The nasal septum is made of bone and cartilage and it divides the right and left side of the nasal cavity. Normally, the nasal septum lies in the center of the nose and rests on the maxillary crest (bony part of the floor of the nose).
When the nasal septum does not align with the middle of the nose it is called a Deviated Nasal Septum. This may have occurred from trauma, perhaps as a child, or you may have been born with a deviated septum. Almost everyone naturally has some curvature or crookedness to his or her septum. If the septum is too deviated it may block one side of the nose or obstruct the openings of the sinuses causing recurrent sinus problems requiring a Septoplasty.
The total time for this operation is 20-30 minutes and is performed using general anesthesia (while you are asleep). You should anticipate going home the same day unless other medical conditions complicate recovery.
Septoplasties are performed through the nose without any scars on the outside of the nose or face. An incision is made on the inside of the nose. The septum is then straightened by removing or reshaping the cartilage and bone and a plastic splint is temporarily placed to support the septum. Dr. Pasha does not routinely use nasal packing, making recovery easier.
Since Dr. Pasha rarely uses packing, significant pain and discomfort usually resolves within the first 2-3 days. The plastic splints prevent you from breathing well until they are removed one week later. Although the plastic splints have a channel that allows you to breathe, this channel is often clogged. After one week, you should find a dramatic difference in your nasal breathing immediately after removal of the splints.
Dr. Pasha routinely combines septoplasties with partial turbinate reductions to widen the nasal cavity. If you have recurrent sinus disease, he may also recommend endoscopic sinus surgery or balloon sinuplasty to allow access to the sinuses.
Deviated nasal septums may easily be diagnosed by using an endoscope to look inside the nose. This procedure is done in the office after spraying the nose with a decongestant and anesthetic (numbing agent). This procedure is typically painless and only takes a few minutes. Cat Scans (a type of X-ray) may also reveal deviated nasal septums and enlarged turbinates.
The operation itself is not painful since you are asleep for the procedure. Discomfort after the surgery varies widely. Generally speaking, septal and sinus procedures are not very painful. Typically, one feels like they have been “bopped” in the nose for a few days. Pain medications will be prescribed to reduce this initial discomfort. Afterward you may feel sore but the pain is much more minimal. Occasionally, one may develop a temporary, secondary sinus infection form the splints blocking the drainage pattern of the sinuses. If this occurs you may have facial pain or a headache, which resolves with removal of the splints.
You should avoid any straining or vigorous activity including bending over, lifting heavy weights, and most sports for at least two weeks. You may return to work or school whenever comfortable; typically Dr. Pasha suggests taking one week off until after the splints are removed prior to returning to work or school. Baths and showers are acceptable as soon as you go home.
Generally speaking, Septoplasties are routine cases with rare complications. The more common risk of the procedure is bleeding which may require nasal packing. Another potential complication is septal perforations or holes. For the majority of cases, these perforations are rarely noticed and require no further intervention. The risk of general anesthesia as well as other rare complications will be discussed with you in the office.