Septoplasty and Turbinate Surgery
What is it?
Septoplasty is an operation to straighten the septum, which is the partition in the middle of the nose. Turbinates are tissue inside the nose which can be trimmed smaller if they are too large and cause blockage.
Who can be helped by it?
Nasal blockage can be caused by a crooked septum and straightening the septum can help to unblock the nose. Septoplasty is also sometimes performed together with endoscopic sinus surgery or surgery to control nosebleeds, if the septum is too crooked to gain access to other structures in the nose.
How is it done?
It is performed under a general anaesthetic and usually requires an overnight stay in hospital. It can be performed through the nostrils or by making a cut in the skin between the nostrils. The decision depends on the anatomy of your nose.
The lining inside the nose is lifted and the bent bone or cartilage is straightened or removed. The cartilage of the septum is an important support for the nose and sometimes some bent cartilage has to be left to preserve enough support.
Dissolvable sutures are usually used inside the nose. Sometimes silastic splints (they look like plastic sheets) have to be placed to help support the nose in the initial stages of healing in which case a non-dissolvable suture is used to hold them in place. If a cut is made in the skin non-dissolvable sutures are also used. Occasionally packing has to be used to control bleeding.
What can I expect during the recovery period?
The nose is usually uncomfortable but strong pain is uncommon. It is usual for blood-stained discharge to drip for the first few days. The nose would be blocked from swelling as well as dried blood and secretions for 2 to 3 weeks. If your work involves physical exertion or a hot environment you need to take 2 weeks off to recover. Otherwise please arrange for 1 week off.
Risks and Complications
- Avoid tablets like aspirin and NSAIDs (eg Nurofen) from 2 weeks before the surgery till 2 weeks after. Avoid physical exertion, hot food and drink and alcohol for 2 weeks. Please do not clean inside the nose.
- Rarely it may be necessary to have a second operation to stop the bleeding or to remove a blood clot.
- Infections are uncommon. If your nose becomes red and swollen, if you develop a fever of more than 38°C or if a greenish smelly discharge comes out of the nostrils it could indicate an infection.
- You may need to be admitted for intravenous antibiotics or a second operation to treat the infection.
- This is a hole in the septum and can result after an infection. Small perforations do not tend to cause symptoms but possible symptoms include a whistling sound, nosebleeds and crusting causing a blocked nose. A large perforation can affect the support of the nose and cause the outside of the nose to sag in therefore affecting the appearance of the nose.
- If this happens you may need further surgery to improve the appearance of the nose. It may not be possible to close the perforation itself.
- If the operation involves a cut on the skin between the nostrils there will always be a scar. It is not usually noticeable but the final appearance depends on how well you heal.
Decrease in sense of smell
- This may decrease or be lost completely after surgery and could be permanent. If this happens your sense of taste would be affected.
Risks with a general anaesthetic
- Allergic reactions ranging from mild to life-threatening can occur. Please discuss them in detail with the Anaesthetic Specialist who will contact you before the surgery.
General instructions and follow-up care
You will be discharged from hospital the next morning. Saline washes need to be started the day after the surgery and to continue for at least 4 weeks. Physical exertion should be avoided for 1 week and blood thinning tablets should not be taken for 2 weeks after the surgery. Please do not clean inside the nose.
Your post-operative check will be about 1 week after the surgery and would be arranged for you before discharge. If non-dissolvable sutures and splints were used they would be removed then. It is important that you attend as I need to check on your healing. If the appointed time needs to be changed or if you have non-urgent questions please contact the rooms on 9417 1041. If you have urgent questions after hours please page me on 9387 1000.
It is normal for blood-stained mucus to drip from your nose but if heavy bleeding occurs sit up and pinch your nose for 10 minutes. If bleeding continues go to the nearest hospital with an emergency department and after you are seen please ask the doctor to ring me on my paging service 9387 1000. If bleeding is very heavy please ring for an ambulance on 000.