Deviated Septum
The shape of your nasal cavity could be the cause of chronic sinusitis. The nasal septum is the wall dividing the nasal cavity into halves; it is composed of a central supporting skeleton covered on each side by mucous membrane. The front portion of this natural partition is a firm but bendable structure made mostly of cartilage and is covered by skin that has a substantial supply of blood vessels. The ideal nasal septum is exactly midline, separating the left and right sides of the nose into passageways of equal size.
Estimates are that 80 percent of all nasal septums are off-center, a condition that is generally not noticed. A "deviated septum" occurs when the septum is severely shifted away from the midline. The most common symptom from a badly deviated or crooked septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and sometimes actually occur on the side opposite the bend. In some cases the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.
Septoplasty is the preferred surgical treatment to correct a deviated septum. This procedure is not generally performed on minors, because the cartilaginous septum grows until around age 18. Septal deviations commonly occur due to nasal trauma.
A deviated septum may cause one or more of the following:
Diagnosis Of A Deviated Septum:
Patients with chronic sinusitis often have nasal congestion, and many have nasal septal deviations. However, for those with this debilitating condition, there may be additional reasons for the nasal airway obstruction. The problem may result from a septal deviation, reactive edema (swelling) from the infected areas, allergic problems, mucosal hypertrophy (increase in size), other anatomic abnormalities, or combinations thereof. A trained specialist in diagnosing and treating ear, nose, and throat disorders can determine the cause of your chronic sinusitis and nasal obstruction.
Your First Visit:
After discussing your symptoms, the primary care physician or specialist will inquire if you have ever incurred severe trauma to your nose and if you have had previous nasal surgery. Next, an examination of the general appearance of your nose will occur, including the position of your nasal septum. This will entail the use of a bright light and a nasal speculum (an instrument that gently spreads open your nostril) to inspect the inside surface of each nostril.
Surgery may be the recommended treatment if the deviated septum is causing troublesome nosebleeds or recurrent sinus infections. Additional testing may be required in some circumstances.
Estimates are that 80 percent of all nasal septums are off-center, a condition that is generally not noticed. A "deviated septum" occurs when the septum is severely shifted away from the midline. The most common symptom from a badly deviated or crooked septum is difficulty breathing through the nose. The symptoms are usually worse on one side, and sometimes actually occur on the side opposite the bend. In some cases the crooked septum can interfere with the drainage of the sinuses, resulting in repeated sinus infections.
Septoplasty is the preferred surgical treatment to correct a deviated septum. This procedure is not generally performed on minors, because the cartilaginous septum grows until around age 18. Septal deviations commonly occur due to nasal trauma.
A deviated septum may cause one or more of the following:
- Blockage of one or both nostrils
- Nasal congestion, sometimes one-sided
- Frequent nosebleeds
- Frequent sinus infections
- At times, facial pain, headaches, postnasal drip
- Noisy breathing during sleep (in infants and young children)
Diagnosis Of A Deviated Septum:
Patients with chronic sinusitis often have nasal congestion, and many have nasal septal deviations. However, for those with this debilitating condition, there may be additional reasons for the nasal airway obstruction. The problem may result from a septal deviation, reactive edema (swelling) from the infected areas, allergic problems, mucosal hypertrophy (increase in size), other anatomic abnormalities, or combinations thereof. A trained specialist in diagnosing and treating ear, nose, and throat disorders can determine the cause of your chronic sinusitis and nasal obstruction.
Your First Visit:
After discussing your symptoms, the primary care physician or specialist will inquire if you have ever incurred severe trauma to your nose and if you have had previous nasal surgery. Next, an examination of the general appearance of your nose will occur, including the position of your nasal septum. This will entail the use of a bright light and a nasal speculum (an instrument that gently spreads open your nostril) to inspect the inside surface of each nostril.
Surgery may be the recommended treatment if the deviated septum is causing troublesome nosebleeds or recurrent sinus infections. Additional testing may be required in some circumstances.
Septoplasty
Why do I need this operation?
The septum is the wall of cartilage and bone in the middle of your nose. It separates your two nostrils. Sometimes this is bent or buckled (see drawing). This reduces the space for air to flow through your nose and causes obstruction or snoring. Sometimes a septoplasty is required to gain access to the sinuses surrounding the nose.
What are the intended benefits of the surgery?
A septoplasty is performed to straighten the cartilage of the septum and allow air to pass through the nose more easily. A Submucus resection of the septum (SMR) is performed where there is only a small bump in the septum. This is simply cut away to leave a straighter septum. Sometimes a septoplasty/SMR is performed to allow easier access through the nose for sinus surgery.
How is the surgery performed?
Septoplasty is performed under general anaesthesia. A small cut is made inside one of the nostrils and from this cut the lining of the septum is lifted off. The septum is then refashinoned and stitched into place with the lining reapplied. Packs are sometimes put into the nose to prevent the build up of blood between the cartilage of the septum and the lining.
What are the potential risks?
1) Bleeding - this may result in a nose bleed, but this usually stops quickly. A bloodstained ooze may persist for a few days.
2) Infection - as with any operation, infection may occur in the area that is involved but this is not very common.
3) Septal perforation - if blood builds up between the cartilage and the lining that was lifted away, the pressure from this blood may damage the cartilage and result in a hole. This is also a possibility when the surgery was technically difficult and the lining of the septum was damaged.
4) Collapse - this unusual complication occurs when the damage to the cartilage is more extensive and the septum can no longer bear the weight of the nose. This leads to a deformity where the nose lies flattened against the face. This is a very uncommon event and occurs in about 1 in 200 patients.
5) Packs - you may wake up from the anaesthetic with pack in your nose. These will make it impossible to breathe through your nose. They are removed the next day.
6) Numbness of the teeth - this is not a common complication but can result if the nerve that supplies your teeth, which is located near the septum, is bruised or damaged. This usually settles in a few months.
What am I to expect after the operation?
You may notice some pinkish fluid coming from your nose, this is normal for a few days after the operation. Your nose will feel blocked for up to six weeks after the procedure, the swelling will need to subside before you notice any improvement. There is not usually very much pain associated with this procedure.
How long will I be off work / school?
Two weeks. This is to decrease the chance of getting an infection in your nose while you are healing.You must avoid any social contact for two weeks after the procedure. You should take extra care to avoid smoky crowded places eg. pubs. A doctor's note will be provided.
Will this operation affect the shape of my nose?
No. The external appearance of your nose will not be affected.
The septum is the wall of cartilage and bone in the middle of your nose. It separates your two nostrils. Sometimes this is bent or buckled (see drawing). This reduces the space for air to flow through your nose and causes obstruction or snoring. Sometimes a septoplasty is required to gain access to the sinuses surrounding the nose.
What are the intended benefits of the surgery?
A septoplasty is performed to straighten the cartilage of the septum and allow air to pass through the nose more easily. A Submucus resection of the septum (SMR) is performed where there is only a small bump in the septum. This is simply cut away to leave a straighter septum. Sometimes a septoplasty/SMR is performed to allow easier access through the nose for sinus surgery.
How is the surgery performed?
Septoplasty is performed under general anaesthesia. A small cut is made inside one of the nostrils and from this cut the lining of the septum is lifted off. The septum is then refashinoned and stitched into place with the lining reapplied. Packs are sometimes put into the nose to prevent the build up of blood between the cartilage of the septum and the lining.
What are the potential risks?
1) Bleeding - this may result in a nose bleed, but this usually stops quickly. A bloodstained ooze may persist for a few days.
2) Infection - as with any operation, infection may occur in the area that is involved but this is not very common.
3) Septal perforation - if blood builds up between the cartilage and the lining that was lifted away, the pressure from this blood may damage the cartilage and result in a hole. This is also a possibility when the surgery was technically difficult and the lining of the septum was damaged.
4) Collapse - this unusual complication occurs when the damage to the cartilage is more extensive and the septum can no longer bear the weight of the nose. This leads to a deformity where the nose lies flattened against the face. This is a very uncommon event and occurs in about 1 in 200 patients.
5) Packs - you may wake up from the anaesthetic with pack in your nose. These will make it impossible to breathe through your nose. They are removed the next day.
6) Numbness of the teeth - this is not a common complication but can result if the nerve that supplies your teeth, which is located near the septum, is bruised or damaged. This usually settles in a few months.
What am I to expect after the operation?
You may notice some pinkish fluid coming from your nose, this is normal for a few days after the operation. Your nose will feel blocked for up to six weeks after the procedure, the swelling will need to subside before you notice any improvement. There is not usually very much pain associated with this procedure.
How long will I be off work / school?
Two weeks. This is to decrease the chance of getting an infection in your nose while you are healing.You must avoid any social contact for two weeks after the procedure. You should take extra care to avoid smoky crowded places eg. pubs. A doctor's note will be provided.
Will this operation affect the shape of my nose?
No. The external appearance of your nose will not be affected.
Rhinoplasty
Nasal bone and cartilage Rhinoplasty (RI-no-plas-tee), also referred to as nose surgery, is a surgical procedure that can shorten or lengthen the nose, change its shape or contour, narrow nostrils, or lift and define the tip.
When planning rhinoplasty, your surgeon considers your features, the skin on your nose and what you would like changed. The upper portion of the nose is bone, and the lower portion is cartilage. Rhinoplasty can modify bone, cartilage or both. Talk with your surgeon about what rhinoplasty can achieve for you.
Why it's done Rhinoplasty can:
Risks As with any major surgery, rhinoplasty carries risks such as bleeding, infection and an adverse reaction to the anesthesia. Other possible risks specific to rhinoplasty include:
When planning rhinoplasty, your surgeon considers your features, the skin on your nose and what you would like changed. The upper portion of the nose is bone, and the lower portion is cartilage. Rhinoplasty can modify bone, cartilage or both. Talk with your surgeon about what rhinoplasty can achieve for you.
Why it's done Rhinoplasty can:
- Straighten the bridge of the nose
- Reshape the tip of the nose
- Reduce or add to the overall size of the nose
- Change the angle between the nose and upper lip
Risks As with any major surgery, rhinoplasty carries risks such as bleeding, infection and an adverse reaction to the anesthesia. Other possible risks specific to rhinoplasty include:
- Recurring nosebleeds
- Difficulty breathing through the nose
- Numbness in and around the nose
- Possibility of an uneven-looking nose
- Pain, discoloration or swelling that may persist
- Scarring