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The nasal septum is the wall between the nostrils that separates the two nasal passages. Made up of thin bone in the back and cartilage in the front, it supports the nose structurally and directs airflow. A deviated septum occurs when the cartilage or bone is not straight, which can make breathing difficult — and also lead to snoring and sometimes sleep apnea.
A person’s septum can bend to one side or another as part of normal growth and development. Or it can be deviated at birth (congenital) or be caused by an injury such as a broken nose.
Surgery to straighten the septum is called septoplasty, or septal reconstruction. The surgery may be combined with other procedures to treat chronic sinusitis, inflammation or bleeding as well as to correct sleep apnea or remove nasal polyps. Individuals can benefit from a septoplasty when they have not had adequate relief with medication. The primary goal of the surgery is to improve breathing through the nose, and secondarily, to reduce nasal discharge and post-nasal drip.
Understanding the Procedure
The septum and nasal passages are lined with a layer of soft tissue known as the nasal mucosa. Through incision made inside the nostril, Dr. Moradzadeh lifts up the tissue (muscosa) covering the septum. This allows him to see the bone and cartilage directly, with the help of an endoscope. The doctor removes or reshapes the deviated portions of the bone and cartilage, leaving enough non-deviated bone and cartilage in tact to maintain the shape of the nose. The internal incision is then stitched closed. The entire procedures takes anywhere from 30 to 60 minutes. Soft plastic sheets are placed inside the nose to help the septum heal straight and reduce the chance that scar tissue will form. Dr. Moradzadeh does not use packing.
What to Expect Afterwards
It is normal for patients to have some mild discharge for the first few days following the surgery, especially after irrigating the sinuses. Use of Afrin spray will generally stop any bleeding. Congestion and some sinus pressure are also common for the first several days after the procedure. Extra-strength Tylenol can be used to relieve this discomfort, but aspirin and Non-steroid Anti-inflammatory (NSAIDS) medications such as Motrin, Advil and Aleve should be avoided because they can stimulate bleeding. Individuals who undergo septoplasty can expect to feel tired for the first few days after the surgery.
Patients should avoid straining, heavy lifting (more than 20 lbs.) and nose blowing for at least 10 days after surgery because these activities can cause excessive bleeding. The use of nasal steroid sprays should be avoided for at least two weeks after the procedure to allow the lining of the nose and sinuses to heal. Nasal saline mist sprays, however, can be used every 2 to 3 hours after surgery to help make the nose feel more comfortable.
Did you know that Dr. Moradzadeh is an expert at treating complex septal deviation and revision septal surgery? He is one of the first nasal surgeons in the United States to use the PDS perforated plate; a dissolvable sheet used during surgery to help support and force the septum to remain straight. Using innovative techniques he is able to correct the deviation without removing septal cartilage. For more information on this procedure make an appointment to see Dr. Moradzadeh for a consultation.