requires surgical treatment.
To minimise the risk of such complications, it is of utmost importance that, post surgery, the patient avoids strenuous physical activity, lifting of heavy weights, smoking, etc.
Inflammation is relatively uncommon. It is identified by pain and redness in the nasal area, most often on the conycinosus, accompanied by a fever. The issue is resolved by repeating the surgery, if necessary.
Important
After surgery, patients often feel that the nostrils are blocked; also, they frequently experience feeling of fullness in the nose, headaches, and disturbed sleep. Such symptoms are normal post-surgery. During recovery, these symptoms gradually diminish. It is recommend to avoid ingesting hot drink and food immediately after surgery.
In case you notice:
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Difficult or even impossible nasal breathing or painful swelling
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Bleeding that will not stop
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Unmanageable pain despite using pain medications
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Body temperature over 38 °C
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Seek professional assistance as soon as possible and return to the clinic
Tearing and pain in the hard palate and teeth
Some patients also notice more pronounced tearing that they have less sensation in the upper incisors. As a rule, this sensation usually subsides within a short period. Occasionally, patients will also experience poor sensation in the hard palate. These issues are usually the result of the swelling that occurs during surgery, which subsides gradually and requires no special treatment.
Occasionally, swelling of the upper lip is also observed, which is similarly resolved spontaneously.
Perforated septum
After the surgery, the nasal septum may also become perforated. This means that a hole develops in the septum between your nostrils. Such injuries occur more frequently after revision surgery. If the perforation is proving bothersome to the patient, it can be surgically repaired; however, the success of the surgery is not guaranteed.
Sensation of nasal congestion
After surgery, you may feel that your nose is blocked and that breathing is difficult. Most often, the culprit is post-surgery swelling. Within 7–10 days, this sensation should diminish significantly.
Disturbed olfactory function
Immediately post surgery, the patient may experience an altered smell perception. In almost every case, the olfactory function is gradually restored. If smell perception has already been affected before surgery, a minor proportion of patients may notice an improvement.
Activities following surgery
It is recommended to raise the head of the bed while sleeping. Blowing one’s nose is advised against for about one week. Straining and lifting of heavy loads is also discouraged. At least a week's sick leave is recommended, or even two weeks in case the patient is performs heavy physical work.
Medication
After the removal of the nasal tamponade, it is recommended that patients keep their noise moist with saline, even antibiotic and anti-inflammatory drops, menthol, or a mild decongestant for up to 5 days. After the removal of the nasal tamponade, it is recommended that patients keep their noise moist with saline, even antibiotic and anti-inflammatory drops, menthol, or a mild decongestant for up to 5 days.
Follow-up
A follow-up appointment will be scheduled approx. 7 to 10 days after surgery. For the needs of post-surgery follow-up, it is recommended that all patients schedule another post-procedure follow-up in about six months to a year. This helps make a realistic assessment of the impact of surgery.
No special dietary considerations are required.