Septoplasty/SMR
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.
For Septoplasty/SMR
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