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Blocked Nose Surgery (Septoplasty)

What is nasal obstruction (a blocked nose)?

The nasal cavity is divided into two parts by a thin, vertical wall called the nasal septum. It is composed of bone and cartilage, and its role is to support the nose and direct airflow. There are three horizontal outgrowths on the sides of the nasal cavity, which are called nasal conchae or turbinates.

Deviated nasal septum; normal caption nose and deviated nasal septum
Deviated nasal septum; normal caption nose and deviated nasal septum

The nasal passage can become blocked for a number of reasons. For example, the nasal septum can be deviated (that is when either the cartilage or the bone is crooked). Other possible reasons include enlarged inferior nasal turbinates, hypertrophic pharyngeal tonsils (adenoids), nasal polyps, and tumors.
If you have a deviated septum which causes troublesome symptoms you may be a candidate for septoplasty.

What are the symptoms of a blocked nose?

A blocked nose can cause breathing difficulties, nosebleeds, recurrent upper and lower respiratory tract infections (sinusitis, bronchitis, pneumonia), postnasal drip, middle ear diseases, headache and facial pain. The condition can also lead to sleeping with mouth open, snoring and sleep apnea.

When is septoplasty (nasal obstruction surgery) recommended?

If you suffer from chronic nasal obstruction, you are advised to see our ENT surgeon for a consultation to find out the cause of your nasal symptoms.
The ENT surgeon will use a nasal speculum and an endoscope (a thin, lighted instrument) to look into your nasal cavity. He will be cheking the shape of your septum and the size of the turbinates, to see if there are signs of pathological alterations (polyps, a hypertrophic pharyngeal tonsil or a tumor). You will get a diagnosis based on the physical examination and the results of the CT scans of the nasal cavity and paranasal sinuses. If there are symptoms of allergic rhinitis, an allergy test will also be performed.
If your doctor diagnoses a nasal obstruction that is due to a deviated septum, you will be advised to undergo septoplasty.

How is the surgery performed?

Septoplasty (nasal obstruction surgery) takes about  40-80 minutes depending on the severity of the septal deviation, and the complexity of the case (whether or not the septoplasty needs to be combined with other surgical interventions, such as a mucotomy or FESS). We recommend having this surgery performed under general anesthesia.
During the operation, the nasal septum will be straightened by trimming, removing, replacing and repositioning cartilage and/or bone. The final step of the operation is the insertion of soft silicone nasal splints into the nose which help stabilize the septum as it recovers. The splints are usually removed after 2 days.

Blocked Nose Surgery Septoplasty

What are the risks and benefits of the surgery?

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

Nasal obstruction surgery is a safe and common procedure, side effects are rare. Before the operation you will receive a patient information sheet and an informed consent form which will provide you with detailed information regarding the risks of the operation, as well as what to expect before, during and after the procedure. By all means feel free to discuss the possible risks or any other concerns with your ENT surgeon before making a treatment decision.

Although complications are rare, risks of septoplasty may include:

  • Post operative infection
  • Bleeding
  • Nasal septum perforation
  • Loss of the sense of smell

 

It is important to call your surgeon immediately if you develop a fever, a permanent nosebleed, vomiting or a severe headache after your release from the hospital.

There are certain risks associated with general anesthesia too, these will be explained to you on a separate information sheet. You will be required to sign a second informed consent form regarding anesthesia. You will also have some preoperative tests to ensure that these risks are reduced to minimum.

Am I a good candidate for septoplasty?

Your ENT (ear, nose and throat) surgeon will decide if surgery is necessary in your particular case.

You will be asked to undergo some tests (nasal endoscopy, blood and allergy tests, CT scan of the nasal cavity and paranasal sinuses, ECG), and to see your anesthesiologist and internist before your operation. This is to ensure that your general health allows a septoplasty under general anesthesia to be carried out safely.

All of our patients are asked to complete a detailed medical history form. It is important to fill out the questionnaire to the best of your knowledge because the answers you provide will help our surgeon decide whether you are eligible for nasal obstruction surgery.

How should I prepare for the surgery?

  • Prepare a list of all of your symptoms and any known medical conditions, past illnesses and allergies, even if they seem unrelated to your current condition. For this purpose, you will be given a detailed form to complete, followed by a physical examination.
  • Be aware of any restrictions to adhere to prior to procedure. Your ENT surgeonwill provide you with all the information you need to prepare for the diagnostic tests.
  • List all the drugs and medications you take, including vitamins and supplements
  • Ask a family member or friend to accompany you to your appointment and aks them to help you recall the information to be provided during your consultation.
  • Before surgery you will receive a patient information sheet and an informed consent form which you will be requested to read carefully and sign. These documents will contain everything you need to know regarding preparation, the surgery itself and recovery.

What to expect after nasal obstruction surgery?

You can expect to have mild to moderate pain during the first few days after surgery because of the nasal packing. The pain can be significantly reduced by the use of oral pain killers. Once the packing has been removed, you may expect nasal stuffiness for about 3 to 10 days. The day after the surgery swelling around the nose and some degree of numbness in the upper lip are normal.
You may be asked to use a nasal oil/ointment and/or a nasal irrigation set after your surgery.
You should only take medication approved by the ENT surgeon at our clinic. In order to ensure a safe and fast recovery follow your doctor’s recommendation at all times regarding post-operative care.

For 2-3 weeks after surgery, you will be advised to avoid any intense physical activity due to an increased risk of nosebleeds.

Why is regular follow-up important?

The first follow-up exam will take place a week after surgery. At this appointment you will receive a nasal cleaning treatment to prevent infections and the development of adhesions. The second follow-up exam is usually due 6 weeks after surgery.