Septoplasty
Septoplasty is a surgical procedure performed on the median nasal septum to straighten it and improve breathing and nasal comfort. The operation is performed under general anesthesia by an ENT surgeon, and requires a one-day hospital stay. No scars are visible, as the procedure is performed through the inside of the nose.
Find out more about septoplasty from Dr Delagranda, an ENT and cervico-facial surgeon in La Roche-sur-Yon in the Vendée.
Indications and target group for septoplasty
Who should consider septoplasty?
Adults with a blocked nose, especially if it’s unilateral and linked to a nasal septum problem.
Children over the age of 15 (exceptionally under this age, due to facial growth) for the same reasons.
When should a septoplasty be performed?
Septoplasty should be performed in cases of:
- Sensation of a blocked nose, especially if unilateral.
- Difficulty tolerating a CPAP (continuous positive airway pressure) device worn at night for sleep apnea syndrome (specific indication discussed after careful examination and elimination of other causes).
- Snoring (specific indication discussed after careful examination and elimination of other causes).
- Orthodontic work.
- Repeated unilateral sinusitis favored by major deviation affecting sinus aeration (specific indication discussed after careful examination and elimination of other causes).
Median nasal septum
The nasal septum separates the 2 nasal cavities and forms the median architecture of the nose, from the tip to the choanae. This complex structure is composed of 3 different bone portions (ethmoid, vomer, maxilla), a septal cartilage and small accessory cartilages, all covered by mucous membrane. The nasal septum is frequently the site of deviation (40% of people), most often on the cartilaginous part, but not exclusively. The bony support base or foot of the septum is also sometimes highly asymmetrical, causing functional discomfort. Deviation of the septal cartilage may be simple (spur-shaped) or complex (watch-glass-shaped), acquired spontaneously or post-traumatically. Spontaneous deviation results from a difference in growth rate between bone and cartilage, with cartilage growing faster than bone in some people, leaving it no choice but to bend. Although 40% of adults have a deviated septum, it doesn’t necessarily need to be operated on, especially as many other anatomical or physiological factors are involved in the sensation of a unilateral blocked nose. Your ENT specialist will examine you carefully and distinguish between purely architectural abnormalities of the septum, nasal wings, turbinates and mucosal changes.
Objectives of septoplasty
- Achieve a sensation of freer airflow through the nasal cavity on inspiration.
- Encourage the use of CPAP (continuous positive airway pressure).
- Optimize the work of the orthodontist.
- Eliminate or reduce snoring in very specific cases.
- Limit sinusitis in very specific cases.
The different stages of the intervention
The surgical procedure
Under general anaesthetic in the operating theatre, the mucous membrane of the nasal septum is opened 2-3 cm from one side to the front, and peeled back on both sides through the anterior part of the septum to expose the cartilage and bone. Once exposed, cartilage and bone are resected as required. The mucosa is then reapplied and sutured over the approach with absorbable sutures. Two silicone Doyle© splints (one on each side) are then placed to hold the mucosa in place, facilitating healing. These splints are very well tolerated, thanks to their supple material and rounded shape, and they allow the patient to breathe through the nose, as they are hollow in the middle.
Post-op recovery period
In the case of outpatient surgery, the patient usually returns home the same day.
After hospitalization, you should remain at home for 8-10 days, resting and checking for bleeding from the nose or throat.
If necessary, the surgeon will give you an 8-10-day medical leave.
Sport is not recommended for the first 15 days, and should be resumed gradually.
Pain is moderate. It is controlled by Class I analgesics.
Post-operative care at home: nose washed with physiological saline for 21 days through the splints and then in the nose, analgesics and antibiotics while the splints were on.
Scarring: no visible scar.
Precautions: the 2 Doyle splints are easily removed in consultation on day 10.
Complications associated with septoplasty
In addition to the risks inherent in any surgery involving general anaesthesia, septoplasty carries the risk of rare complications:
- Nasal haemorrhage (epistaxis) after the procedure, which is very minor and subsides rapidly with nose-blowing and nose-washing.
- Crusts in the nose for 4 weeks.
- Septal perforation may lead to persistent bleeding, and noise when breathing (whistling, hissing). This can be corrected secondarily.
- Temporary or permanent loss of sensitivity in the upper incisors.
- Scar adhesions in the nose that may restrict airflow. This can be corrected secondarily. They are rare due to the presence of silicone splints during the initial healing phase.
- Surgical site infection.
Please refer to the College of ENT’s information sheet on septoplasty for further explanations and exceptional complications:
Frequently asked questions about septoplasty
Here is a selection of questions frequently asked by Dr Delagranda’s patients during septoplasty consultations.
Is surgery compulsory?
No, never. It’s purely functional, but can be of great benefit to your health if, for example, you have difficulty with a CPAP.
Is the result immediate?
When the splints are removed (10th day), breathing is much improved, but crusts may still slightly impede it for up to 2 weeks.
Fees and coverage for the procedure
Septoplasty is covered by French health insurance. Contact your mutual insurance company to find out how much coverage there is for any extra fees.
Do you have a question? Need more information?
Dr. Antoine Delagranda is available to answer any questions you may have about septoplasty. Dr Delagranda is a specialist in ENT surgery at the Clinique st-Charles, sla Roche sur Yon.
Consultation ORL pour une septoplastie en Vendée
Le Docteur Antoine Delagranda est à votre écoute pour toute question supplémentaire concernant la septoplastie. Le Dr Delagranda est médecin spécialiste en chirurgie ORL, au sein de la Clinique Saint Charles à La Roche-sur-Yon en Vendée.