Michael P. Martin, M.D.
Otolaryngology and Head and Neck Surgery
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SEPTOPLASTY AND POLYPECTOMY
Septoplasty:
Septoplasty is a procedure performed to straighten the central
wall within the nose that is displaced into one of the nasal passages
and causes chronic nasal obstruction not relieved with decongestant
medication. This usually a result of some kind of trauma to the nose,
but not necessarily a trauma extensive enough to cause fracture of the
nasal bones or the external nasal appearance. This procedure is usually
successful 95-98% of the time. It entails an incision made in the nose
to lift the lining of one side, overlaying the cartilage of the nose and
on both sides overlaying the bone. Bone and cartilage that is out of place
is incised and removed, to relieve the obstruction. Sometimes there is
some weakening of the cartilage necessary in order to get it to lie in the
midline. The incision is closed with absorbing sutures and usually silastic
splints are placed in the nose, to put the lining back down and reapproximate
the lining to the cartilage and bone, or to the other mucosal lining on
the other side. This helps to reestablish blood supply. This is not intended
to hold the septum straight. Significant complications result from scarring
and from elevation of the lining of the nose on both sides of the cartilage,
and if a defect is created, sometime a septal perforation results, which
can result in abnormal air turbulence and giving a sensation of nasal
obstruction and recurrent crusting and bleeding of the nose. Small septal
perforations posteriorly are usually not a problem, but the more anterior
they are can cause crusting and bleeding of the nose. Most people have
some discomfort, nasal congestion, bloody mucus drainage.
Use of pain medication, decongestant, anitbiotic and salt water
nose spray, are essential in the care of the nose until the splints are
removed, and then thereafter. Splints are usually removed 4-7 days post-operatively,
depending upon the patients status. This is usually checked again at
one month post-operatively to make sure the procedure has been successful.
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