Deviated Septum

The nasal septum plays an integral role in nose structure. Located in the center of the nose, the septum separates the left and right nasal cavities, and it is lined on each side by nasal mucous membrane. The septum is made of bone and cartilage, and the front part of that cartilage is part of the external support and structure of the nose.

Septum Related Problems

When not positioned in the nose properly, a septum is deviated and a potential source of problems. It is common for a septum to be crooked, which may be a condition present at birth, or the deviation may be caused by trauma from a facial injury. A significantly deviated septum may cause a nasal blockage or obstruction. If the deviation blocks sinus drainage pathways, it may cause sinusitis, which occurs when sinuses are inflamed. Millions of people are affected by this every year, which accounts for around 16 million doctor’s visits annually. Medicine is beneficial on a short-term basis, but it can’t remedy the underlying cause of the problem. Surgery to straighten a deviated septum can improve airflow and other problems.

Deviated Septum UCI Head Neck 1 - Deviated Septum
Deviated Septum UCI Head Neck 2 - Deviated Septum

Septoplasty

Septoplasty is the name of surgery used to correct problems in the nasal septum, and it’s the third most common surgical procedure for head and neck issues in the United States. Most often, the procedure takes an hour or one-and-a-half hours and is usually done on an outpatient basis. Once anesthesia takes effect, the doctor makes an incision along the inside wall of one side of the nose.

Often, a hemitransfixion incision is performed, which allows the doctor access to anterior and posterior deviations. Sometimes, with a straight anterior septum, a killian incision is preferred because it places the cut toward the back of the affected area. Once the cut is made, the mucous membrane is lifted, and the bone or cartilage causing the blockage is either repositioned or removed. Then, the doctor replaces the mucous membrane, which is reattached with splints, stiches, or packing materials.

Most patients recover well from septoplasty, but there are some risks associated with it, including having the nasal blockage return, which might require additional surgery. Sometimes nasal obstructions persist after surgery because there may be deviations that were not corrected during the original procedure. Other risks include an uneven nasal appearance, skin discoloration or changes in skin sensation, scarring, and a hole in the septum. There are also general risks associated with any surgery, including infection, which may be seen more in immunocompromised patients than others. Allergic reaction to medicine, breathing problems, and bleeding are also potential risks associated with deviated septum surgery.

Recovery

Both sides of the nose may be stuffed with spongy materials or cotton to prevent nosebleeds after surgery. Packing is usually removed within 36 hours. Patients may experience swelling and draining for several days after septoplasty, including a small nasal discharge of bloody mucous. When resting during the first two days after surgery, the head should be elevated. Antibiotics are usually unnecessary.

Deviated Septum UCI Head Neck 3 - Deviated Septum