Why it’s done

A crooked septum is common. But when it’s severe, a deviated septum can block one side of your nose and reduce airflow, causing difficulty breathing through one or both sides of your nose.

Septoplasty straightens the nasal septum by trimming, repositioning and replacing cartilage, bone or both.

If you experience symptoms — such as difficulty breathing through your nose — that affect your quality of life, you may consider surgery to fix a deviated septum.

The goals of Septoplasty surgery include the following:

. Improve airflow through the nose

. Control nosebleeds

. Enhance visualization of the inside of the nose (to identify other nasal problems).

. Relieve nasal or sinus headaches associated with swelling of the inside of the nose.

. Promote drainage of the sinus cavities

What is a deviated septum?

A septum is deviated if it is crooked or bent instead of straight. A deviated septum can block one or both chambers of the nose and interfere with airflow. A septum can become deviated from an injury, but it can also grow that way naturally.

How is a deviated septum diagnosed?

A doctor will examine the inside of the nose, possibly by performing a nasal endoscopy, which involves inserting a tube with a camera on the end. A computed tomography (CT) scan can also detect a deviated septum, but it is usually unnecessary. After the diagnosis, the doctor will discuss treatment options, including septoplasty.

How you prepare

. Before scheduling septoplasty, you’ll meet with your surgeon to discuss benefits and risks of the surgery. This meeting generally includes:

. Your medical history. Your doctor will ask about conditions you have or have had, as well as any current medications or supplements that you’re taking.

. A physical examination. You’ll have a physical exam, including any relevant tests. The doctor will inspect your skin and the inside and outside of your nose.

. Photographs. Someone from your doctor’s office may take photographs of your nose from different angles. Your doctor can use these photos for discussion before septoplasty or for reference during and after surgery.

. A discussion of your expectations. You and your doctor should talk about your expectations. He or she will explain what septoplasty can and can’t do for you and what your results might be.

Food and medications

Avoid medications containing aspirin or ibuprofen (Advil, Motrin IB, others) before and after surgery. These medications may increase bleeding. Take only those medications approved or prescribed by your surgeon.

Other precautions

If you smoke, stop smoking. Smoking increases your risk of having problems during and after surgery. Smoking can slow the healing process.

What you can expect

Septoplasty straightens the nasal septum by trimming, repositioning and replacing cartilage or bone. The surgeon works through incisions inside the nose. Occasionally it is necessary to make a small incision between the nostrils.

If the nasal bones are crooked and pushing the septum off to one side, it may be necessary to make cuts in the bones of the nose to reposition them. Spreader grafts are small, reinforcing strips of cartilage that can be used to help correct a deviated septum when the problem is along the bridge of the nose. Sometimes these are necessary to effectively straighten the septum.

What are the benefits of septoplasty surgery?

The benefits of this type of surgery include:

. Improved breathing: Overall breathing function is greatly improved since the nasal passages are opened up.

. Better sleep quality: Reshaping a crooked septum not only improves airflow while you’re awake, but also reduces or eliminates snoring and/or sleep apnea and improves the overall quality of your sleep.

. Fewer sinus infections: Opening the airways can allow mucus to drain normally from sinuses that were previously narrowed or partially blocked.

. Improved senses: For patients that previously had an impaired sense of smell or taste due to the effects of a deviated septum, this surgery may improve both senses.

Risks and Complications

As with any major surgery, septoplasty carries risks, such as bleeding, infection and an adverse reaction to the anesthetic. Other possible risks specific to septoplasty include:

. Continued symptoms, such as nasal obstruction

. Excessive bleeding

. A change in the shape of your nose

. A hole in the septum

. Sense of smell

. Clotted blood in the nasal space that has to be drained

. Temporary numbness in the upper gum, teeth or nose

. Scarring

. A discoloration of your nose

You may need additional surgery to treat some of these complications. You may also need additional surgery if the outcome of septoplasty doesn’t match your expectations. Talk to your doctor about your specific risks before surgery.

Who is a good candidate for Septoplasty?

A septoplasty procedure can help you breathe more easily. Commonly done for individuals dealing with a deviated septum, there are other medical issues with the nose that can cause breathing problems. A septoplasty procedure is typically performed for individuals who have the following:

. Deviated septum or crooked nasal septum.

. Nasal valve insufficiency so the nose doesn’t properly open and close when breathing.

. Consistent snoring or sleep apnea symptoms at night.

. Chronic or consistent nosebleeds.

. Nasal polyps or growths which can impede proper breathing.

. Oversized turbinates which are the inner structures that help keep the nose moist when breathing.

During Septoplasty Surgery

During the procedure

A septoplasty takes anywhere from 30 to 90 minutes to complete, depending on the complexity of the condition. The procedure may be done with either local or general anesthesia. Which type of anesthesia is used depends on how complex your surgery is, and what you and your surgeon prefer.

. Local anesthesia. This type of anesthesia is limited to your nose. Your doctor injects pain-numbing medication (anesthetic) into your nasal tissues. If you’ll also be sedated, this is done using IV medication. The medication makes you groggy but not fully unconscious.

. General anesthesia. With general anesthesia, you inhale an anesthetic agent or receive an anesthetic through an IV line. This type of anesthesia affects your entire body and induces a temporary state of unconsciousness.

Talk with your doctor beforehand about which kind of anesthesia is best for you.

During a septoplasty, the surgeon will attempt to straighten bent cartilage and bone in the septum. Firstly, they lift the mucosa lining covering the cartilage and bone.

The surgeon then reshapes the cartilage and bone, sometimes removing portions. After that, they will then put the lining back in place.

If enlarged turbinates are causing a blockage, the surgeon might attempt to shrink them with radiofrequency reduction. In some other cases, the surgeon will remove a portion of the turbinate.

Finally, the incision is closed with absorbable suture. Soft silicone splints may be inserted inside each nostril to support the septum. To prevent postoperative bleeding, your doctor may place bandage-like material in your nose (packing).

After Septoplasty Surgery

What happens after deviated septum surgery (septoplasty)?

After surgery, the patient will be taken to the recovery room where a nurse will monitor the patient. They will be able to go home the same day as the surgery once fully recovered from the anesthetic. This usually takes several hours. The patient will need a friend or family member to pick them up from the surgical facility and take them home. It may be necessary for the family member or friend to spend the first night with the patient after surgery for assistance.

When patients arrive home from the surgical facility, they should go to bed and rest with their head elevated on two to three pillows. By keeping the head elevated above the heart they can minimize fluid accumulation in the tissues (edema) and swelling. They may get out of bed with assistance to use the bathroom. Patients should avoid straining while urinating or passing stool. If constipated they should take a stool softener or a gentle laxative.

Patients may have some swelling of the nose, upper lip, cheeks, or around the eyes for several days after surgery. This swelling will gradually resolve and is normal. They can help reduce the swelling by putting ice on the face, bridge of the nose, and eyes as much as tolerated. This will also help with postoperative edema and pain. Some patients have found frozen vegetable in packages (for example bags of frozen peas) to be a convenient ice pack which is more likely to conform to the face.

Moderate bleeding from the nose is normal, and will gradually decrease. The gauze dressing (“mustache dressing”) will collect blood and should be changed only when saturated. It is not unusual to change these dressings every hour during the first 24 hours after surgery. After a few days, patients will usually no longer need to use the dressing. Patients should not take aspirin, aspirin-containing medications, or nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen or naproxen for three weeks following surgery.

It is best for patients to eat a light, soft, and cool diet as tolerated once recovered fully from the anesthetic. Hot liquids should be avoided for several days. Even though the individual may be hungry immediately after surgery, it is best to proceed slowly with food intake to prevent postoperative nausea and vomiting. Occasionally, the person may vomit one or two times immediately after surgery; if vomiting persists, the doctor can prescribe medication to settle the stomach. It is important to remember that a good overall diet with ample rest promotes healing.

Patients will be prescribed antibiotics after surgery, and should finish all the pills that have been prescribed. Some form of a narcotic may also be prescribed and is to be taken as needed. If patients require narcotics, they are cautioned not to drive. In some situations, the doctor may prescribe steroids to reduce inflammation either preoperatively and/or postoperatively. It is very important that patients take this medication as prescribed, and not discontinue it prematurely. If patients have nausea or vomiting postoperatively, they may be prescribed anti-nausea medications (antiemetics). If patients have any questions or they feel they are developing a reaction to any of these medications, they should consult their doctor. Patients should not take any other medication, either prescribed or over-the-counter, unless they have discussed the medications with the doctor.

General instructions and follow-up care for deviated septum surgery (septoplasty)

In most situations, packs will have been placed in the nose to control bleeding; often times a septal splint is placed that will be removed by the surgeon at the first post-operative visit. The doctor will let the patient know when they are to return to the office to have these packs removed. Patients may need to call the office to schedule this postoperative appointment and should arrange for someone to drive them to and from the office for this first visit. They should eat a light meal before going, and avoid taking excessive pain medications. They may also have several subsequent office visits to assess healing, remove crusts (debris) that may accumulate at the surgical site, especially if combined with sinus surgery. Such visits help insure a speedy recovery. The nose will probably be tender after surgery, so the doctor will spray it with a special numbing medication before removing crusts.

After the packing has been removed, patients may breathe through the nose, but are not to blow or sneeze through the nose for 7 to 10 days. If the person must sneeze, they should open their mouth. Patients can expect some light blood-tinged drainage from the nose for several days. If bleeding becomes excessive, apply ice and rest quietly with head elevated while holding the nose. If bleeding continues, they should call the surgeon’s office for advice.

One of the most important things patients can do after surgery is nasal irrigation (rinsing). Immediately after the nasal packs are removed they should use a saline nasal spray such as “Ocean Spray” several times per day to prevent crusts from forming in their nose. Patients are to continue using irrigation until the doctor tells them to stop. Many patients will use irrigations (for example, neti-pots) indefinitely or when they have an upper respiratory infection. Failure to irrigate especially as instructed after surgery will likely cause the surgery to fail.

Patients may go back to work or school only when the doctor indicates it is safe to return. They should rest for the first week following surgery. They must also avoid excessive talking, smiling, chewing hard foods, strenuous activities, bumping their nose, bending over, and lifting heavy objects. They should not rest glasses on the bridge of the nose until soreness and swelling subsides. They may wear contact lenses once eye swelling and any irritation has resolved. Alcohol and tobacco products should be avoided because they may prolong swelling and healing. Smoke, dust, and fumes may irritate the nose and cause an infection. Facial tanning is discouraged for six months after surgery. If patients must be in the sun they should use a number 15 or greater sun block. Patients may use their usual make-up any time after surgery.

Patients should lubricate the nostrils, as instructed with a Q-tip and Vaseline to soften crusts that are hard and firmly attached to healing tissue. Peroxide helps to loosen crusts. After several days they may notice a few of the absorbable sutures and should not try to disturb or remove them. They must be gentle while brushing the upper teeth. These teeth will often be tender for several weeks, and there may be some numbness of the teeth and palate for several months.

After three weeks if patients are not having problems with bleeding, they may resume exercise and swimming, but no diving for two months. They should plan to stay in town and not travel for three weeks to allow for postoperative care and in case bleeding occurs.

When to call the doctor after septoplasty

Patients should notify the doctor if they have:

. A sudden increase in the amount of bleeding from the nose unrelieved by pressure, ice, and head elevation.

. A fever greater than 101.5 F (38.6 C) that persists despite increasing the amount of fluid and acetaminophen (Tylenol). A person with a fever should try to drink approximately one cup of fluid each waking hour.

. Persistent sharp pain or headache which is not relieved by the pain medication prescribed.

. Increased swelling or redness of the nose or eyes.

Most surgeons want to know about complications or problems that develop with their patients, so do not hesitate to call the surgeon to inform them and ask questions about any problems you are experiencing.

Lifestyle tips

As the nose heals, people can avoid the following to ease recovery:

. For at least 2–3 days, blowing the nose

. Drinking alcohol

. Smoking tobacco

. Returning to work too soon

. Crowds, especially in areas where people are more likely to encounter cigarette smoke and other individuals with colds or coughs, increasing the chances of getting sick.

Results

Up to 85 percent of people experience improvement in their nasal blockage after surgery.

Septoplasty Surgery cost

Cost of the best Septoplasty surgeons in Iran

Cost of Septoplasty surgery in Iran is between $1000- 2000.

There are many factors that determine the overall Septoplasty cost, including:

1. The surgeon’s skill: The most skilled and best Septoplasty surgeons are in high demand.
2. Geographical location: the cost Septoplasty surgery is varied according to geographical location.