Nasal obstruction is common problem which can cause difficulty in breathing through the nose. This can get worse especially at night when they are lying flat leading to restless sleep. There are many factors that can cause nasal obstruction like allergies, narrow nasal passages due to problems with the nasal septum and turbinates etc.
The nasal septum divides the nasal passages into two separate nostrils. The turbinates lies inside the nose near the septum which allows air to pass through the nose. When these turbinates are too large they can cause nasal obstruction. Septum consist of two main parts cartilage and bone which are lined by a thin membrane called mucosa that covers and protects the cartilage and bone and also keep the nose moist from inside. When the septum is deviated, it can block one or both the sides of the nose and person would require surgery to correct the deviation and improve airflow. Some people are have deviated septum since birth or it can be caused by any accident or injury to the nose.
Surgery to correct the deviated septum is known as septoplasty that straighten the septum allowing a better airflow through the nose. It is the most common procedure to help relieve nasal obstruction and can also be a part of other surgical procedures like sinus surgery or nasal tumor removal.
Doctor will evaluate the symptoms and will examine the nose thoroughly through nasal endoscope or CT scan to diagnose the cause of the nasal obstruction. Patient will be suggested to stop taking certain medications or blood thinners that can cause excessive bleeding during the surgery and should also inform the doctor if the patient is allergic to any medicines or if have a history of bleeding problems.
During the surgery, patient will be given local or general anesthesia as decided by the doctor. Surgeon will make an incision on one side of the nose to reach the septum. The mucous membrane will be lifted up and the deviated septum is moved into the right position. Any extra pieces of bone or cartilage may also be removed. Then surgeon will reposition the mucous membrane and stitches will be given to hold the septum and membrane in place. Patient may have splints, or packing inside the nose to keep in position during the healing process. The complete procedure can take anywhere from 2-3 hours depending on the complexity of the condition. It is usually performed as an outpatient procedure and patient can go back home once the anesthesia is worn off.
Post surgery, patient may experience pain, fatigue, nasal stuffiness, and mild nasal drainage for which doctor will recommend some pain medications or antibiotics to prevent infection. Patient may also advised to use saline sprays or irrigations as a post operative care to fasten the healing process. Doctor will ask patient to limit the physical activity for some weeks to minimize swelling, to avoid intense exercise such as weight lifting, running, swimming etc that can increase the blood pressure and cause heavy bleeding. It is very important to keep the nose clean and hygienic to reduce any risks or further complications.
There are some potential risks involved in septoplasty that may include:
· Unexpected bleeding
· Septum perforation
· Altered nose shape
· Discoloration of nose
· Loss of smell sense
· Swelling or bruising
· Adverse reaction to anesthesia