Nasal breathing is important to get a good adaptation of the air entering our body. Deviation nasal septum, a structure of cartilage and bone that separates the two nostrils inside the nose, is the leading cause of adult nasal obstruction.
The consequences of nasal obstruction can be dry throat, headache, repeating sinusitis, nosebleed, snoring, exhaustion to sport and even tooth malposition and alteration of smell.
Septal deviation is corrected by an intervention called Septoplasty. Surgery often is accompanied septum surgery on turbinates, some elements inside the nose used to heat and humidify inspired air and excessively developed in cases of nasal deviation and in cases of chronic rhinitis.
Indication and alternatives to surgery
The only effective treatment for a deviated nose is septoplasty, since medical treatments can not modify the shape of the septum. However, if the deviation does not give a significant symptoms the patient may decide not operated.
Sometimes it is necessary to make septoplasty to access the sinuses of the nose when the patient requires a Endoscopic sinus surgery.
Septoplasty is a functional surgery, ie which aims to improve nasal breathing. When you also want to modify the shape of the nose with a purpose aesthetics is called Rinoseptoplastia.
This surgery is usually done in a short stay unit, entered remaining few hours, based on patient characteristics and operation.
Usually performed under general anesthesia, so it is necessary to perform some preliminary preoperative tests. The patient must fast 6-8 hours before surgery.
The duration of surgery is 30-60 minutes, although it may take longer depending on the complexity or other procedures such as cosmetic surgery are added.
Septoplasty in only a small incision is made inside the nose through which the deformed septum corrected. We currently use endoscopic surgery, laser, argon plasma, radiofrequency, absorbable staples (you do not need to remove) and other methods to improve the technical accuracy. After straightening the septum incision with stitches resorbable also closes.
Usually both nostrils are plugged to reduce bleeding, pero hoy en día usamos esponjas que se deshacen solas o tapones con protección deslizante, do not bother to be withdrawn. Also put pieces of a special plastic into sheets to both sides of the wall to prevent the formation of abnormal scars.
If adhesive strips rhinoseptoplasty on nasal skin and a protective splint plaster can be placed, plastic or other materials.
The patient has a tamponated nose so it is not possible to breathe through the nose. Furthermore normal bleeding through the nose so gauze is placed “bigotera” you can change many times as necessary.
After completing the anesthetic recovery comes hospital discharge with the necessary instructions regarding medication, repose, Cures, monitoring visit and emergencies.
The 3-4 early days the patient should not drink alcohol, smoke, make efforts neither drive. Relative rest is recommended at home, avoiding to blow the nose and make efforts. It is preferable to be sitting or semi-sitting for reducing blood pressure in the head, cephalic congestion and bleeding. It is also recommended to drink plenty of fluids and eat soft and cold during the first days due to the dry throat that causes nasal packing.
Although not a painful intervention, plugging causes frequent discomfort so different power antiinflammatory prescribed according to individual tolerance to pain and antibiotics to prevent secondary infection of mucus plugs retained by.
Nasal packing is removed in consultation with the 2-6 days, according to patient characteristics and intervention. If nasal sheets have been placed, should remain from 1 and 3 weeks. In rhinoseptoplasty usually change again the splint a week because it loses its function Support swelling to his nose and held a week.
It is normal a light bleeding during early 7-10 days and also nasal obstruction or congestion in the first weeks, crusts and nasal secretions, so are very important nasal washes. Are also normal some discomfort at the nasal tip and / or upper lip disappear progressively.
Normally you can return to normal activity in 1-2 weeks, but it is preferable to avoid exercise during 1 mounth.
The nose can take up 3 months to normalize after septoplasty and up 6-12 months rhinoseptoplasty. We recommend avoiding dusty, smoke pollution and to improve healing.
Risks and Complications
As all interventions and although they are generally low gravity, septoplasty presents a number of risks that should be known before surgery.
- Scarring between the septum and nasal turbinates (sinechiae)
- Infection (sinusitis)
- Recurrence deviated septum or why has operated
- Internal communication between both nostrils (drilling)
- Nosebleed (epistaxis)
There are other rare complications, such as the change in the external nasal form, loss of smell and / or taste, a fistula of cerebrospinal fluid or other anesthetic problems.