A deviated septum occurs when the thin wall between your nostrils is twisted to one side. It's actually pretty common in a lot of people.
When a deviated septum is severe, it can block one side of your nose and reduce airflow, causing difficulty breathing. Treatment of a severely deviated septum may include medications to reduce the swelling or nasal dilators that help open the nasal passages. When medications don't work, you may need surgery to correct the septum and help normalize breathing.
When it comes to surgical procedures that can correct a deviated septum, you have a few different options to choose from:
Deviated Septum Surgery or a "septoplasty", unless major complications arise, is a fairly common outpatient procedure that is done in a hospital, clinic, or surgery center.
The surgery is minimally invasive meaning no external incisions are made and any stitches put in will dissolve by themselves within a few days. It's around a 30-90 minute operation and once the anesthesia has worn off, most patients can go home the same day (someone else will need to drive them home.)
During the procedure, the septum is straightened and repositioned in the middle of the nose. The surgeon does this by making an incision to separate the mucosa (the soft layer of tissue lining the nasal passages) from the cartilage and bone. The surgeon then trims or straightens the bent cartilage and replaces the mucosa over the cartilage and bone.
After the surgery, you may have a nasal splint or pack placed in your nostrils to keep the septum in place during the healing process.
Deviated Septum Balloon Surgery
Also known as a Balloon Sinuplasty, this procedure uses a balloon attached to a wire catheter and is inserted into the nasal cavity. The balloon is then inflated and expands and remolds the collapsed or deviated wall of the nose. Once this correction has been made, the patient can then breathe normally and comfortably without any complications.
This procedure is minimally invasive and can be done in a doctor's office as opposed to a hospital or surgery center and can be done with local anesthesia as opposed to general anesthesia. No surgical cuts are required which reduces risks of bleeding and infection and the recovery period can be only a single day of rest before returning to work.
Deviated Septum Endoscopy Surgery
Endoscopy or Sinoscopy as it is commonly referred to in medical terms is another procedure that can repair a deviated septum.
This procedure is unique from a septoplasty in that a small camera tool called an endoscope is inserted into the nasal cavity, and with an eyepiece, the surgeon can go into the exact location and correct the obstruction without having to make any cuts to the face.
Due to the minimal invasiveness of the procedure, the patient can go home the same day as the procedure is done.
By improving nasal drainage this procedure can improve airflow and other nasal functions that may suffer due to a deviated septum or other sinus problems.
Deviated Septum Surgery Combined with Other Surgeries
Many patients who have a septoplasty performed, will choose to add an additional surgery on top of it and kill two birds with one stone. The most common type of surgery done together with a septoplasty is a rhinoplasty.
Patients who wish to have cosmetic work done to fix anything they don't like about their nose will do go ahead and do it if they are having a septoplasty done anyway.
Rhinoplasty with a Septoplasty
Also known as a Septorhinoplasty, these two surgeries are often combined and should be done by one surgeon.
A rhinoplasty is a procedure done to reshape the external part of the nose and the septoplasty fixes the internal structure and any issues such as obstruction or other airway blockages. These two procedures done together allow the surgeon to improve both the form and function of the nose in one shot.
Some insurance companies may not choose to cover the rhinoplasty because it is the cosmetic part of the surgery and not medically necessary. Therefore you may be required to pay for that part upfront.
The combined procedures are more invasive than a septoplasty done on its own and are done with general anesthesia in a surgery center or hospital. The procedure takes between 1-2 hours and patients will generally need to wear a splint or cast on their nose while it heals.
Around a week after surgery, the cast is removed and patients can go back to work. There is usually swelling that will develop under the eye area but will gradually subside over a month. The nose will continue to heal for a year after the surgery is done and regular check-ups will be required during that time.
Deviated Septum and Turbinate Reduction Surgery
A septoplasty done together with a turbinate reduction surgery is also pretty common.
Turbinates are small fleshy structures in your nose that help filter, warm, and moisten the air you breathe before it goes into your lungs. If they become enlarged or displaced they can make breathing more difficult and often times if they are chronic they will need to be operated on to fix them.
During the surgical procedure, the surgeon goes in with a knife and surgically removes some of the bone that is underneath the turbinates to reduce their overall size.
Other times the procedure is done with a shaving device in which the surgeon goes in and shaves done some of the tissue. The procedure is done with local anesthesia given through an IV and depending on the type of turbinate reduction surgery that was done, the recovery time can take up to 6 months. The area may need to be packed with gauze to keep the tissues in place which will heal over time.
To avoid bleeding or swelling you will be advised not to do any strenuous activity or blow your nose for the first few weeks of the healing process.