What is Septoplasty

Septoplasty, also known as nasal septal reconstruction or nasal septoplasty, is a procedure to straighten the wall of tissue (septum) that divides the nostrils inside the nose.

If the septum is misaligned, curved, or angled, it is called a deviated septum. This condition may be present at birth or could be due to an injury.

You may need this procedure if you have a deviated septum that is severely out of place and is causing problems such as:

• Difficulty breathing through your nose.
• Snoring or difficulty sleeping.
• Repeated infection of the sinuses. The sinuses are air-filled cavities in the skull.
• A blood clot in the septum that interferes with your breathing.
• Frequent nosebleeds.

During the procedure, the internal structures that stick out from the side walls of the nose (turbinates) into the nasal passage may also be trimmed (reduced) to help you breathe more easily.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Allergic reaction to the medicines used during surgery.
• Infection.
• Temporary or permanent:
  • Loss of sensation in your upper lip or teeth.
  • Damage to your sense of taste.
• Need for additional surgery because of:
  • Scar tissue (adhesions) inside your nose.
  • The return of nasal blockage after surgery.
• A hole (perforation) in your septum.
• Increased snoring or sleep disturbances.
• Changes in the appearance of your nose. This is rare.

What happens before the procedure?

Staying hydrated

• Follow instructions from your health care provider about hydration, which may include:
  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

• Follow instructions from your health care provider about eating and drinking, which may include:
  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• An IV may be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your health care provider will make an incision on the inner lining of the septum.
• If there is a blood clot, your health care provider will remove it.
• The bone and cartilage of the septum will be reshaped. In some cases, part of the cartilage or bone may need to be removed.
• The turbinates may also be reduced.
• Your health care provider will put in plastic sheets or splints to hold the straightened septum in place.
• Your nose may be packed with gauze to control the bleeding.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You may be asked to breathe through your mouth.
• You may be given medicines for discomfort and nausea.
• You may be given antibiotic medicine to prevent infection.
• If nose packing was inserted, it may need to stay in place for some time to control bleeding. Follow instructions from your health care provider about when it is safe to remove the packing.

Summary

• Septoplasty is a surgical procedure to straighten the wall of tissue (septum) that divides the nostrils inside the nose.
• You may need this procedure if you have a deviated septum that is severely out of place and is causing problems such as difficulty breathing through your nose or frequent sinus infections.
• Ask your health care provider about changing or stopping your regular medicines before the procedure.
• Plan to have someone take you home from the hospital or clinic.
• If your nose was packed during the procedure, follow instructions from your health care provider about when it is safe to remove the packing.

Care After Septoplasty

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• A mild headache.
• A stuffy nose.
• A feeling of fullness in your ears.
• Bloody fluid coming from your nose.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, use it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.

What to avoid

• Avoid eating hot and spicy foods for several days after surgery or as told by your health care provider.
• Do not blow your nose for 2 weeks after surgery or as told by your health care provider.
• Avoid strenuous activities for 2 weeks. These include activities such as running or playing sports. These activities can cause nosebleeds.
• Avoid straining when having a bowel movement. Straining can cause a nosebleed.
• Avoid very hot or steamy showers for several days after surgery or as told by your health care provider.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

General instructions

• You may be asked to clean your nostrils with an over-the-counter saline nasal spray. This will help to clear the crusts and blood clots in your nose. Use it as told by your health care provider.
• Raise (elevate) your head while you are lying down.
• If you have nasal splints, follow your health care provider’s instructions about removal.
• If your nose was packed with gauze, follow your health care provider’s instructions about removal.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Develop swelling or increased pain in your nose.
• Have yellowish-white fluid (pus) coming from your nose.
• Have a fever.
• Have severe diarrhea.
• Have nausea that does not go away.
• Cannot breathe through your nose.

Get help right away if you:

• Are short of breath.
• Feel dizzy or you faint.
• Have vision changes.
• Are bleeding heavily from your nose.
• Are vomiting.
• Have a severe headache or a stiff neck.

Summary

• After the procedure, it is common to have a mild headache, stuffy nose, feeling of fullness in your ears, and bloody fluid coming from your nose.
• Follow instructions from your health care provider about food and fluids that you should avoid.
• Do not blow your nose for 2 weeks after the surgery.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.