Septoplasty of the nose - what is it? Septoplasty - correction of the nasal septum Video: deviated nasal septum in the program “About the Most Important Thing”

Types and causes of deviated nasal septum, ways to solve the problem, types of septoplasty, rules for preparing for surgery, possible complications and features of the recovery period.

The content of the article:

The importance of unhindered nasal breathing is difficult to overestimate. The curvature of the nasal septum plays a major role in this process. Breathing is not always disrupted for this reason, but it is the curvature that can provoke various types of inflammation and exacerbation. In any case, this problem can currently be corrected only by surgical intervention. Septoplasty is an operation to correct and correct a deformed nasal septum.

Causes of a deviated nasal septum

The causes of curvature can be either congenital or acquired. However, they are all divided into three groups:

1. Physiological. This includes all deformations formed due to the growth and development of the body. Uneven growth of bone and cartilage tissue during adolescence most often provokes a deviated nasal septum. In this case, it is characterized by a displacement to the side, the formation of spines and ridges.
2. Traumatic. This group contains all deformations that were formed under mechanical influence. Often such curvature is accompanied by bone fractures. In some cases, a displaced septum may develop in children due to dislocation of the cartilage during childbirth.
3. Compensatory. Changes in the shape of the paranasal structures can lead to enlargement of the shells (hypertrophy). This problem, in turn, provokes a curvature of the nasal septum from constant contact with the sink.

Types of nasal septum deformation

• C-shaped. In a simple sense, this is a hump (Greek profile). Most often the cause is genetic predisposition. It is observed in many residents of the East and some peoples of Europe.
• S-shaped. The most common type of displacement. It mainly forms after injury, but in some cases it can also develop due to heredity.
• Posterior-anterior S-shaped. Congenital curvature, which is much more difficult to correct than other types. For correction, several operations are performed, since in this case it is important to improve not only the respiratory function, but also the olfactory and speech function.
• Deformation to the upper or lower jaw. Straightening such a defect is carried out only with an integrated approach. In some cases, bite correction may additionally be necessary.

Regardless of the type of deformity, the nasal septum can only be corrected and straightened through surgery.

Indications for nasal septoplasty

1. Difficulty in nasal breathing. It may spread to both nostrils or affect only one. It depends on the type and degree of curvature.
2. Snoring (noise when inhaling or exhaling through the nose). May provoke the development of hypoxia (lack of oxygen in the blood).
3. Chronic inflammation in sinusitis (sinusitis, frontal sinusitis, ethmoiditis). Constantly stuffy nose and frequent runny nose.
4. Allergic rhinitis. Most often it is formed due to compensatory deformation. Usually accompanied by hypertrophy of the nasal turbinates.
5. Aesthetic problem. In this case, septoplasty is combined with rhinoplasty. In medical practice, this type of surgery is called septorhinoplasty.

Contraindications for nasal septoplasty

In addition, contraindications for such an operation include:

• Oncological disease;
• Pathologies of the cardiovascular system in decompensation;
• Diabetes;
• Acute infectious inflammation;
• Mental disorder;
• Poor blood clotting.

Before deciding on the advisability and necessity of straightening the nose with septoplasty, you need to be examined by an ENT specialist and pass all the necessary tests.

Types of septoplasty of the nasal septum

Today, correction of the nasal septum can be performed in two ways: classical (endoscopic septoplasty) and using laser equipment. Each of these options has its own advantages and disadvantages. Less commonly, but still used, methods of ultrasound or radiosurgery. Depending on the type of operation, the operation can be performed using a closed or open method. The first is more traumatic due to the incision in the columella area, and therefore is used only in cases of severe deformity. In the second case, doctors make small incisions through which access to cartilage and bone tissue is available.

Features of endoscopic nasal septoplasty

Today in medicine, endoscopic septoplasty is practiced by resection of small sections of the septum and changing its position, which ensures symmetry and normal functioning. In case of traumatic deformities, it may be necessary to remove some sections of cartilage.

Methods of laser septoplasty of the nasal septum

1. Septochondrocorrection with laser beam. In this case, only the cartilage tissue of the septum is corrected. During the operation, the problematic cartilage part is heated until it becomes plastic. After this, it is given the desired shape. This method is limited, because isolated cartilage deformation is an extremely rare phenomenon. Septochondrocorrection occurs without blood or pain, but is used less frequently than classic laser straightening. The reason for this lies not only in the limited area of ​​influence, but also in the fact that the method is relatively new, and therefore the consequences have not yet been fully studied.
2. Classical. This type of surgery is practically no different from traditional endoscopic septoplasty. Only here it is not a scalpel that is used, but a laser beam, which has significant advantages. The main advantage is the immediate coagulation of blood vessels after resection, which reduces blood loss and the rehabilitation period.

Technology of classical nasal septoplasty

The duration of classical (endoscopic) septoplasty is usually 40-60 minutes. The operation is performed under local, general or combined anesthesia.

Preparation for septoplasty of the nasal septum

Computed tomography and laboratory diagnostics allow the doctor to get a holistic picture of the problem and choose the optimal method for solving it.

When preparing for surgery, it is important to follow the following rules:

• 15 days before septoplasty, you need to stop smoking or reduce your usual dose of nicotine to a minimum.
• For women, the operation is performed only when at least two weeks have passed after the critical days.
• You should not take non-steroidal anti-inflammatory drugs or blood thinners before surgery.
• You should not eat food 12 hours before the procedure.

Compliance with these rules will facilitate and shorten the postoperative period, and also reduce the likelihood of complications.

Scheme of classical nasal septoplasty

Other operations can be performed simultaneously with septoplasty:

1. Vasotomy. Necessary for patients suffering from chronic vasomotor rhinitis. Involves resection of thickened mucosa.
2. Conchotomy. It involves trimming the hypertrophied nasal concha.
3. Sinusotomy. Manipulations are carried out in the affected nasal sinus.
4. Polypectomy. With this intervention, growths of the nasal mucosa are removed.
5. Rhinoplasty. Aesthetic correction of nasal asymmetry.

As for laser septoplasty, it is carried out in several stages: anesthesia, correction itself, suturing, installing tampons, applying a plaster cast.

Possible complications and consequences of nasal septoplasty

This is less common, but the following consequences are possible: bleeding and blood clots, nasal deformation, perforation or abscess of the septum, suppuration, hematomas, otitis media.

Recovery after septoplasty of the nasal septum

• Drink more fluids (juice, mineral water). This will help relieve dry mouth.
• Bed rest is not at all necessary, but you need to walk less, especially outside.
• Avoid hot foods and drinks for the first few days.
• For the first few days, measure your temperature in the morning and evening. If the increase lasts for a long time, consult a doctor.
• Don't tilt your head too much. Try to sleep on your back.
• Place plenty of saline solution into your nostrils. It will soften the crusts and promote the removal of mucus.
• Full working capacity is restored in 10-14 days.
• After surgery, it is recommended to avoid strenuous physical activity for at least 1 month.
• It is not recommended to visit the bathhouse, swimming pool, beach, solarium.
• Vasoconstrictor drops should not be used.
• In some cases, doctors use polyamide or catgut threads for suturing. If pieces of thread fall out during washing, don’t worry, this is normal.

Many patients of otolaryngologists, faced with a choice - surgery or further suffering, sometimes do not know how to guide themselves in such a complex issue.

Studying the intricacies of the upcoming intervention, a thorough preoperative examination, strict adherence to preparation recommendations and unquestioning compliance with the doctor’s instructions in the postoperative period will help you decide to take the right step and achieve the desired success.

For patients who fully feel the impact of a deviated nasal septum, doctors recommend a solution such as septoplasty. What it is and how it can affect the quality of life is very important to know when giving consent to surgery.

Septoplasty is a plastic surgery to correct a deformed nasal septum. The essence of the operation is either the correction of cartilage or bone tissue, or their partial removal. No external incisions are made; all manipulations are performed through the nostrils. Depending on the complexity of each specific case, local anesthesia or general anesthesia is used.

Along with septoplasty, there is also such a type of operation as rhinoplasty. These two concepts have significant differences. In the first case, the need for surgery is dictated solely from a medical point of view, because a deviated nasal septum is a pathology that leads to deterioration of health.

And rhinoplasty, although it is a surgical intervention, is a purely aesthetic procedure to change the shape of the nose. There are, of course, cases when it is necessary to combine these manipulations, then we will talk about rhinoseptoplasty.

Indications for surgery

When writing a referral for septoplasty, the ENT specialist is guided by the following patient complaints:

• most often and first of all, these are difficulties with breathing through the nose, sometimes on one side, sometimes on both;
• rhinitis, sinusitis, becoming chronic;
• congestion in the ears, otitis media, up to hearing impairment;
• increased incidence of nosebleeds;
• heavy snoring;
• headache;
• decreased or complete absence of sense of smell.

All these symptoms, if measures are not taken in time, lead to more severe consequences. Decreased oxygen supply to brain cells, which causes drowsiness and chronic fatigue. The air inhaled through the mouth enters the respiratory tract as cold, contaminated, and the mucous membrane dries out. All this increases the risk of glossitis, bronchitis, pharyngitis and pneumonia.

How to prepare for septoplasty of the nasal septum

Septoplasty, despite its apparent simplicity, is a serious operation. What it is - the otolaryngologist should describe to the patient in great detail. He also prescribes additional consultations with other specialists, among whom should be: a plastic surgeon, a therapist and an anesthesiologist.

The plastic surgeon who monitors the patient before, during and after septoplasty, determining what exactly needs to be adjusted and how it will happen, makes this explanation in a detailed surgical plan.

To select the correct anesthesia, it is important for the anesthesiologist to know about the patient’s injuries and infectious diseases, the presence or absence of allergies. The therapist examines the general condition of the patient: pulse, blood pressure, laboratory test results, the presence of chronic diseases, and based on them, with a personal signature, gives permission for septoplasty.

No later than 10 days before the operation, the following must be carried out:

• hardware examination (X-ray of the nose, ultrasound of the abdominal cavity, fluorography of the lungs;
• blood tests (blood group and Rh factor, HIV infection, Wasserman reaction, hepatitis, coagulation, as well as general analysis);
• general urine analysis.

If the patient has chronic diseases, consultation with a specialist in this field is necessary.

A week before the scheduled day of the operation, all physical activity is excluded: heavy work, sports activities, dragging heavy objects, running. A ban is introduced on foods that thin the blood: fatty fish, some types of berries and fruits, onions and garlic, flaxseed and olive oil, cereals containing a high percentage of magnesium, green tea, ginger, coffee.

During the 4 days preceding septoplasty and 6 days after it, it is necessary to undergo a special course of therapy to prevent swelling in the postoperative period: twice a day before or after meals, 20 drops of lymphomyositis and traumeel.

The last meal is allowed no less than 8 hours, drinking - 6 hours before surgery. Upon admission to the hospital on the day of surgery, the patient must present the results of all studies in the original, no more than 10 days old.

How is septoplasty performed?

Septoplasty - what it is and how it is performed - will help you understand the description of its five types.

Resection with threads

This is the alignment of the septal bone with its fastening with special threads.

Special fibers are implanted into the cartilage tissue to reinforce the curved bone.

Endoscopic septoplasty

A modern technique in which minimal tissue dissection is performed, which has a beneficial effect on healing and shortens the postoperative recovery period. Endoscopic septoplasty, in turn, is divided into three types:

• Vasotomy is the intersection of vessels connecting the mucous and bone tissues of the nose.
• RR technology – using a laser, the cartilaginous shell is exfoliated, followed by removal or straightening of the curved part of the septum.
• Reimplantation of autocartilage - securing the rearranged curved part of the cartilage in a new place with silicone inserts.

Laser septoplasty of the nasal septum

Laser septoplasty of the nasal septum is considered the most bloodless. To carry it out, a laser scalpel of the required angle is selected, with its help the cartilage shell is heated to a certain temperature, at which the cartilage tissue becomes plastic, like clay. Special instruments straighten and hold the cartilage until it maintains its correct shape.

Radio wave septoplasty

Radio wave septoplasty uses the ability of the Surgitron device to emit high frequency radio waves.

Under the influence of high-frequency radio waves, the possibility of severe bleeding is eliminated, there is a powerful antibacterial effect, thanks to the ideally smooth edges of the incisions, rapid tissue fusion occurs, which means that the rehabilitation period is reduced as much as possible, and there is an almost complete absence of postoperative pain.

Ultrasound septoplasty

Under the influence of high-energy ultrasound, spongy bone tissue is destroyed, tissue dissection, coagulation of blood vessels, which creates the same effects as with radio wave septoplasty. This method is effective for removing thorns and ridges.

Postoperative period – recovery after septoplasty

Immediately after the operation, tampons are inserted into the nostrils, and ice is applied to the bridge of the nose for half an hour. The recovery period, depending on the method used, lasts from one to two to three weeks.

You will need to wear tampons in your nose for a maximum of three days after surgery. During this same period, it is recommended not to have strict bed rest, avoid hot food, and avoid all kinds of stress. Given the need to breathe through the mouth, there should be a certain supply of fluid next to the patient during the postoperative period.

Drug treatment consists of taking Tsiprolet for five days (500 mg 2 times a day) and Erius- for 10 days (1 tablet per day), for severe pain - no more than 3 times a day, 1 tablet of Nurofen. After the final removal of the tampons, Aquamaris is injected into the nostrils as often as possible to speed up healing, soften and peel off the resulting crust.

Swelling subsides 1-2 weeks after septoplasty, which is average. This is a period when the temperature may rise, the ichor may be released, and the softened remains of the threads will fall off along with the crust. These symptoms, according to surgeons, are completely normal and do not indicate the occurrence of a complication.

For a month after septoplasty, sports and hard work are strictly prohibited.

Possible negative consequences

Provided that the operation is carried out correctly and the recommendations of specialists are followed, the occurrence of negative consequences in the postoperative period is extremely rare.

• One of the most common complications is bleeding, to prevent which tampons are necessary, which are removed 2 days after surgery.
• Hematoma is the second most common negative reaction of the body to surgery. If the tampon is heavily saturated with blood, the nasal passages are drained to eliminate the possibility of a hematoma.
• If septoplasty is performed carelessly, the surgical instrument can damage the mucosal layers, which leads to perforation of the septum. This operation requires high precision and accuracy from the doctor so that such a complication does not arise.
• A less common consequence is septal abscess.
• A change in the external shape of the nose can be caused by high resection of the quadrangular cartilage. This defect may appear at a later date - after the swelling subsides and all tissues return to normal.

The risk of complications increases significantly with uncontrolled drug use, alcohol abuse, smoking, long-term use of certain medications, the presence of scars from previous operations, and diseases not identified during the preliminary examination.

Prevention of complications

The first preventive measure will be careful selection of a clinic and consideration of reviews from former patients. The next stage is the transition to a healthy lifestyle a month before the operation - giving up bad habits, a balanced diet, eliminating blood thinning products from the diet.

The therapist should be notified in detail about the state of health, the presence of chronic diseases, past infectious diseases and surgical operations.

It is very important to undergo a complete examination prescribed by your doctor and otolaryngologist, perform all procedures the day before and on the day of surgery, paying special attention to the postoperative course of treatment and rehabilitation.

If any unusual symptoms, pain, excessive bleeding, dizziness, or nausea occur, the medical staff must be notified immediately.

Contraindications

Additional therapeutic measures will be required to relieve acute conditions and exacerbations of chronic diseases, especially diabetes mellitus, the cardiovascular system, and the respiratory system. The refusal to undergo septoplasty is clearly due to poor blood clotting indicators.

Price for septoplasty

Prices for septoplasty in different clinics vary significantly. This largely depends on the method used, devices, materials and instruments, methods of anesthesia, inclusion of a bed and food in the price.

The lowest price is 11.5 thousand, the highest is about 100 thousand rubles. The last figure includes, in addition to the operation itself, general anesthesia, 2-week hospitalization with food and consumables. To this figure it is necessary to add the cost of laboratory and hardware examination.

A responsible approach involves any intervention, including septoplasty. It is important that this is such a simple, but still operational effect. Such an important decision as choosing the right clinic will save patients from troubles.

It is desirable that the hospital is not multidisciplinary, narrowly focused in the field of otolaryngology. First of all, you need to decide which method is suitable for eliminating the problem, and contact a surgeon who specializes in operations of this particular type.

If price matters, you should consider all the options offered in detail. The price list must indicate what services and materials are included in the price.

To be more confident in a favorable outcome of a surgical intervention, it is a good idea to inquire about the reputation of the medical institution, find out its history, staff, and the number of similar operations performed there per month. The main criterion when determining the place of treatment is the qualifications of the attending physician, his track record, and patient reviews.

Septoplasty results (before and after photos)

If all conditions are met in the days preceding the operation and several weeks after it, in most cases the outcome of the intervention is positive. The main goal - free breathing, sound sleep, absence of upper respiratory tract diseases - is achieved in most cases.

A positive side effect is always visible on the face - the appearance of the nose after a properly performed septoplasty always improves. Humps, curvature, and asymmetry disappear.

Videos about septoplasty. What is it and how effective is the operation?

This video will answer what nasal septoplasty is:

Laser septoplasty pros and cons:

Septoplasty is a surgical procedure that needs to be performed to correct a deformed nasal septum. This is done while preserving the bone and cartilage structure.

Anatomical structure of the nose

The initial section of the upper respiratory tract is the nasal cavity. Air masses immediately enter it, which then enter the pharynx, larynx, and pass into the trachea, branches of the bronchi and pulmonary structures. In the lower sections, natural gas exchange and oxygen saturation of the blood already occur.

According to anatomy, the human nose consists of:

• the external openings of the nostrils through which air enters;
• a section with a vertical partition consisting of cartilage;
• posterior nasal canals;
• two narrow openings connecting the nasopharynx and the nasal cavity;
• cartilage and bones of the skull forming the anterior wall;
• inferior nasal wall.

The osteochondral plate forms the nasal septum, dividing the nasal cavity into 2 parts. Over time, it may develop growths and bends due to injury or bruises.

Over time, other protrusions may form that partially or completely block air movement. If this occurs in childhood, the development of the facial skeleton is disrupted.

An operation is necessary to restore the integrity of the nasal septum to prevent sleep apnea, bleeding, frontal sinusitis, acute or chronic sinusitis, sphenoiditis, respiratory infections and hearing impairment.

What does a deviated nasal septum look like?

Outwardly, a crooked nose is immediately noticeable. This occurs as a result of traumatic injury or is a congenital pathology.

Improperly fused cartilage can cause a lot of unpleasant symptoms:

1. Chronic runny nose, which periodically worsens. It is not caused by a cold or viral disease, but by a septal defect.
2. Irregular shape of the nose, for example, if one nostril is larger than the other, the cartilage is bent into an arch, there is a pronounced hump.
3. Headaches and chronic migraines due to tissue compression.
4. Heavy snoring during sleep, dizziness.
5. Sharp and profuse nosebleeds occurring due to drying out of the mucous tissues.
6. Decreased ability to work, weakness due to oxygen starvation of the brain.
7. There is pain when breathing through the nose.
8. Complete loss or partial loss of nasal sense of smell.
9. Decreased immune strength and deterioration of mental activity, weakening of memory.
10. Frequent ear inflammations, hearing loss.
11. Sensation of a foreign body in the throat, sore throat, unproductive cough.

Additionally, due to the curvature of the nose, the following may occur: difficulty breathing through the nose, heart pain, shortness of breath, dryness in the nasal canals, high blood pressure.

Causes of deformation of bone structures

The nasal septum becomes deviated for various reasons.

This can be not only a congenital, but also an acquired defect due to:

1. Too active growth of the skull skeleton, as a result of which there is less space for the nasal septum, and it bends inward or outward. This often happens with teenagers.
2. Injury in the form of a blunt blow or fall. As a result, the bone structures shift, and the septum becomes deformed. If there is no treatment or it is carried out incorrectly, the broken nose will remain uneven.
3. Proliferation of polypous tissue in the nasal canals.
4. Oncological tumors in the nose.
5. Incorrect development of one nostril, tissue hypertrophy. The enlarged shell puts pressure on the septum, forming its irregular location and shape.

Such causes can be eliminated using the scalpel of an experienced surgeon. The nasal septum can be shaped like a ridge, an S-shaped arch, a growth, or a spike. There may be several pathologies at once. The healing process itself and the technique of septoplasty depend on this.

Indications for septoplasty

Almost every second inhabitant of the Earth has a curvature of the nose in small parameters, but not everyone needs surgical correction, but only if there is:

• prolonged nasal congestion;
• frequent colds;
• chronic sinusitis or sinusitis;
• chronic otitis and eustacheitis;
• heavy snoring;
• dry mucous membranes.

A pronounced curvature may not cause any human complaints, since the breathing process adapts and is transferred to a wider nasal passage.

In old age, consequences may appear - lack of oxygen in the brain and tissue atrophy, deterioration of lung function. In such situations, the person is sent to a specialized department and undergoes treatment using septoplasty.

How to prepare for septoplasty

There are certain rules that must be followed when preparing for major surgery. It is important to undergo a comprehensive examination by several specialists at once, as well as undergo tests, fluoroscopy, ECG, and x-rays of the sinuses.

Surgery should not be performed during an exacerbation of chronic illnesses and infections. After healing you should wait a few more weeks. During the menstrual cycle, septoplasty should also be postponed.

A few days before the intervention, you should not take medications that affect blood clotting, alcohol, anti-inflammatory drugs or steroids. All facial hair is shaved off to prevent infection.

Septoplasty is performed in the ENT department of the hospital. Before starting, you should not eat anything or drink a lot of liquid. It is recommended to take a drinking straw and colorless lipstick with you. The operation itself is performed mainly under general anesthesia.

At the beginning, a sedative is administered to calm the person and prevent pain symptoms. Afterwards, vasoconstrictor drops, anesthetic sprays and antibiotics in the form of syrup or tablets are used. In the absence of contraindications, local anesthesia can also be given.

Types of septoplasty

There are different modifications of the septoplasty process:

Simultaneously with the change in the nasal septum, other therapeutic actions can be performed, for example, removing overgrown mucous tissue, polyps, tumors, and clearing the sinuses of inflammatory secretions. The entire process takes place under the supervision of a plastic surgeon.

Rehabilitation after septoplasty

Immediately after the operation, which usually lasts about an hour and a half, it is necessary to postpone the recovery from anesthesia. Doctors place cotton swabs in the nasal canals, making it impossible to breathe through the nose. This is necessary to prevent nosebleeds.

Breathing will be restored again in a couple of days. Mouth breathing will dry out the mucous membranes of the mouth and lips. You will feel constant thirst. To reduce discomfort, you need to purchase special silicone tampons with air venting tubes.

For several days after the operation, pain is felt; it can enter the oral cavity, lower and upper jaw. Difficulty eating solid foods. To eliminate pain, painkillers or injections are prescribed.

In the first days, ichor may ooze from the nasal canals. To stop it, a bandage soaked in an antiseptic is applied. Do not pick off crusts in the nose, blow your nose too much, or take a hot bath or shower.

The swelling usually goes away from the nose area within 10 days. Breathing through the nose is completely restored within a month. During this period, you can work, but without physical overload, you cannot play sports, visit the beach, pool, sauna or bathhouse.

Possible complications after septoplasty

Nasal correction can have negative consequences:

In the first weeks after septoplasty, the patient's nose may look unnatural due to swelling. There is a disturbance in the sense of touch, changes in the disturbance in the perception of smells may pass, or they may remain forever.

There are complaints of numbness of the tongue and oral cavity. This occurs due to injury to the nerve endings. The problem usually goes away within a couple of days. After discharge home, you can walk in the fresh air, but not in the heat or extreme cold.

What factors increase the risk of complications and their prevention?

Complications after septoplasty arise due to improperly performed surgery, inexperience of the doctor, failure to comply with hygiene rules or preparation rules.

The sterility of instruments is also an important aspect, violations of which lead to suppuration and inflammatory processes. The patient can take illegal drugs before surgery and hide from the doctor that they have contraindications.

In order for the surgical intervention to take place without dangerous consequences and to completely straighten the nasal septum, it is necessary to follow all the doctor’s recommendations, avoid physical activity, avoid nervous shock and hypothermia, and sudden tilts of the head during rehabilitation.

Every day it is necessary to make dressings, treat the nasal canals with an antiseptic, do the prescribed rinsing, for example, with hydrogen peroxide or furatsilin solution, and use Levomekol. The patient should be warned about the risks and negative consequences of septoplasty before the operation.

Contraindications for nasal septoplasty

You cannot correct the nasal septum surgically if you have diabetes, blood clotting disorders, acute forms of diseases, or infections.

This operation is contraindicated for pregnant and lactating women, patients with hypertension, those with reduced immunity, mental disorders, diseases of the vascular system and heart, cancer, HIV infection, and endocrine disorders.

This is an ENT surgery to correct its deformity. This operation differs from rhinoplasty in that it is performed not for aesthetic reasons, but for medical reasons. Usually a combination of these two techniques is used.

Causes of deviated septum

The nasal septum can be deformed during childbirth due to dislocation. The uneven formation of the cartilage and bone skeleton is also associated with its deformation. Physiological deformation of the septum is expressed in its displacement to the side, the presence of spines and ridges. Fractures of the nasal bones lead to its mechanical curvature. There is also a compensatory type of deformity, the causes of which are the anatomical pathologies of several formations in the nasal cavity and other factors:

• polyps, adenoids, other neoplasms;
• vasomotor rhinitis (swelling of the mucous membrane);
• foreign body in the nasal cavity (piercing).

The danger of a deformed nasal septum is that difficulty breathing causes many related problems. These are prolonged respiratory diseases, inflammation of the respiratory tract, paranasal sinuses. A deviated septum also causes the development of chronic sinusitis, rhinitis, tonsillitis, otitis, frontal sinusitis, and laryngitis. Often, only septoplasty surgery can get rid of these diseases.

Difficulty breathing, constant congestion in one or both nostrils are the main symptoms of a deviated septum. The aerodynamics of nasal breathing depends on the same size of channel diameters. Deformation of the cartilaginous septum leads to a narrowing of one of the channels, which increases the resistance to air flow. As a result, several types of complications arise that serve as indications for surgery:

• sinusitis;
• dryness, itching in the nasal cavity;
• chronic swelling of the nasal mucosa, which results in allergic rhinitis;
• predisposition to colds;
• pain in the face, head;
• nosebleeds;
• snoring, noisy breathing;
• apnea;
• oxygen starvation of the brain and heart;
• loss of smell, sometimes complete;
• presence of aesthetic defects.

Aesthetic defects can be expressed in the adenoid type of face. It is characterized by a constantly slightly open mouth, a nasal voice, and an incorrect bite. Features of the nose in the form of humps and protrusions also indicate a deviated septum. If there is no discomfort, septoplasty surgery is not mandatory, but can be performed at any time. Rhinoplasty often requires additional septoplasty due to narrowing of the nasal passages during aesthetic correction of the nose.

Surgical removal of the nasal septum has been practiced since ancient times. To this day, the Killian operation, which is a classic operation, is used. Basic techniques for performing septoplasty surgery:

1. Classical. An incision is made using a scalpel on the inner surface of the nose using an open or closed method. This is an outdated technology, the most traumatic against the background of new methods for correcting the nasal septum.
2. Endoscopic. Minimally invasive surgical equipment is used, providing the best aesthetic result. The process is controlled by a mini camera. The technique is effective for any complex defects of both cartilage and bone tissue. Endoscopic septoplasty produces minimal damaging effects on cartilage and tissue. The rehabilitation period is shorter.
3. Laser septoplasty (septochondrocorrection). Laser surgery is intended to correct cartilage; bone tissue cannot be corrected using this method. The essence of the process is to heat cartilage tissue through concentrated light radiation. The disinfecting effect of the beam creates an antiseptic effect, which makes it possible not to use turundas in the nose. When exposed to laser, coagulation of blood vessels occurs, so bleeding does not occur.
4. Radio wave. It has the positive effects of laser technology, and allows you to operate on both cartilage and bone tissue. The technology is considered the most gentle of all, which is ensured by exposure to high-frequency waves.

The essence of septoplasty is the excision of deformed areas of cartilage. New technologies make it possible to remove small sections of the septum that prevent its correct position. Sometimes individual parts of the cartilage removed from the nasal cavity become thinner and are returned back.

Operation

Preparing for surgery begins with stopping taking blood thinning medications. Eating is prohibited 12 hours before the procedure. The patient undergoes tests and undergoes the necessary procedures:

• visit to an otolaryngologist;
• fluorography;
• general, blood and urine tests;
• blood chemistry;
• blood test for HIV, hepatitis, syphilis;
• coagulogram.

The operation lasts from 1 to 2 hours.

Septoplasty can be performed under general or local anesthesia. The operation is performed on the cartilage of the nasal septum. After making incisions in the nasal cavity, the perichondrium along with the mucous membrane is lifted, opening access to the cartilaginous tissue of the septum. Then the cartilage is separated from the bone tissue. The periosteum along with the cartilage tissue is lifted, exposing areas of curvature. Bone and cartilage areas that interfere with the normal position of the septum are removed. Deformations are corrected. When using the latest technologies, a method is used to thin the sections of cartilage removed from the cavity, which are then returned back again. When completing the operation, the doctor returns the tissue to its place and applies self-absorbing sutures.

Tampons or silicone splints are placed in the patient's nose to fix the nasal septum in the desired position. The patient is forced to breathe through his mouth, which brings some discomfort. After 2-3 days they can be removed. After septoplasty, the nose is covered with a special plaster bandage from the outside. After the effects of anesthesia have subsided, the patient can return home. In the first few days, pain is felt, so the doctor prescribes analgesics. After 1.5 weeks, the pain disappears. Due to swelling of the operated nose, breathing is restored gradually. After 2-6 weeks, the patient's breathing returns to normal. Blood clots, mucus, and crusts will come out of the nose. To speed up the process, the patient must soak them with saline solution, as well as with the help of nasal agents based on sea water.

The full recovery time after septoplasty is about 4 weeks. For a month, you must refrain from physical activity, do not overheat or become hypothermic. It is not recommended to take alcohol or hot food for about 2 weeks. It is forbidden to bend forward for long periods of time, wear glasses, fly on an airplane, or sleep face down. You should also not take blood thinners. To avoid displacement of an unhealed septum, the nose should not be massaged, scratched, rubbed, and it is also prohibited to blow your nose.

Contraindications

Septoplasty of the nose is not performed in the presence of the following diseases:

• blood clotting diseases;
• pregnancy, lactation;
• neoplasms;
• infectious diseases;
• diabetes;
• pathologies of internal organs;
• diseases in the acute stage;
• heart failure, arterial hypertension;
• epilepsy, mental illness.

Septoplasty can cause complications. The main consequences of the surgeon's intervention are: bleeding, the formation of adhesions on the mucosa, and perforation of the septum. Hematomas between areas of the mucosa, degenerative changes in the mucosa, loss of sensitivity in the nose and teeth of the upper jaw may be detected. If the operation was performed by an inexperienced surgeon, then damage to neighboring areas may occur. This leads to paralysis of the oculomotor nerves, short-term blindness, and problems with the sense of smell.

Septoplasty surgery allows you to get rid of chronic respiratory diseases and restore normal breathing. In combination with rhinoplasty, the aesthetic appearance of the nose can also be improved.

The cause of chronic respiratory diseases is not always weak immunity or unfavorable climatic conditions. A deviated nasal septum occurs in both children and adults, due to trauma or congenital pathologies. Such deformations of cartilage and bone tissue negatively affect the quality of life, leading to dry nasal cavity, colds, snoring and headaches. The only way to restore the nasal septum is through surgery. Septoplasty is an operation during which deformed cartilage is removed and curved areas are straightened. The history of surgical correction dates back to the 18th century and was performed using finger pressure and displacement. Modern technology allows incisions to be made from the inside through the nostrils, so there are no scars or marks left.

Indications for use

It is carried out exclusively for medical reasons, the operation does not change the size and shape of the nose, the correction is carried out exclusively of the nasal septum. Otolaryngologists do not recommend performing it before the age of 21; before this time, the nose is formed, so the outcome of the operation is difficult to predict; the nose may become crooked. Only after anatomical formation is it possible to perform it, otherwise repeated surgery will be required.

Indications for use:

• chronic swelling of the mucous membrane;
• allergic rhinitis;
• noise accompanying the breathing process, snoring;
• frequent headaches;
• tendency to respiratory diseases;
• runny nose, sinusitis;
• regular nosebleeds.

Types of surgery

Septoplasty with turbinate vasotomy is an operation to reconstruct the nasal septum. Through the inner lining of the nose, the doctor gains access to the cartilage tissue. The surgeon then straightens it, in some cases it is possible to remove the area and then place it in the already corrected form. Vessels are also dissected between the mucous membrane and the periosteum to reduce the mucosa and reduce swelling; the technique allows one to cope with vasotomic rhinitis.

To fix the cartilage, a special mesh made of absorbable materials is used, which disintegrate after a year. When using non-absorbable materials, the doctor removes the threads after 3 months. The operation is performed under general anesthesia; the patient should not eat 12 hours before the procedure. The method also has a long recovery period, is difficult to carry out, and requires crushing bone tissue.

Endoscopic- the surgeon monitors the progress of the operation using a camera, which is inserted through an umbrella. Both local and general anesthesia can be used, depending on the individual characteristics of the patient. Using 2 incisions, access is made to the cartilage tissue of the nasal septum. Then the deformed areas are removed and tampons are installed for the next 24 hours. The operation takes about an hour, due to less trauma, a faster healing stage, and is the most popular technique.

Laser septoplasty It is bloodless, local anesthesia is used, and is prescribed for simple deformities when only cartilage tissue is affected. The doctor also monitors the progress of the operation through an endoscopic camera. The laser beam excises tissue while simultaneously sealing the vessels. It has a short recovery period, and the operation itself lasts no more than half an hour.

Microwave- combines the advantages of laser and classical septoplasty. The doctor monitors the progress of the operation on a monitor using a camera. The main instrument used to excise deformed tissue is a radio wave knife. The use of Surgitron allows you to work with bone structures. The doctor makes small incisions, removes the deformed septum, and after alignment, installs cartilage tissue.

Ultrasonic- incisions are made using an ultrasonic knife, a method that avoids blood loss. In case of severe curvature, the tool allows you to get rid of growths and bumps of varying degrees.

Preparation

First of all, a diagnosis is carried out, including examination, as well as anterior and posterior rhinoscopy. The doctor evaluates the breathing of each nostril separately and examines the nasal mucosa using a special instrument. If there are indications for septoplasty, a full examination is prescribed to prepare for the operation.

Analyzes, examinations:

• general blood test, urine test;
• markers for HIV, hepatitis, syphilis;
• coagulogram;
• X-ray;
• fluorography;
• electrocardiogram.

You will also need to consult a therapist and anesthesiologist. Depending on the individual patient, additional studies may be required.

Limitations during the preparation phase:

• 3 weeks before surgery you should avoid taking antibiotics, hormonal drugs, aspirin, and anti-inflammatory drugs;
• give up smoking, alcohol, remove from the menu salty, spicy, hot dishes that provoke swelling;
• lead a gentle lifestyle, give up sports and intense physical activity for a week;
• It is not prescribed to be carried out immediately before menstruation, or in the first week after.

Progress of the operation

Surgical correction should be carried out in trusted clinics with an impeccable reputation. Correction of the septum can be done in specialized centers, institutes or a regional hospital in the ENT department. When choosing where is better, it is important to pay attention to the qualifications and experience of the doctor.

For septoplasty, local, general, or mixed types of anesthesia can be used, depending on the individual characteristics of the patient and his wishes. Anesthesia is discussed before the procedure and significantly influences the preparation stage.

Important point! General anesthesia is used in complex cases where correction of bone tissue is required. Local anesthesia is often used in combination with sedative drugs.

Stages of implementation:

1. The patient is prepared for surgery and anesthesia is administered.
2. Soft tissue is peeled off and incisions are made on the internal mucosal surface.
3. Removal of malformed cartilage tissue.
4. Straightening of the nasal septum by displacement and resection of cartilage.
5. Removing fragments of the partition, restoring its shape, and installing it in its original location. Whether the area has become cartilaginous is checked using a camera.
6. Applying sutures to the incisions, fixing them with tampons, bandages or plaster.

The duration depends on the complexity of the operation; the doctor may need from 30 minutes to 4 hours to restore the septum.

Photos before and after

Postoperative period

The rehabilitation process includes 3 stages - postoperative, restorative, final. The first lasts 2 weeks, the rehabilitation process is carried out under the supervision of a doctor. Recovery takes about 3 months, the patient is at home. After healing is complete, you can lead a full life, the results last a lifetime. There are no scars left, since the incisions are located on the mucous membranes from the inside.

Postoperative stage:

1. The patient is in the hospital for 2–3 days. Medical staff monitors the condition and provides assistance if complications arise.
2. Tubes and tampons are inserted into the nasal passages and secured with a bandage; the patient feels thirsty and can only breathe through the mouth. For the first hours after surgery, you should not drink; you can only rinse your mouth or moisturize your lips with water. Then you can drink without limitation up to 3 liters of clean, non-carbonated, non-hot water.
3. Every 2 hours, the tubes are washed with saline solution or Aqualor, Dolphin to remove blood clots.
4. During the first days, walking and intense physical activity are not advisable.
5. Only salty, spicy, hot dishes that cause chewing difficulties are excluded from the menu.
6. For painful sensations, sleep disturbances associated with difficulty breathing, the doctor may prescribe painkillers and sedatives.
7. To prevent the occurrence of the inflammatory process, antibacterial therapy is carried out; for treatment, the patient is usually prescribed a penicillin group.
8. On the third day, the tampons are removed, the splints and plates are removed by the doctor after 2 weeks. There is no need to remove sutures, as biodegradable threads are used.
9. The crusts are removed by the doctor; after discharge, the patient carefully softens them with Vaseline or peach oil and removes them with a cotton swab.
10. After discharge, the patient needs to periodically visit an otolaryngologist for 2–3 weeks to monitor the healing process, as well as for hygienic procedures of the nasal cavity. If it gets worse, your condition changes dramatically, you need to consult a doctor.

How much does the operation cost?

You can make an appointment with an otolaryngologist in both public and private clinics; the cost of a consultation is from 2,000 to 5,000 rubles. In Moscow, diagnostics can be carried out at the Mechnikov Institute or a specialized center. It is necessary to undergo a full examination and tests to make an accurate diagnosis and determine a treatment regimen.

You need to find out how much the operation will cost in a specific clinic. For example, the price in a leading clinic in Israel and Makhachkala differ significantly. Also, the cost depends on the complexity of the procedure, the type of septoplasty, the innovative set of instruments, and the anesthesia used, which is determined on an individual basis.

You will also need to stay in a hospital for several days and consult with specialists during the recovery period. The cost of the operation varies from 20,000 to 150,000 rubles.

Possible consequences

Septoplasty does not eliminate the risk of side effects; as with any surgical intervention, there is a risk of complications. The operation can cause a sore throat, tearing, voice changes, impaired taste, and bruises in the eye area.

Consequences:

• Swelling and bleeding can be either minor or require stopping the operation or blood transfusion.
• In most cases, nasal congestion can be overcome. But there is still a percentage of patients who note not only a lack of results, but also a deterioration in respiratory function. During the first 10 days, restoration of functions is hampered by tampons, bandages, scabs, and swelling.
• Teeth may hurt and become numb; this is due to damage or stretching of nerve fibers during surgery; this is a temporary symptom and should not cause concern.
• Headaches are often observed with ear congestion. Patients also report drowsiness, fatigue, and dizziness.
• Frequent sneezing and the formation of green mucus is not always a deviation, but a reaction of the immune system. In any case, a doctor's examination is required.
• Nasal discharge and unpleasant odor may be signs of infectious inflammation.
• Snoring may persist even after successful restoration of respiratory functions.
• Infection of the septum and accumulation of pus are dangerous symptoms that require treatment.
• Loss of sensation in the tip of the nose may last for several months.
• Painful sensations, bags under the eyes, and nasal discharge disappear after breathing is restored.
• Patients may complain that their sense of smell has disappeared, which is restored on its own. A complete lack of perception of odors is dangerous; you must contact a specialist.
• The first days after surgery, a temperature of up to 38º may be observed. Long-term persistence indicates inflammatory processes.

Attention! Side effects such as perforation, accompanied by a characteristic whistle and dryness in the nasopharynx, synechiae - cartilaginous or bone bridges, sinusitis, hump, and deviated septum should cause concern. These are direct indications for reoperation.

Restrictions after surgery

The recovery period lasts about 3 months. It is necessary to visit an ENT specialist once a week; regular examination will prevent possible complications. To speed up the healing process, it is important for the patient to follow medical recommendations:

• the patient needs to rinse his nose with sea salt preparations for the first week, such as Aqualor, Humer, Dolphin;
• after washing, you need to remove blood clots and crusts yourself using a cotton swab, make turundas soaked in sea buckthorn or peach oil, to soften you first need to treat the nasal sinuses with saline solution;
• Vasoconstrictor drops may also be prescribed; respiratory functions will recover on their own, but patients can use similar medications to relieve uncomfortable symptoms;
• You can’t blow your nose or hold your head down for a long time;
• to speed up healing, 10 days after surgery, the doctor usually prescribes Nasonex spray, which has an anti-inflammatory effect;
• it is necessary to give up sports and lead a gentle lifestyle;
• It is prohibited for 2 weeks to smoke, drink alcohol, hot, spicy, salty foods that cause chewing difficulties;
• you cannot visit saunas, steam baths, solariums, carry out procedures that involve heating tissues, or stay in the sun for a long time;
• You cannot wear glasses; it is advisable to choose clothes with buttons or zippers to prevent injury to the nose;
• sleep exclusively on your back, monitor your health, and do not expose yourself to the risks of colds and infectious diseases.

Comparison with rhinoplasty and other types of nasal septum correction

Septoplasty is an operation to restore a deformed nasal septum. Indications for the procedure are deterioration in the quality of life associated with the breathing process, frequent respiratory diseases caused by a deviated septum. The correction does not affect the size of the nose; the aesthetic effect is achieved by straightening the back and eliminating the hump.

Rhinoplasty solves a whole range of aesthetic problems. Thanks to the operation, you can change the size and shape of the nose, eliminate congenital and post-traumatic consequences, correct large nostrils, and also restore a deviated nasal septum. Care during the recovery period is identical to that for septoplasty.

In addition to surgical methods, conservative treatment, vasoconstrictor drops, antibiotics, and sprays are used. They provide a temporary effect, eliminating symptoms, but surgery is still required to restore full breathing.

Contraindications

The main limitation for this is young age. The facial skeleton is formed before the age of 21; before this period, any operations are undesirable.

Until this time, the facial septum can recover on its own, and excision is associated with the risk of repeated curvature. But if there are medical indications, it can be prescribed earlier - starting from 6 years.

Contraindications:

• chronic diseases in the acute stage;
• inflammatory processes;
• elevated temperature;
• oncology;
• pathologies of the cardiovascular system;
• pregnancy, lactation;
• menstruation;
• postoperative period;
• autoimmune diseases.

Advantages and disadvantages

Septoplasty is not an aesthetic procedure; it requires medical indications. It is prescribed to restore respiratory functions, which improves the quality of life.

Pros:

• normalization of breathing and general well-being;
• opportunity to improve health outcomes;
• the result lasts for life.

Minuses:

• requires a comprehensive examination before implementation;
• a painful, traumatic procedure is performed under general or local anesthesia;
• long recovery period requiring medical supervision;
• there are risks of developing side effects;
• The result of the operation depends on the qualifications of the doctor.

Opinion of cosmetologists

On forums, doctors dispel myths about the operation and reveal the specifics of the procedure.

The user writes that the operation is not always performed using a laser, but general anesthesia is required. The doctor also determines a list of tests during the consultation.

The user writes about the peculiarities of using anesthesia during the procedure.

The review states that the shape and supporting function of the septum do not change during the operation.