Septoplasty and Nasal Airway Surgery
Did you know you could have a crooked nose without ever having an accident? The impact that a blocked nasal airway has on an individual’s quality of life can be huge, but it can start off so subtle. You may experience chronic stuffiness on one side or just simply feel that there is decreased or no air flow. This can lead to chronic mouth breathing during the day and night, dry mouth, and even affect the health of your teeth. Over the years, poor airflow through the nose can put strain on the heart and lungs and may lead to apnea.
Sometimes a septoplasty is more than enough to address this issue, and this straightforward procedure completely leaves the nose looking the way it was pre operatively. Some patients may have a completely straight septum, but other anatomic issues with the nose can lead to restricted air flow. This more complex repair is called a nasoseptal reconstruction and requires cartilage grafting, reshaping the nose and sometimes even straightening out crooked nasal bones. The goal of both of these surgeries is to improve airflow, not to cosmetically change or enhance the nose. With a nasoseptal reconstruction there are more structural changes that are made, and there can be some slight and subtle changes to the nose, but the overall goal is to keep the nose looking the same way.
At your initial consultation visit Dr Kim will carefully evaluate the inside of the nose to determine where the blockage is coming from as well as the overall structure of the nose. She will test the additional structures of the nose to see if they also will require correction.
What is a Septoplasty?
The term septoplasty simply means molding or grafting the septum. The septum is a combination of both cartilage and bone in the center of the nose and separates the right side of the nose from the left. The main portions include the septal cartilage in front, but also two large, thin plates of bone that meet in the middle behind the cartilage. Additional parts of the septum come up from the maxilla, or hard palate of the mouth, along the floor of the nose, and these portions are also addressed if they form “bone spurs”.
In a septoplasty, a small incision is made internally along the front edge of the septum. With careful dissection tissue is lifted off the cartilage and bone of the septum on both sides, and the areas of bone and cartilage that are causing the obstruction are removed. A strong L-strut of cartilage and bone and cartilage are left to ensure the overall structure of the nose is left unchanged. Once the nasal passages are opened up sufficiently, the incision is closed with 2-3 absorbable sutures. Internal, thin nasal splints are then placed to help the lining of the nose heal, and these splints are removed one week later.
What is a Nasoseptal Reconstruction?
In some patients a septoplasty may not completely improve the airway enough. These patients typically have a straight septum but experience collapse of the external structures of the nose, or their natural anatomy does not allow for good air flow dynamics.
A nasoseptal reconstruction is performed through an external or open approach and the underlying anatomy is altered in a more favorable manner to optimize air flow. This does require cartilage grafting and reshaping of cartilage. If the nasal bones are holding the cartilage in the wrong position then the nasal bones are sometimes broken and straightened.
What is the Healing Process Like?
Healing from a septoplasty is very quick, and complete once the nasal splints are removed. There may some residual swelling internally that takes time to resolve, but the improvement in airflow is often immediate
Healing from a nasoseptal reconstruction can be immediate, but overall air flow improvement can take several weeks longer to several months longer due to the amount of soft tissue dissection that is required.
If the inferior turbinates are addressed then there may be some internal debris and crusting that forms and can require up to a month to heal.
Frequently Asked Questions
Men, women, and teens (as young as fourteen) in good health seeking improvement in their nasal function are perfect candidates for septoplasty surgery.
Septoplasty surgery is performed in an operating room under anesthesia for maximum patient comfort and the best results. Dr. Kim’s septoplasty techniques vary and are tailored to each patient’s individual aesthetic needs. Small incisions are made to be undetectable following surgery. Dr. Kim will determine which technique is best for you during a surgical consultation.
Patients are free to go home a few hours following surgery. Recovery may take up to two weeks. Patients may have an internal splint for the first week to aid in healing and reduce swelling. Dr. Kim speeds up her patient’s recovery time by recommending oral vitamins C and arnica during the recovery process.