Endoscopic septum surgery

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Septum operation, what is it?

Difficulty in nasal breathing is a very common problem. And often it is caused by a deviated nasal septum. But the situation can be corrected; septoplasty will help with this.

Table of contents:

When and how it is performed, are there any contraindications to surgical correction and what needs to be done in the postoperative period - such questions can best be answered by a specialist.

General information

Septoplasty, or so-called septum surgery, is a surgical method for correcting the nasal septum. Normally, during breathing, air is distributed evenly in both nasal passages; it flows freely into the paranasal sinuses and, for its main purpose, into the lungs. But when the nasal septum is deviated, this process is disrupted, which entails a number of negative consequences and the need for surgical intervention. After all, it is impossible to eliminate deformation using conservative methods.

Indications

The main indication for surgery is a deviated nasal septum. The deformity can be congenital or acquired during life (after injuries, with disproportionate growth of the bones of the facial skull). As a result, nasal breathing becomes difficult, and in the future there is a likelihood of developing other problems:

All this significantly worsens the patient’s condition and prevents him from leading an active lifestyle, and therefore requires elimination. In addition, after the operation the shape of the nose will improve, positively affecting the patient’s appearance. Therefore, septoplasty has not only medical, but also aesthetic significance. True, in the latter case it is most often combined with rhinoplasty.

The operation is performed for deformed nasal septum and eliminates the symptoms caused by it.

Contraindications

We must not forget that surgical intervention also has a number of contraindications. Conditions limiting intervention include:

  • Age up to 18 years.
  • Pathology of the coagulation system (coagulo- and thrombocytopathy).
  • Acute infectious diseases.
  • Oncological processes.
  • Severe diseases of internal organs.
  • Decompensated diabetes mellitus.

Septoplasty can be performed only after acute rhinitis and sinusitis have been eliminated, so that inflammation of the mucous membrane does not lead to postoperative complications.

Preparation

Before the operation, a consultation with an ENT doctor is required, during which an examination and endoscopy of the nasal cavity is performed. The nature of the deformation is determined, and if there is accompanying inflammation, it may be necessary to take a mucus smear. To exclude contraindications, anamnestic and clinical data are taken into account, a blood test is done, and, if necessary, other studies. Check the body's reaction to anesthetics (individual test).

Carrying out

In modern surgery, preference is given to minimally invasive interventions, which provide high effectiveness, rapid recovery and a low risk of complications. Therefore, septoplasty in most cases is performed endoscopically. Deformed tissues are removed as gently as possible by submucosal or conventional resection, all done without external incisions.

Laser septochondrocorrection is considered a separate technique. It allows you to correct crooked cartilage on the front of the nasal septum. Deformed parts are evaporated by laser radiation. The operation lasts no more than an hour. The type of anesthesia is determined individually (most often local). But with more pronounced changes in the external nose, rhinoplasty is required.

Recovery

At the end of septoplasty, gauze turundas are installed in the nasal passages, and a plaster bandage is applied outside for rigid fixation. For pain, analgesics are taken. Patients should refrain from physical activity, eating hot food and other factors that provoke nosebleeds.

On the third day, the tampons are removed. Next, regular irrigation of the nasal cavity with saline solutions is required to moisturize the mucous membrane and better remove crusts. It is not recommended to sleep on your stomach, wear glasses or go to the bathhouse. Any damage to the nose should be avoided. Breathing is fully restored after 2 weeks, and healing can last up to 3 months. It is then that you can feel the full effectiveness of the operation.

In order for the postoperative and recovery period to go smoothly, it is necessary to follow the doctor’s recommendations in everything.

Septoplasty is an operation that corrects a deformed nasal septum. As a result, breathing is normalized and other unpleasant phenomena are prevented. The surgical technique and the volume of intervention are determined on an individual basis, and rehabilitation measures also correspond to them.

Source: http://elaxsir.ru/zabolevaniya/nosa/septum-operaciya.html

Septoplasty: indications, surgery, cost, rehabilitation

Septoplasty surgery is a surgical procedure performed to correct a deviated nasal septum. Despite the fact that the name contains the word “plastic”, this operation is not a correction of aesthetic defects.

It is done for medical reasons, since a displaced nasal septum is a disease that disrupts such an important vital function as breathing and leads to serious complications.

Why is it necessary to straighten a deviated nasal septum?

The nasal septum is a bone-cartilaginous structure that divides the nose into two cavities. The two halves of the nose, as a rule, are not equal and most often the reason for this is a displacement of the septum to one side or the other. Only 5% of the lucky ones can be classified as having a perfectly straight septum and a perfectly symmetrical nose.

However, most people live to old age and are not even aware of any abnormality with their nose. It happens that even in cases of severe deformation of the nasal plate, nothing bothers the person.

But in some cases, deviation of the nasal septum causes such unpleasant problems as:

  • Difficulty in nasal breathing (usually on one side, but can be on both sides);
  • Development of chronic inflammation of the paranasal sinuses;
  • Ear congestion, hearing loss;
  • Constant night snoring;
  • Insensitivity to odors;
  • Chronic inflammation of the middle ear;
  • Headache;
  • Constant fatigue, weakness, drowsiness, decreased performance as a result of insufficient oxygen supply to the brain and other organs;
  • Due to compensatory breathing through the mouth - drying out of the oral mucosa, development of pharyngitis, glossitis, bad breath;
  • Frequent bronchitis and pneumonia, since the air that does not pass through the nose is not cleaned or warmed properly.

In cases of prolonged difficulty in nasal breathing, it is necessary first of all to exclude deformation of the nasal septum.

Causes of abnormal position of the nasal septum

Seeming at first glance to be a simple anatomical structure, the nasal septum consists of several parts: it is made up of processes of several bones of the facial and cerebral skull, an independent bone (vomer) and quadrangular cartilage.

In addition, this entire complex composition is, as it were, inserted into a frame, which also consists of several different bones. Therefore, in order for the nasal septum to become perfectly straight and not bend anywhere, it is necessary that all these bones and cartilages grow simultaneously and evenly, which is extremely rare.

The largest number of deviated septums detected for the first time occurs during adolescence, since at this time the greatest intensity of body growth, a “growth spurt,” is observed.

The causes of septal deformation may be:

  1. Injuries (fractures and bruises).
  2. Uneven growth of different parts of the skull.
  3. Impact of any external factors on the septum (thickened nasal concha, polyps, tumors, foreign bodies).

There is also a congenital displacement of the nasal septum: the curvature can form during intrauterine development or occur during childbirth (birth trauma).

The types of curvatures can be different: spikes or ridges that form in the bony part of the septum and block the lumen of the nasal passages, as well as the actual curvature of the plate, C-shaped or S-shaped.

Since a deviated nasal septum is an anatomical defect, it can only be corrected surgically.

Indications for septoplasty

Although 90% of the population has a deviated nasal septum, surgery is indicated for only a few - those for whom this crooked septum interferes with their lives, namely:

  • Patients with prolonged nasal congestion. Nasal congestion in such people does not go away for a long time after a cold, or the nose does not breathe at all, even without connection with a cold. A person constantly uses drops for congestion, which only aggravates the situation.
  • In persons with developed chronic sinusitis or other sinusitis. The displaced nasal septum in this case creates an obstacle to the outflow of inflammatory contents of the sinuses, and the cure of chronic inflammation is impossible without eliminating this obstacle.
  • Patients with chronic otitis media, the cause of which is the closure of the mouth of the auditory tube by a deformed part of the septum.

However, it should be noted that septoplasty of the nasal septum can also be offered to patients without any special subjective complaints, but with a pronounced curvature. The fact is that if one half of the nose is obstructed, many simply adapt to this position, breathe on the other side and do not experience any inconvenience. But any compensatory reserves are exhausted over time. This usually occurs in old age, when there is a natural decrease in the vital capacity of the lungs, and this is where inadequate nasal breathing begins to affect. And in people over 60 years of age, doctors are reluctant to undertake correction of deviated septum.

Therefore, the doctor is obliged to warn the patient about such possible consequences of untreated curvature, even in the absence of complaints, and further tactics depend on the wishes of the patient himself.

The indications for surgery are determined by an ENT doctor, who issues a referral to a specialized department.

Septoplasty can be done free of charge as part of state guarantees under the compulsory medical insurance policy, but there is likely to be a waiting list for the free operation. You can have an operation in a paid clinic, the cost is from 40 to 100 thousand rubles.

Preparation for septoplasty

Like any operation, septoplasty surgery requires preliminary examination and preparation. It is necessary to take blood tests, urine tests, blood sugar tests, determine clotting time, the presence of antibodies to HIV, viral hepatitis, do an ECG, fluorography, and be examined by a therapist. To get a complete picture of the condition of the nose and paranasal sinuses, it is advisable to undergo a CT scan.

The operation is not performed during a period of acute infection or exacerbation of a chronic disease; after the inflammation subsides, it is necessary to withstand a period of days. It is also undesirable for women to undergo surgery during menstruation or immediately after it.

A week before surgery, it is necessary to exclude medications that slow down blood clotting - aspirin, Plavix, warfarin, non-steroidal anti-inflammatory drugs, alcohol. It's better to shave your mustache.

The operation is performed in a hospital, in a specialized ENT department. On the appointed day, you must appear on an empty stomach, with the necessary things for hospitalization. In addition to the usual things, it is usually recommended to take drinking straws (regular drinking will be difficult), and chapstick.

The operation is usually performed under local anesthesia with premedication: immediately before the operation, a sedative is administered to reduce the perception of pain impulses, and the local surgical field is infiltrated with anesthetics and vasoconstrictor drugs.

General anesthesia is used in complex cases where a large volume of intervention is required, as well as at the request of the patient in the absence of contraindications.

Contraindications to septoplasty

Both at the clinic appointment and directly in the hospital, contraindications to surgery are identified. This:

  1. Blood clotting disorder.
  2. Decompensation of chronic somatic diseases (heart failure, arterial hypertension, diabetes mellitus and others).
  3. Mental illnesses.
  4. Age up to 18 years (in exceptional cases, septoplasty is performed for children from 6 years of age).
  5. Age over 60 years (conditionally).

What is septoplasty surgery?

Attempts to establish normal nasal breathing with a crooked nasal septum through surgery have been made since ancient times. Basically, this operation was reduced to the complete removal of the septum. At the beginning of the twentieth century, Killian proposed a technique for submucosal resection of the septum, which, with slightly modified variations, is still used today.

The essence of the operation: an incision is made in the mucous membrane along with the perichondrium. An incision is made from the nasal cavity on one side (usually on the convex side of the curvature). Next, the quadrangular cartilage is isolated, the mucosa and perichondrium on the other side are peeled off, and most of the cartilage is removed. After removing the cartilage, the surgeon gains access to the bony part of the septum, and the periosteum is exfoliated. Using special forceps or a chisel, bone ridges and spines are removed, and sometimes part of the bone septum is resected.

The separated parts of the mucous membrane, perichondrium and periosteum are pressed tightly against the remaining skeleton of the septum and fixed in the middle position with tampons on both sides. Self-absorbing sutures may be placed. For a more reliable fixation, a plaster cast is applied to the outside of the nose.

Subsequently, all layers grow together, and a simulated partition without curvature is obtained.

Types of septoplasty

Of course, over more than 100 years, Killian’s operation has undergone some changes; various modifications have appeared that allow one to avoid many of the unpleasant consequences of classical resection, namely:

  • “Collapse” of the nasal bridge due to the fact that the supporting part of the nasal septum is removed almost completely;
  • Excessive mobility of the nasal septum after surgery;
  • Heavy bleeding and perforation of the septum as a consequence of the highly traumatic operation;
  • Frequently developing cicatricial adhesions of the nasal cavity requiring repeated intervention.

Modifications of submucosal resection

  1. Partial sparing resection. Nowadays, with submucosal resection, the cartilage is mainly preserved, only curved areas are removed.
  2. Redressation of the septum. V.I. Voyachek proposed a method of sparing surgery on the septum: the cartilage is separated from the perichondrium on only one side, then a movable cartilage flap is formed using four incisions on all sides, fixed to the mucous membrane of the other side. The curved part of the bone septum is broken. The septum is given the correct median position and fixed with tampons.
  3. Circular resection. Also, a quadrangular flap is isolated in the cartilage, a thin strip is cut out around it and removed to give even greater mobility.
  4. Resection – reimplantation. The isolated plate of cartilage is cut into several pieces, which are given the desired shape using a scalpel or a special flattener. The pieces are placed in their original place and fixed.

Endoscopic septoplasty

All surgical procedures are performed under the control of a microendoscope, which allows minimizing surgical trauma and more thoroughly examining and removing all defects. The surgeon sees the entire surgical field, enlarged several times, on the monitor screen.

Laser septoplasty

The term “Laser septoplasty” has been heavily promoted recently. Laser treatment is a very fashionable method and, like a magnet, attracts sufferers who want to be treated “without pain and without blood.” But it must be said that in rhinosurgery its importance is greatly exaggerated.

The concept of “laser septoplasty” confuses two methods that must be clearly separated:

  • Laser septochondrocorrection. A new, but rather limited method for correcting only the cartilaginous part of the septum (isolated cartilage curvature is rare). The laser beam heats the problematic part of the cartilage, it becomes plastic, and is given the desired shape. The operation is truly painless, bloodless, and is performed on an outpatient basis. Due to the fact that the method is new, the long-term consequences are unknown. Calls to correct a septum with a laser are usually a lure to the client. During your consultation, you will probably be told that you need traditional septoplasty.
  • Another method, which is mainly advertised by paid clinics as “laser septoplasty”, is the same classic septoplasty, but instead of a scalpel it uses a laser beam. The laser actually has advantages over a conventional scalpel: when cutting tissue, blood vessels immediately coagulate, which significantly reduces blood loss and shortens the rehabilitation period.

Operations performed simultaneously with septoplasty

As a rule, the operation of septoplasty of the nasal septum is planned simultaneously with other interventions in the nasal cavity, which have one goal - to improve nasal breathing. It could be:

  1. Conchotomy – cutting of the hypertrophied lower or middle nasal concha.
  2. Vasotomy is resection of thickened mucous membrane in chronic vasomotor rhinitis.
  3. Polypectomy – removal of growths from the nasal mucosa.
  4. Sinusotomy is endoscopic access to the affected sinus, carrying out manipulations in it aimed at eliminating the chronic inflammatory process.

It should also be noted that sometimes septoplasty is performed simultaneously with rhinoplasty, the purpose of which is to aesthetically correct the shape of the nose. This operation is performed by plastic surgeons.

What a patient who agrees to septoplasty needs to know

In addition to the above information, you need to clearly understand what awaits you immediately after the operation:

  • The operation lasts about an hour. It’s not a very pleasant sensation, but it’s quite tolerable to endure it under local anesthesia. If you wish, you can choose general anesthesia, but you will have to, firstly, pay extra for it, and secondly, you will also have to endure the aftereffects of anesthesia drugs (weakness, stupor, dizziness, nausea, etc.)
  • After surgery, the nasal passages will be tightly blocked with tampons, making it impossible to breathe through the nose. You need to tune in to this and endure 1 or 2 days before removing them from the nose. Breathing will be possible only through the mouth, as a result of which the mucous membranes of the mouth, lips (this is why chapstick is needed), tongue will dry out, and there will be a constant desire to drink. To make this moment easier, you can purchase special silicone tampons with air tubes in advance.
  • For several days after the operation, pain is felt in the nose and upper jaw, active movements of the lips are painful, so it is difficult to eat solid food. A straw is useful for drinking here. To reduce pain, painkillers are prescribed.
  • Bloody discharge from the nose is possible in the first day. To absorb them, a sling-shaped bandage is applied, which needs to be changed as it gets wet. Hemostatic agents are prescribed.
  • After removing the tampons, it is necessary to daily rinse the nasal cavity with moisturizing solutions and antiseptics, as well as free it from crusts. This is done by a doctor or nurse.
  • Antibiotics are usually prescribed for several days to prevent infection. You cannot blow your nose, pick your nose, take a hot shower or bath, or eat hot food.
  • Postoperative swelling persists for at least 7-10 days; complete restoration of nasal breathing occurs differently for everyone - within a period of from a week to a month.
  • Discharge from the hospital usually occurs on days 6–7; in some cases, discharge can occur immediately after removal of the turundas with the condition of daily attendance for examination and treatment of the nose. Working capacity is restored after 2 weeks.
  • For a month after the operation, it is not recommended to perform heavy physical activity, play sports, or visit the bathhouse, sauna, swimming pool, or beach.

Complications of septoplasty

Like any operation, nasal septoplasty may result in some complications:

  1. Bleeding. It can occur both during surgery and in the early postoperative period. Moderate bleeding during the first two days is not considered a complication.
  2. Hematoma in the nasal cavity. It occurs when blood does not flow outward, but under the mucous membrane.
  3. Abscess (suppuration). Occurs when an infection gets into a surgical wound.
  4. Perforation of the septum. Minor perforations usually do not cause any inconvenience. Large holes require repeated intervention.
  5. Scar adhesions in the nasal cavity. Repeated surgery (dissection of adhesions) is also required.

Where is the best place to have surgery?

Submucosal resection for deviated nasal septum can be performed free of charge under the compulsory medical insurance policy in almost any ENT department. Doctors in public clinics are quite qualified and are fluent in this technique, even though they are under-equipped with modern equipment.

When contacting a paid clinic, we pay first of all for comfort, the absence of queues, the opportunity to choose a doctor and a more modern method of treatment (endoscopic septoplasty, laser septoplasty). The cost of septoplasty in paid clinics starts from 40 thousand rubles. The price depends on the complexity of the operation, which is determined during a preliminary examination, on the qualification category of the surgeon, the category of the clinic, length of stay in the hospital, type of anesthesia and some other factors. Any additional intervention planned at the same time as septoplasty will increase the price accordingly.

You can choose a clinic based on reviews from patients who have undergone septoplasty. There are many forums on the Internet on this topic; reading them is very useful for those who are just planning to do this.

Source: http://uhonos.ru/nos/lechenie-nosa/septoplastika/

Septum operation

Correct nasal breathing provides the brain and other organs with oxygen, supplying warmed and humidified air, purified from street dust, into the lungs. In the case of a deviated nasal septum, proper ventilation of the lungs is disrupted, ENT diseases often appear, and deformations of the nasal dorsum become noticeable. Performed by a qualified specialist, septum surgery helps restore full breathing and straighten the shape of the nasal bridge.

Causes of a deviated nasal septum

Deformation of the osteochondral nasal septum occurs for various reasons, resulting in slight or significant curvature:

  • uneven development of the cartilaginous and bone parts of the nose, contributing to the formation of spines and ridges on the septum;
  • injury to the nose, including from falls and bruises, in infancy during childbirth;
  • unilateral nasal polyps, hypertrophy of the nasal turbinates, a combination of various anomalies in the structure of the nose.

Indications for surgery

Septoplasty is necessary when a number of diseases are identified that not only worsen the quality of life, but can also lead to a fatal outcome:

  • snoring with elements of apnea (stopping breathing during sleep), which can result in sudden death;
  • difficulty in nasal breathing in many patients causes the need to breathe through the mouth, which contributes to the development of sore throats and other ENT diseases;
  • chronic inflammation of the nasal sinuses due to improper outflow of mucus and the creation of a favorable background for bacteria;
  • dryness in the nose, causing discomfort and microcracks in the mucous membrane, which provokes inflammation;
  • allergies with the development of rhinitis, including in chronic form;
  • noticeable outward curvature of the nasal bridge.

Septoplasty and rehabilitation

Septum surgery, depending on the condition and age of the patient, is performed under local anesthesia or general anesthesia. The average duration of the entire procedure is half an hour, unless you need to additionally change the shape of the nose as a whole. Surgical manipulations are performed through the nostrils, without external incisions, with the removal of the bony parts of the septum protruding from the side of the bend. If there is a curvature only in the cartilaginous elements, laser correction is possible, which is less traumatic. Rehabilitation takes a month, during which you should not increase the load or visit the bathhouse. Immediately after septoplasty, the nasal passages are tamponed, sick leave is issued for one to two weeks, and the nose is periodically washed by an ENT doctor.

St. Petersburg, Vasilievsky Island, Sredny Prospekt, 48/27 (entrance from the 12th line of V.O.)

Source: http://orkli.ru/practice/lor/septumoperaciya/

Septoplasty

Septoplasty is a surgical procedure that allows you to adjust and correct a deformed nasal septum.

Despite the fact that septoplasty is a surgical procedure, it is the least traumatic operation; in addition, in addition to eliminating the defect and problem, septoplasty allows you to preserve the bone and cartilaginous structure of the nose without changes or damage.

All surgical procedures are performed inside the nose through small incisions, thus, thanks to minor submucosal resection of the septum, its shape is corrected. Based on this, septoplasty in a short time allows:

    • quickly improve quality of life;
    • resume nasal breathing;
    • relieve the patient from numerous problems associated with chronic ENT diseases caused by a deformed nasal septum.

It should be noted that septoplasty does not change the shape of the nose and is not an aesthetic surgical intervention for its correction, but it may well be combined with rhinoplasty.

Causes of nasal septum deformation

The nasal septum is a section of osteochondral tissue that divides the nasal cavity into two parts. When it is deformed, a shift in the position of the septum from the midline is noted.

Photo: deformation of the nasal septum

Deformation of the nasal septum can cause a lot of inconvenience to a person, and even provoke a number of chronic diseases of the respiratory organs (rhinitis, tonsillitis, sinusitis, frontal sinusitis, and the like).

There are a number of reasons why the septum becomes deformed. These include physiological characteristics, as well as traumatic and compensatory causes.

The physiological factor is the most common cause of deformation of the nasal septum. This means that a person’s bone and cartilage tissues acquire uneven growth, and this happens during the development and growth of the entire organism. In the case of a physiological cause, the nasal septum is usually completely deformed, often shifted to one side, or it develops projections called ridges or spines, as well as their combinations. A less common cause of a deviated nasal septum is a traumatic factor; it is most often found in athletes, but can also be caused by other reasons (fall, bruise, blow).

Photo: deviated nasal septum after injury

Traumatic deviated septum is a mechanical defect of the nose, trauma or fracture, which entails various complications. Even a minor injury, in which the bone is not deformed, but only the cartilage, especially if it occurs in childhood (or an age concomitant with the growth of the body as a whole), leads to a disruption in the development of the osteochondral tissue of the nose, and, accordingly, to a curvature of the nasal septum. Compensatory causes of septal deformation usually include:

  • the presence of a foreign body in the nasal cavity (for example, piercing);
  • the presence of polyps, adenoids and other neoplasms in the nasal cavity;
  • the presence of vasomotor rhinitis in humans (swelling of the nasal mucosa).

In any case, no matter what factors and reasons are responsible for the deformation of the nasal septum, its correction today lies only in surgical intervention, that is, septoplasty.

Types of septoplasty

In modern medicine, septoplasty of the nasal septum is performed in several ways, in particular endoscopically (conventional surgery) and using laser technology.

In the vast majority of cases, people faced with the problem of a deviated nasal septum prefer a proven method - endoscopic septoplasty.

Laser septoplasty

Laser septoplasty is characterized by correction of the nasal septum using a laser beam. This procedure is often performed under local anesthesia; it is bloodless and practically non-traumatic. In addition, the laser beam has pronounced antiseptic properties, which significantly reduces the risk of infections and complications in the postoperative period. Rehabilitation after laser septoplasty is quick and painless. Tight tampons (turundas) are not used in the postoperative period. After the operation, the patient does not need to stay in the clinic; the operation is performed on an outpatient basis and takes minutes. However, the laser method of septoplasty has a number of contraindications and, in addition, may be ineffective in complex cases when the curvature occurs not only in the cartilage tissue. Therefore, there are reasons why it is worth operating only through classical surgical septoplasty.

Video: laser septoplasty

Endoscopic septoplasty

Endoscopic septoplasty is a gentle, low-traumatic surgical intervention. Resection is performed on the mucous membrane inside the nose, which avoids scars and traces of surgery on the face.

Modern technologies for endoscopic septoplasty not only make it possible to maintain the aesthetic effect and avoid scars, but also make the rehabilitation period much easier and shorter.

Photo: resection of the nasal mucosa

Classic endoscopic septoplasty in modern medicine involves resection of minor areas of the septum that interfere with its normal position and functioning. At the same time, the nasal mucosa is preventively exfoliated, which preserves its integrity and prevents damage. However, there are individual cases, most often these include curvatures due to a traumatic factor, where deformed areas of cartilage tissue must be removed in order to leave the supporting function of the nasal septum unchanged. Typically, endoscopic septoplasty lasts 30 to 40 minutes; Considering the patient’s preparation for surgery, all manipulations can take about an hour. Anesthesia can be either general or local, or combined (for example, local anesthesia of the nose and the introduction of fairly strong intravenous sedation to the patient).

Symptoms of a deviated septum, or who is septoplasty indicated for?

The first, and perhaps the main symptom of a deformed nasal septum is difficulty breathing through the nose, whether it is chronic congestion of one or both nostrils. Full breathing through the nose is literally necessary for a person. The inhaled air is moistened and purified precisely in the nasal passages before entering the lungs, which is why the nasal cleansing and filtering functions are so important for human health, in particular the prevention of bronchial diseases (including asthma), heart and other vital organs. A deformed nasal septum prevents normal breathing through the nose, and often makes it completely impossible. But it should be borne in mind that at a young age, even with a significant deformation of the septum, this symptom may be mild or absent, which makes it difficult for the person to diagnose his pathology, but does not at all negate the fact of its existence.

Photo: normal nasal septum

A deviated nasal septum is the cause of frequent and protracted respiratory diseases in humans, often acquiring chronic forms. People with a deformed nasal septum also often experience recurrent inflammatory diseases of the respiratory tract and paranasal sinuses. Chronic sinusitis and rhinitis develop, and sinusitis, tonsillitis and otitis are also often observed. Concomitant pathologies of the throat are a very natural process with a deviated nasal septum. This leads to diseases of the pharynx such as pharyngitis and tonsillitis, as well as diseases of the larynx such as laryngitis, which become chronic. Often people begin to self-medicate, constantly use vasoconstrictor drops and take antiviral medications, without even suspecting that the cause of their frequent illnesses and constant nasal congestion lies in another defect that can be corrected by septoplasty.

Photo: deviated nasal septum

  • dry nasal cavity;
  • allergic reactions;
  • deterioration of hearing ability.

The last symptom is due to the fact that difficulty in nasal breathing does not provide proper ventilation of the middle ear cavity (tympanic cavity). If you observe any symptom, the most reasonable decision would be to visit an otolaryngologist, who will prescribe the correct treatment or refer you for surgery. It should be remembered that for minor violations and deformations of the nasal septum, there are alternative methods of septoplasty - such as laser or radio wave.

Contraindications

As with any operation, there are a number of contraindications to septoplasty. As with any other surgical intervention, an absolute contraindication to septoplasty is impaired blood clotting. Also, contraindications include:

  • diabetes;
  • diseases of the cardiovascular system;
  • infectious diseases of various types (including syphilis, hepatitis, etc.);
  • oncological diseases;
  • In addition, septoplasty is contraindicated for persons under the age of majority, since the bone and cartilage tissues of the nose are not fully formed until this moment.

Surgery to correct the curvature of the nasal septum

The operation to correct the nasal septum is painless and fairly quick, with minimal trauma and virtually no damage to cartilage and bone tissue. Modern methods of septoplasty are minimally invasive and allow you to correct dysfunction of the nasal septum with minimal damage and resection. Endoscopic septoplasty is performed mainly endonasally (inside the nose), which guarantees the preservation of the cosmetic effect and the absence of injury to nearby tissues.

Video: modern surgery - deviated nasal septum

How is the operation performed?

Let's figure out how septoplasty is done. Before performing the operation, the doctor prescribes a list of necessary tests and examinations. In most cases, they are generally accepted for any operation. Before septoplasty of the nasal septum, the patient must undergo some examinations and pass the following tests:

  • consultation with an otolaryngologist (ENT);
  • ECG (electrocardiogram);
  • coagulogram (test for blood clotting);
  • general clinical analysis of blood and urine;
  • fluorography;
  • blood test for HIV, syphilis and hepatitis;
  • blood chemistry;

Septoplasty, like any other operation, includes several stages. First, the patient is prepared for surgery, regardless of the chosen method of anesthesia. Currently, in most cases local anesthesia is used, but some patients still prefer general anesthesia (or have indications for it). Then an endonasal incision is made on the mucous membrane.

Complications and contraindications of septoplasty

Septoplasty is an operation that almost always allows for rehabilitation without complications.

But even with a low probability of complications, it should be understood that septoplasty is still a surgical procedure, and any operation carries certain risks. Complications after septoplasty can mainly be associated with bleeding and/or infectious diseases against their background. You should be aware that some medications taken by the patient before and after surgery may increase the risk of bleeding.

Photo: consultation before surgery

Therefore, before undergoing septoplasty, it is necessary to consult with a doctor regarding medications and medications, and in some cases, discontinue them some time before surgery. Before surgery, it would be a good idea to stop taking antibiotics and use medications aimed at preventing vascular fragility. It is also necessary to quit smoking, since smoking not only complicates the operation process, but also significantly complicates the rehabilitation and healing of tissues after it.

Rehabilitation and recovery (postoperative period)

The postoperative period (rehabilitation) after septoplasty is also almost painless and quite smooth. On the first day (or several, depending on individual characteristics), special tight tampons are placed in the patient’s nose. They are designed to reduce the postoperative risk of bleeding and stabilize the correct position of the nasal septum. Therefore, you should prepare for the fact that the nose after septoplasty will not breathe while tampons are in it.

Photo: silicone nasal swabs

Some modern clinics now use silicone tampons, which also effectively maintain shape and prevent bleeding, but due to the fact that they are empty from the inside, breathing is not difficult. Their removal from the nasal cavity does not bring any inconvenience or pain to the patient.

During the period after removing nasal tampons, you should also follow the doctor's recommendations regarding hot drinks, smoking, physical activity and water treatments.

All these simple things will have some restrictions that will have to be observed for a speedy recovery and return to functionality. To prevent infections and provide general relief, after septoplasty, various painkillers and antipyretic drugs are prescribed, and, in some cases, injections and drips of antibiotic drugs are given. After removing the tampons, the doctor often prescribes the patient special moisturizing drops for the mucous membrane, since after the operation the nasal cavity becomes quite dry, and clots of mucus and blood accumulate and dry out in it. Of course, you cannot remove them yourself with your hands, so special drops, sprays and solutions help soften this substance and “drive” it out of the nasal passages.

Photo: nasal spray to ease breathing

Most often, such preparations include drops and sprays based on saline and oil solutions. Sometimes the doctor prescribes ointments, including antibiotics, to the patient. As the nasal passages are cleansed and restored, breathing becomes easier, the mucous membrane is completely restored, and the surgical incisions heal. Completely normal breathing usually occurs in the patient within a few weeks. If we talk about laser septoplasty, here rehabilitation proceeds much faster, thanks to the bloodlessness of such an operation. The laser automatically coagulates the incision sites (seals their edges) and also disinfects them due to its strong antiseptic function. Therefore, after laser septoplasty, additional treatment is usually not required, and the introduction of tampons is not required.

If the patient has chronic and allergic rhinitis, relapses may occur during rehabilitation, which will require additional prescriptions from the attending physician and, accordingly, their implementation by the patient himself.

Performance fully returns 8-10 days after surgery. Even if a plaster fixation bandage is installed, by this time the patient is freed from it. There are practically no external bruises and swelling after septoplasty. With proper care of the nose after previous septoplasty, the postoperative period passes quickly and does not cause any discomfort to the patient.

Prices. How much does the operation cost?

The cost of correcting a nasal septum (septoplasty) varies widely in Moscow clinics, depending on the specialist who will operate, the authority of a particular clinic, as well as the chosen method of septoplasty and anesthesia. The average cost of septoplasty from a qualified specialist in a good commercial clinic is approximately 00 rubles.

This amount usually includes anesthesia, the patient’s hospital stay in the clinic (if necessary), subsequent postoperative dressings and sometimes medications (in most cases, they are purchased separately by the patient as prescribed by the doctor). In city hospitals, such an operation is performed free of charge, but the patient pays all costs for anesthesia and medications. In addition, in private clinics the patient has full guarantees that the operation will be successful and the rehabilitation period will proceed under the supervision of a doctor.

FAQ

Among the frequently asked questions about septoplasty by potential patients, the most common are the following: 1. Does septoplasty change the shape of the nose? Of course, with a traumatic curvature of the septum, when the deformation is severe, the shape of the nose acquires normal features, the septum becomes horizontal and even, not displaced to one side. If the curvature is purely on the inside, the shape of the nose remains completely the same. In general, septoplasty refers to ENT operations and has nothing to do with plastic surgery and aesthetic medicine. However, very often septoplasty (correction of the nasal septum) is combined with aesthetic rhinoplasty to completely change the shape of the nose, its aesthetic correction and eliminate problems with a deviated septum. 2. Does a deviated nasal septum pose a threat to health and life? A deformed nasal septum, of course, does not pose a direct threat to life. But it causes a number of health problems that can end very badly and at least pose a threat to the quality of life (ranging from hearing impairment, problems with the cardiovascular system, and ending with chronic diseases of the respiratory tract and organs). In addition, frequent diseases can develop into chronic and severe forms; insufficient air purification through the nasal passages and its direct entry into the lungs can lead to the development of asthma and heart disease, which, in turn, can pose a threat to life and normal functioning. 3. Is it possible to correct a septum without resorting to surgery? Today, septoplasty is the only way to effectively cope with the problem of a deformed nasal septum. If the deformity is not too complex, it is possible to avoid direct surgical intervention (endoscopic septoplasty) and use the most minimally invasive techniques - laser and radio wave septoplasty. However, even if the case is quite complex, and the curvature affects not only areas of cartilage tissue, modern medicine allows the use of classical endoscopic septoplasty with minimal trauma and health risks, and also maintains a cosmetic effect (no traces or scars of surgical intervention on the face). 4. Are there any scars after endoscopic septoplasty? All manipulations during endoscopic septoplasty are performed endonasally (inside the nose), including incisions that are made on the mucous membrane. This ensures that there are no scars on the nose after septoplasty. In rare cases, the skin is involved, but this is the exception rather than the rule. If we are talking about septoplasty combined with rhinoplasty (aesthetic correction of the shape of the nose), there are scars if the surgeon performs rhinoplasty in an open way. Septoplasty itself does not involve skin incisions, and no technique (endoscopic, laser or radio wave) requires that any traces remain after the operation. 5. What is the optimal age for septoplasty, and is there an age limit for it? There is no optimal age for nasal septum correction, because... problems can develop at any age, for example, due to trauma, polyps, tumors and other factors. Some people turn to septoplasty in adulthood, and often this can also happen because the symptoms of such a deviation as a deviated nasal septum may not be felt at a young age. As for age restrictions, the operation is not recommended for persons under age, since the anatomy of the face is such that by this age the osteochondral skeleton of the nose is not fully formed, and surgical intervention may not lead to the elimination of the problem, but to its aggravation. 6. Will surgery help if I have been using vasoconstrictor drops for a long time and my normal breathing is impossible without them? It is likely that the curvature of the nasal septum forced me to start using vasoconstrictor drops to ease nasal breathing. However, it should be understood that regular, and even more so constant, use of such drugs often leads to irreversible consequences (the mucous membrane atrophies), and there is little that can help here.

Photo: nose rhinoplasty

In the case of combining septoplasty and rhinoplasty, both a full version of plastic surgery is possible (with intervention in the bone section and elimination of aesthetic defects in it), as well as manipulations aimed at the aesthetics of the tip (its reduction, narrowing, elevation). Even if the bone part is not involved, any plastic surgery on the nose is called “rhinoplasty,” while septoplasty can get rid of breathing problems, chronic respiratory diseases and other problems caused by a deviated nasal septum.

Source: http://plastgid.ru/plasticheskaja-hirurgija/plastika-lica/septoplastika/

Endoscopic septoplasty - surgery to correct the nasal septum

A deviated nasal septum is quite common, since the causes of such a pathology are quite diverse - from birth trauma to trauma received already at a conscious age, for example, after a blow to the face.

In many cases, the curvature of the nasal septum is so significant that it can lead to impaired nasal breathing, snoring, and the development of chronic runny nose. A person with a significantly deviated nasal septum begins to breathe through the mouth, which is fraught with hyperventilation and disruption of the blood gas balance. As a result, such a patient may develop persistent hypertension and heart disease.

Doctors believe that 80% of people have such an anatomical disorder of the nasal septum, but not all of them have this pathology as a result of impaired nasal breathing.

For those people suffering from a deviated nasal septum, in whom this disease causes severe disruption of nasal breathing and frequent inflammatory processes in the nasal cavity and paranasal sinuses, doctors correct the defect through surgical operations.

In recent years, low-traumatic endoscopic operations have become widespread during which, without performing extensive intervention, the otolaryngologist uses an endoscope, a device that allows the doctor to see the deepest parts of the nose on the monitor screen. If necessary, you can enlarge a specific area of ​​the image.

The doctor also uses special instruments, and at the very end of the intervention, fixes the nasal septum using splints - special metal plates that hold the septum in the desired position.

Source: http://www.health-ua.org/video/otolaringologiya/758.html

What is endoscopic correction of a deviated nasal septum?

The nasal septum is the so-called wall, consisting of cartilage and thin bone, located in the nasal cavity and dividing it in half.

In cases where the septum is deviated, a person experiences a lot of health problems: difficulty breathing, swelling, respiratory failure, chronic sinusitis and much more. Today this problem can be overcome.

Operating principle

Endoscopic septoplasty is a gentle surgical intervention aimed at restoring the correct position of the nasal septum, correcting the cartilaginous or osteochondral wall, and removing excess tissue.

The operation is performed directly in the hospital under local or general anesthesia, within several hours.

The nasal septum is corrected using an endoscope - a specially equipped instrument with which the doctor sees the entire surgical field.

With vasotomy

Vasotomy of the inferior turbinates has the most flattering reviews, and therefore is very popular among those who want to improve their health.

Vasotomy is a surgical method of treatment, which is based on the intersection of vessels located directly between the mucous membrane itself and the periosteum.

After this procedure, the mucous membrane decreases in size, swelling is relieved, as well as the nasal sinuses themselves are reduced, thereby improving nasal breathing.

The surgical intervention lasts no more than 5 minutes under local anesthesia. Today, the latest surgical methods are used - electrosurgery and radiosurgery.

When performing such operations, the risk of developing trauma to surrounding tissues and bleeding is reduced.

Using rr technologies

During this operation, the mucous membrane in the area of ​​the nasal septum is separated.

Using a surgical laser, deformed areas of the septum are removed, straightened, or replaced. At the end of the operation, stitches are placed and the nasal passages are sealed.

The operation lasts up to 30 – 40 minutes, mainly under local anesthesia.

Laser septoplasty can be performed only in case of damage to the cartilage tissue.

During the operation, under the influence of a laser, the cartilage tissue melts, after which it becomes possible to establish a normal shape without an incision.

With autocartilage reimplantation

Reimplantation of septal autocartilage as a variant of septoplasty is a common procedure aimed at correcting nasal curvature.

Implantation of straightened autocartilage guarantees a stable position of the immediate septum and the external nose as a whole.

If necessary, the septum is fixed using special silicone stands in the middle position, which allow the patient to breathe immediately after the operation.

The rehabilitation period lasts up to 2 weeks, after which the patient must avoid heavy physical activity for another couple of months.

It will not become easier to breathe right away; it takes time for the swelling of the mucous membrane to subside and crusts to stop forming.

Indications for surgical intervention

Most often, septoplasty is performed for medical reasons that lead to disruption of the patient’s respiratory system.

Factors that may contribute to this include:

  • frequent acute sinusitis (up to 4 times a year);
  • chronic form of sinusitis;
  • recurrent nosebleeds;
  • chronic inflammation of the nasal mucosa;
  • ronchopathy;
  • allergic diseases;
  • frequently recurring colds;
  • feeling of dryness in the nasal cavity;
  • sinusitis, sinusitis;
  • noisy breathing;
  • constant nasal congestion (regardless of the time of year).

Contraindications

Contraindications for surgical intervention include:

  • severe diseases of the cardiovascular system;
  • blood clotting disorder;
  • the patient's age is less than 18 years;
  • oncology;
  • infectious and viral diseases;
  • pathology of internal organs;
  • diabetes.

At what age is it best to have surgery?

When prescribing this method of treatment, it is worth taking into account the fact that cartilage tissue continues to grow up to 24 years of age, so surgical intervention before the end of the formation of the osteochondral system of the body can only aggravate the situation, provoking a new deformation, the correction of which will require repeated surgery.

Progress of the operation

During septoplasty, the incision is made inside the nose, so the scar afterwards is invisible.

Correction of the nasal septum is carried out endonasally and lasts about an hour.

An endoscope is inserted directly into the nasal cavity - a tube up to 4 mm in diameter, equipped with fiber optics to allow the doctor to monitor the entire progress of the operation to avoid injury.

If necessary, other endonasal interventions are performed simultaneously.

After the operation is completed, the nasal cavity is tamponed; the tampons are removed after 2-3 days.

Postoperative period

Rehabilitation after the operation does not last long, after a day the patient is discharged from the hospital, on the second or third day all postoperative materials are removed - tampons, which are placed after the operation in order to reduce the risk of developing nosebleeds and stabilize the correct position of the nasal septum.

For the first few days, nasal hygiene is mandatory - removing crusts and dried blood. To do this, the nose is washed with a solution of sea water or saline. solution, lubricate with a special ointment or use sprays and drops.

Immediately after the operation, the patient is given a cold compress on the septum area, antibiotics are prescribed (to avoid infectious complications) and pain-relieving injections.

For 2-3 weeks after septoplasty, the patient is not recommended to do heavy physical activity, visit pools or saunas.

Postoperative complications

Complications after endoscopic septoplasty are unlikely, but still possible; any correction carried out surgically carries the risk of various side effects such as:

  • bleeding;
  • severe pain syndrome;
  • hyperemia;
  • edema;
  • damage to the mucous membrane;
  • formation of hematomas;
  • modifications of the nose;
  • sinusitis;
  • abscess of the nasal septum;
  • infectious infection.

Prevention of postoperative complications

To avoid possible complications, you should regularly perform tamponade of the nasal passages, rinse with saline. solution into the nasal cavity and apply antibacterial therapy.

The incidence of postoperative complications is quite low.

Durability result

The durability of the results obtained directly depends on the implementation of all the doctor’s recommendations during the rehabilitation period, as well as further care of the nasal cavity as a whole.

In 85% of cases after endoscopic septoplasty, patients are completely satisfied with the results obtained.

Almost all medical services provided today are not free.

Photos before and after correction

Video: Endoscopic septoplasty

We had septoplasty for two weeks, everything went at the highest level - preparation for the operation, the postoperative period. The operation was carried out under local anesthesia, at first, of course, it was unpleasant (the injections were very painful), but then everything was as expected. When they separated the mucous membrane itself, I didn’t feel anything at all, but as soon as we got to the ridge it became scary, aching pain appeared, so the anesthesiologist had to inject more painkillers. As a result, I received 4 injections in the nose and 2 or 3 (I don’t remember exactly) in the gums. The operation lasted exactly two hours, maybe a little less. The good news is that after the anesthesia wore off, the pain did not return. I had to walk around with turundas for a couple of days. Immediately after the operation, the doctor asked me to breathe and yes, a miracle happened, my nose began to breathe again. I don’t regret the operation for a second and everyone who is worried about problems with the nasal septum is recommended to go and have septoplasty. It’s better to suffer once, but then get a free life for a long time.

I have a huge problem since I was born - it is incredibly difficult for me to breathe. I constantly sleep with my mouth open, after any physical exertion, even minor ones, I begin to choke, very often (up to 6 times a year) I get sick with all possible colds. The fact that I have a deviated nasal septum can be seen with the naked eye. At the age of 28, I finally decided on a similar experiment and turned to an ENT doctor, who immediately offered to perform an operation on me, the essence of which was to remove the excess cartilage that was preventing me from breathing. Without thinking twice, I, of course, agreed. The operation was performed through the nostril, under local anesthesia. It was very scary, but I pulled myself together. A few minutes later I felt sick, had a fever, my heartbeat increased, I was very scared and wanted to drop everything and leave, but the doctors stopped me in time. As it turned out, this is a typical reaction to an injection, for some it goes unnoticed, but for me it’s like this, then the process went like clockwork. The operation lasted a total of 40 minutes. My postoperative period was normal, without complications. After two months, maybe a little more, I felt all the delights of the operation - it became easier to breathe, my dream came true.

I also decided to have surgery to correct my nasal septum and I can say right away that I don’t regret anything. Seven years of suffering because your nose can't function properly isn't worth it. I spent a very long time and meticulously choosing a clinic and finally decided, after consulting with a specialist, they set the date for the operation on July 17 - my lucky day. I went to the hospital the day before the scheduled date of the operation, for observation, the next day in the morning, under general anesthesia, I had an operation that lasted 2 - 3 hours maximum. The sensations after anesthesia were of course terrible, dizziness, nausea. I spent a week in the hospital, every day after removing the tamponade I had to go to the attending physician to rinse my nose. Now I breathe perfectly, I sleep with my mouth closed, which is good news. After discharge, I rinsed my nose with various solutions for a couple of weeks and took specially prescribed drops.

Source: http://plastika.hvatit-bolet.ru/%D1%8D%D0%BD%D0%B4%D0%BE%D1%81%D0%BA%D0%BE%D0%BF%D0%B8 %D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F-%D1%81%D0%B5%D0%BF%D1%82%D0%BE%D0%BF% D0%BB%D0%B0%D1%81%D1%82%D0%B8%D0%BA%D0%B0/