About the procedure
Septoplasty (straightening of the nasal septum) combined with turbinoplasty (reduction of the inferior turbinates) is the most commonly performed procedure to treat a blocked nose.
Septoplasty involves gently lifting the lining inside the nose to access the septum, which is the cartilage dividing the nasal passages. The bent or misaligned portion is then straightened or removed. The incision is made inside the nose, so there are no visible external cuts or bruising. This procedure is performed under general anaesthetic and usually takes around 60 minutes, although can be longer if a more extensively deviated septum is addressed.
In most cases, septoplasty is performed by Dr Phillips as a completely endoscopic minimal access procedure. This together with reduction of the turbinates can often be done as day case surgery when done entirely endoscopically. In more advanced cases a one night overnight hospital stay may be recommended.
The nasal turbinates can be enlarged or swell due to a range of conditions, particularly from allergies such as allergic rhinitis. Turbinoplasty involves carefully lifting the lining over these structures and reducing their size by removing some of the underlying bone.
This surgery is generally not associated with significant pain and is commonly performed as a day procedure. Some, mild blood stained ooze bleeding is expected during the first week which usually settles on its own. A saline douche (saltwater rinse) such as FLO post op sinus rinse is required for around 6 weeks after surgery to support healing.
Overall, the procedure is more than 90% effective in improving nasal blockage.
Before the procedure
Before surgery, a detailed assessment of the nose is required. This includes a thorough discussion of symptoms along with a physical examination. In most cases, a nasal endoscopy is performed using a small camera to assess the back of the nasal passages.
Tests to measure airflow through the nose (rhinomanometry) are also commonly carried out for patients undergoing septal or turbinate surgery.
Prior to the operation, there will be a detailed discussion outlining the surgical plan and what to expect during recovery.
During the procedure
The operation is usually performed through very small incisions made inside the nose. In some cases, particularly when the septal deviation is located towards the front of the nose, a small external incision may be required on the columella (the tissue between the nostrils).
Once the deviated section of cartilage has been corrected or removed and any necessary grafts have been placed, the incisions are closed. The septum is then positioned centrally. Silicone splints may sometimes be placed inside the nose to provide support during healing if there has been very extensive surgery required.
The turbinates are reduced using specialised endoscopic instruments. Dissolvable packing is often used to minimise bleeding. This gradually clears with the help of saline rinses in the weeks following surgery, supporting proper healing.
Post procedure recovery
Most patients can go home on the same day as surgery without needing to stay overnight. Depending on whether splints or packing have been used, a short course of antibiotics may be prescribed, but mostly is not required.
If splints are inserted, they are typically removed about one week after surgery. A further follow-up appointment is usually arranged at around 4 to 6 weeks.
Some bleeding during the first week is normal, although significant bleeding requiring readmission to hospital is uncommon. Pain is usually mild and can be managed with simple medications such as paracetamol and ibuprofen.
What’s next?
After recovery, the nasal blockage that led to surgery should be noticeably improved. In some cases, repeat nasendoscopy and surveillance of sinuses may be required.