Dear Sir/Dr.,
I read your explanation regarding surgery for a Deviated Septum but I am still a little bit unclear as to the exact procedure. Like your previous writer, I also have a laser Surgery scheduled to correct my deviated septum. I would like to understand exactly how things are moved around inside my nose. I am a little bit nervous as this seems to be quite an invasive surgery.
Thanks in advance for your help.
Reply: ---------------------
First of all, there is little to be gained from the use of a laser in septal surgery. I have personal and fairly extensive experience with a wide variety of lasers over the past decade and do not use the laser for septal surgery as I find absolutely no advantage to its use in this type of surgery. On the other hand I do use the laser for turbinate surgery and other types of nasal surgery and find it very useful in those instances.
Septal surgery is performed to straighten the middle partition of the nasal passages which is composed of thin cartilage and bone covered by a moist pink lining. Septal deviation can be due to trauma or one may simply be born with a septal deformity. The primary indication for septal surgery is to alleviate nasal airflow obstruction that can not be alleviated with medication.
The actual surgery can be performed with local anesthesia supplemented with intravenous sedatives or under general anesthesia. Either way, the surgery is performed as an outpatient. The surgery is performed by making a small incision inside the nose on the lining of the septum and then lifting the lining off of the underlying cartilage and bone. The cartilage is then separated from the bone and straightened by various methods - occasionally severe deviations require partial removal of angulated segments. Once the septum is adequately straightened and the airway is thus patent on both sides, the lining is replaced and sutured with absorbable stitches. A medical grade synthetic sheet of thin plastic is often then used to splint the septum so that it doesn't bend or deviate during the healing process. Intranasal packing may also be used for 1-3 days. There is generally no external bruising and usually minimal external swelling. No nose blowing or vigorous activity such as heavy lifting is allowed for a couple of weeks. The splints and/or packing are removed in the surgeon's office.
The surgery is very safe and highly effective when performed with proper indications. Potential risks include nose bleeding, infection, septal perforation, etc.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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