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Reconstructive Surgery American Board of Otolaryngology - ABO

Deviated Septum – General Information

A deviated septum is a medical condition characterized by improper airflow through the sinuses as a result of a crooked or asymmetric nasal septum. The septum, which is made up of a layer of skin and cartilage that separate the nostrils into two chambers, helps channel air into the sinuses for the purpose of cleansing, warming, and humidifying. People who suffer from a deviated septum are more prone to snoring, sinus infections, nosebleeds, and even sleep apnea. A deviated septum can be corrected permanently with surgery.

Deviated septa can occur as a result of trauma, congenital defects, or more rarely, certain medical conditions. While no septum is perfectly straight, extreme hindrance of airflow through the nasal passageways will lead to frequent congestion, inflammation, and infection. This may affect your quality of life greatly, as breathing through the nose can be more difficult and often irritating. Septal surgery, also known as septoplasty, is a common and safe surgical procedure that will reposition the septal wall at the mid-line of the nose and restore symmetry to the nasal passageways. Patients report being able to breathe through the nose much more easily after surgery and typically report decreased occurrences of sinusitis.

Incisions are made entirely within the nostrils so there will be no visible scaring. Most patients heal very well and find that their airflow obstructions are permanently resolved through septoplasty. An endoscope (a small flexible tubular camera) will be used to visualize the inside of the nostrils before the operation. The entire procedure will last under two hours and you will be under anesthesia the entire time. The procedure is generally done in an outpatient center, so you should arrange for a friend or family member to take you home. Do not attempt to drive a car or operate heavy machinery while recovering from the effects of anesthesia.

The surgery involves separating the mucous lining and skin tissue from the cartilage of the septum. A variety of sanding equipment and grafts may be used to properly shift and reposition the septum to restore symmetry. After these adjustments, the overlaying tissues are placed back over the cartilage and stitched with dissolvable sutures. Splints may be used to hold the position in place as the body heals. These will be removed within the first two weeks after surgery.

As with any invasive operation, there are risks associated with septoplasty, including infection, adverse reaction to anesthesia, or surgical error. While perforation of the septum is rare, such occurrences have been reported. If you experience discomfort or a whistling noise when breathing through the nose after the healing phase, contact your septoplasty surgeon, as this may point to a septal perforation. You may be advised to adapt a nasal irrigation regimen after surgery to keep your nose and sinuses clear of bacteria and quicken the healing process. If you experience dizziness or develop a fever after surgery, call your doctor immediately, as this may be a sign of infection. Be sure to tell your doctor about any medications you may be taking and whether it is safe to take them before or immediately after surgery. Avoid any sports or exercise that may damage the nose during the healing period. Full recovery time may range between six months to a year.

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