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This is a common operation used to overcome nasal obstruction when due to a distortion in the mid line cartilage or septum of the nose. Some people are born with a bent septum; others acquire a bend as a result of trauma, often a sporting injury. The operation is performed usually with the patient asleep and the incisions are all made inside the nose, there should be nothing visible externally. If you put one finger up each of your own nostrils you will feel between those fingers the septum, which should be in the mid line! The skin on one side is incised with a knife and lifted off the cartilage, the bent bit of cartilage is then removed and the remaining septum is repositioned toward the mid line to improve the airway. It was traditional to leave the patient with plastic splints in their nose with or without packing, in order to prevent bleeding and encourage the septum to heal in the mid line. Nowadays this is not thought to be necessary and indeed most patients find it far more comfortable not to have any form of packing or splints in their nose and certainly it is my practice to avoid it where at all possible. Disposable sutures are often used to close incisions and to quilt the septum to prevent any bleeding.

Post operative complications

There is often a degree of bleeding from the nose for a day or two afterwards. The tissues inside the nose swell as a result of the operation and so it is common to feel quite blocked for a week or two until the swelling goes down. During this recovery phrase I encourage patients to douche with salt-water solution in order to rinse away any blood and crusts and freshen the nose, this is preferable to blowing the nose or any other form of drug. Other rare complications which can occur as a result of surgery are 1) subtle change in the shape of the nose, whereby a slight indentation appears above the tip (supra tip depression). The bony bridge of the nose is thrown into prominence and it is sometimes misinterpreted as a hump rather than the depression it really is. The treatment is usually fairly straightforward and involved putting a small cartilage graft under the skin from the inside of the nose. Perforation of the septum can occur, very rarely and this may or may not be symptomatic.

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