While in bed? While these questions may seem strange, they are very effective at determining the cause of blockage before I have even touched the patient. After this, I often introduce a special camera and telescope made specifically for looking into the nose. Before doing this, I almost always give the patient a special spray that numbs the nose.
This spray tastes very bad and the numbing sensation often lasts for up to an hour, so try to avoid eating in the period. Most importantly this medication can very rarely cause severe reactions. Make sure to tell your doctor if you have a history of heart problems, such as placement of a cardiac stent, or recent heart attack.
Also tell your physician if you are allergic to anesthetic medication, such as Lidocaine. After examining the nose with the camera any board-certified ENT surgeon will be able to tell you if have a deviated septum. Approximately 75 percent of the population has some degree of deviation in their septum.
The real question is if the deviation is actually causing the nasal obstruction…or is it something else. Your physician can offer you a variety of treatment options when faced with this diagnosis. They fall in one of these three categories: do nothing, surgery, or medical treatment. Nasal obstruction, while often times extremely debilitating, does NOT need treatment. However, patients can experience significant benefit in their quality of life, ability to exercise, snoring, quality of sleep, energy level etc.
The most common and prevalent issues patients with nasal obstruction from deviated experience include:. Fixing the septum is not always necessary and your doctor should always supply you with other treatment options, as well as with reasonable expectations after surgery. In addition, before you agree to have any procedure, you should always know the risks of the surgery.
This includes the risk of having general anesthesia, complications from septoplasty surgery which include the need for more surgery, bleeding, pain, nasal obstruction, etc. The goal of this surgery is to straighten and align the cartilage structure that exists in the midline of the nose in order to increase the airflow to the nose. Septoplasty is one of the major procedures I do to achieve this; however, there are other related procedures a surgeon can perform that can increase airflow and often times these procedures are performed together.
A second procedure is nasal valve surgery, also called functional rhinoplasty. This is a procedure often performed by a facial plastic surgeon where the cartilage of the nose is modified to allow for more airflow. This can sometimes slightly alter the shape of the nose and is often performed during cosmetic nose surgery as well.
One of the most important things I do when discussing surgery with patients is manage their expectations and educate them about all possibilities after surgery. By doing this they are well prepared for anything that may arise after surgery. Here are some key takeaways:. Alfred Marc Iloreta Jr. In addition to general head and neck surgery, Dr.
His current research is focused on health outcomes following skull base surgery, sinus surgery and rhinoplasty. Sleep surgeon Courtney Chou, MD, explains how this advanced diagnostic tool helps surgeons assess the anatomy of the upper airway and better evaluate patients. Each year, nine out of , people are diagnosed with this rare ear condition that, if left untreated, can cause infection or facial paralysis.
Awesome post in this information of Septoplasty Surgery. I do feel the difficulty of sleeping could be much worse right after the surgery. If the septum is crooked, the outside will be crooked. You may need to remove a small hump, realign the bones of the outer nose, or work on the cartilages on the tip of the nose. But a key part of this procedure is first straightening the septum — which makes it logical to do these procedures together. You can do the septoplasty by itself.
If the septum is straight, you could do the rhinoplasty by itself. But if the septum is not straight, a septoplasty should accompany the rhinoplasty. Think of it like a home renovation. If you have a solid structure, you can focus on the cosmetic updates. This can be a hindrance for many patients. While we can do a septoplasty without a rhinoplasty, when a patient has a significant cosmetic deformity, we strongly recommend coupling these procedures together.
A rhinoplasty can take a little longer because of the finesse involved. Even one millimeter can make a difference in the outward appearance.
Expect this procedure to last hours. Surgeons must be informed of previous cardiac procedures, including stents or pacemakers, or a history of blood clots.
Patients who take blood thinners will need clearance from their prescribing doctor to stop medications before surgery. Patients should also avoid other substances like fish oil or aspirin that may cause excess bleeding during surgery. Also, all patients should complete a COVID test and the necessary paperwork with the surgery center prior to the date of the procedure.
Patients will get specific instructions from the office staff regarding when to stop eating, when to arrive, and who should accompany them to their procedure. If you have any remaining questions, be sure to ask the staff prior to your procedure. With the septoplasty, we place small splints in the nose that help hold the septum straight.
We also pack the nose with dissolvable packing. This packing can be lightly blown out of the nose after several days and irrigated with saline solution. Splints from a septoplasty are removed days after the procedure. It also commonly comes up that they just have what's called septal deviation and the septum itself separates basically the right and left side of the nose. Alt: Yeah. It's made up of both cartilage bone.
The septal deviation can occur just from normal development as everything is not perfectly symmetric as we develop. So it can be deviated to one side or the other.
It can also occur from trauma. Alt: Getting boxed, vehicle accidents, getting bumped in the nose. So after the trauma, this is an acute event, someone would come and say, "I can't breathe out of the right side of the nose," after getting bumped or something that's been there their whole lives and they've just noticed that they're having increased trouble breathing, they can't sleep as well. Miller: I think the majority is they're born with it or we have a known etiology of why it's deviated. Miller: Okay.
So the come to you and they complain that they have difficulty breathing out of one side of the nose or the other or maybe both. At what point do you say, "Well, look, maybe we can repair this surgically if you need to have it repaired"? Alt: A lot goes into talking about the deviated septum.
In many instances, it's found incidentally, which means we look in their nose and they have a deviated septum but they don't describe nasal obstruction. Alt: Correct. In those situations, I don't even like to bring it up because then it's something that patients start to worry about. But if it's significantly deviated and we look at it and we assess the patient and it's significantly closing off one side of the airway, we can discuss different surgical options and how to correct that.
Miller: I have a question. How often do people come to you to looking for cosmetic reconstruction of that bone? Alt: That bone itself is usually not cosmetic. It's functional. It doesn't correlate into how the nose looks. Alt: So that's really talking about what we usually term open septorhinoplasty is where were able to change the look of the outside of the nose or [Inaudible ] and changed inside the nose for functional breathing, which sometimes we do in combination if the nose is broken or twisted on the outside, we also have to fix the outside in addition to the inside.
Miller: So how often do you find the patients with need to have surgical correction for a deviated septum? Alt: It's actually quite common.
It's one of the most common procedures we perform. Not only is it bothersome in the sense that they can't breathe but it substantially affects patients quality of life, which has been shown over and over again by improving the way we breathe through our nose substantially affects how we feel in our day-to-day activities.
And this is most likely partially contributing to the way we sleep and the way we get good night's sleep. If we can't breathe through the nose, it forces us to breathe through the mouth and we may have more obstructive events and it can also potentially lead to what we call obstructive sleep apnea. Alt: So there are several options to do surgery and one that we're doing more and more that gets great results is doing endoscopic septoplasties.
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