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Blocked Nose Surgery (Septoplasty)

What is a blocked nose?

The nasal cavity is divided in two by a thin, vertical wall called the nasal septum. It is composed of bone and cartilage, and supports the nose and directs airflow. There are three horizontal outgrowths on the sides of the nasal cavity, which are called nasal conchae or turbinates.

Deviated nasal Septum; Caption Normal and deviated nasal septum
Deviated nasal Septum; Caption Normal and deviated nasal septum

The nose is blocked when the nasal septum is deviated, e.g. when the cartilage or bone is not straight. Other reasons for a blocked nose include enlarged inferior nasal turbinates, hypertrophic pharyngeal tonsil (adenoid), nasal polyps, and tumors.
In case of a crooked septum with troublesome symptoms you may be a candidate for septoplasty.

What are the symptoms of blocked nose?

A blocked nose can cause breathing difficulties, nose bleeding, recurring upper and lower airway infections (sinusitis, bronchitis, pneumonia), postnasal drip, middle ear disorders, headache and facial pain. The condition can also lead to “open mouth sleeping”, snoring and sleep apnea.

Why is a blocked nose surgery needed?

In case of chronic nasal obstruction you are advised to see our ENT surgeon for a consultation, and to get a diagnosis for the cause of your nasal symptoms.
Your ENT surgeon will use a nasal speculum and endoscope (a thin, lighted instrument) to look at your nasal cavity and check the shape of your septum, the size of the turbinates, and to look for any pathologic alterations (polyps, hypertrophic pharyngeal tonsil or tumor). The final diagnosis is based on the physical examination and on the result of nose and paranasal sinus CT. If there are symptoms of allergic rhinitis, an allergy test will also be done.
If your doctor diagnoses a nasal obstruction that is due to the deviated septum, you will be advised to undergo blocked nose surgery.

How does the procedure work?

Septoplasty (blocked nose surgery) takes about  40-80 minutes depending on the degree and complexity of the deviated septum, and on any other potentially needed surgical intervention (mucotomy, FESS). We recommend to have this surgery performed under general anaesthesia.
During the operation the nasal septum will be straightened by removing, replacing and repositioning cartilage and/or bone. The final step of the operation is inserting soft nasal packing or silicone nasal splints in the nose to stabilize the septum as it recovers and stays inside for two days.

What are the benefits and risks of the surgery?

The benefit of the operation is that you get rid of the symptoms of having a deviated septum.  You will also have less trouble with infections in the future, and above all, you will be able to breathe more easily.

Blocked nose surgery is a common and safe procedure, and side effects are rare. You will get patient information sheet and consent form for detailed information about septoplasty, risks of the operation, and perioperative tasks. By all means, you will discuss the possible risks of surgery before you make a treatment decision with your ENT surgeon.
Although it happens rarely, risks of septoplasty may include:

  • Post operative infection
  • Bleeding
  • Formation a permanent hole (perforation) on the septum
  • Loss of ability to smell

It is important to call your surgeon immediately in case of fever, permanent nasal bleeding,  vomiting or serious headache.
There are certain risks associated with general anaesthesia, for which we will provide a separate information sheet and an informative consent form. The tests and examinations that you will have before your surgery will ensure that these risks are reduced to minimum.

Am I a good candidate for nose operation?

Your ENT (ear, nose and throat) surgeon will advise surgery if it is necessary.
You will be asked to undergo some tests (nasal endoscopy, blood and allergy test, nose and paranasal sinus CT, ECG), and to see your anaesthesiologist and internist before your operation to ensure that your overall health condition is good enough to safely allow a blocked nose surgery under general anaesthesia.
All of our patients are asked to complete a detailed medical history form that is necessary for our surgeon and physicians so that they can decide if you are suitable for surgery.

How should I prepare for the surgery?

  • Prepare a list of all of your symptoms and other medical conditions, past illnesses and allergies, even if they seem unrelated to your nose or sinuses. For this reason, you will receive a detailed medical history form to complete, followed by a physical examination.
  • Be aware of any pre-appointment restrictions. Your ENT surgeon will provide you with all the information regarding preparation for the diagnostic tests.
  • List all your medications and drugs, including vitamins and supplements
  • Ask a family member or friend to accompany you, someone who can help you recall all the information need to be provided during your consultation.
  • Before surgery you will get a patient information sheet and an informed consent form with the necessary pre- and postoperative information to read and sign.

What should I do after nose surgery?

You can expect to have mild to moderate pain during the first two postoperative days because of the nasal packing and it is well controlled with oral pain killers. After the nasal tampon removal you may only expect nasal stuffiness for 3-10 days. The day after the surgery swelling around the nose and also some numbness in the upper lip is normal.
You may be asked to use nasal oil/ointment and/or nasal irrigation sets after your surgery.
Please only take medications approved at our clinic and check with your ENT surgeon about any post-operative care you will need to perform to allow your nose to recover properly.
For 2-3 weeks after surgery you will be advised to avoid intensive physical activities that may lead to nasal bleeding.

Why is regular check-up important after the surgery?

The first check-up  is due after a week, when a nasal cleaning treatment is needed to prevent nasal infections and formation of adhesions. The second control is usually due whitin 6 weeks.

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