The nasal septum is a normal anatomical structure located inside the nose. It consists partly of bone and partly of cartilage. It develops until the age of 16 for women and until the age of 18 for men. Under normal conditions it is located in the middle of the nose and divides the nasal cavity into two equal parts. It allows the smooth flow of air through the nose, its humidification and temperature regulation, as well as the normal olfactory function.
In cases where the nasal septum is not in the middle of the nose but is displaced to one side, we are talking about a crooked septum, or the common deviated septum. In fact, according to Harvard Medical School, this condition affects 80% of people and, depending on its severity, it can cause from minimal to very serious symptoms.
The most common causes that can lead to a deviated septum are the following:
The deviated septum is a source of worry for the patient as it causes a series of symptoms:
A deviated septum is responsible for a range of symptoms that affect the patient’s quality of life.
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The deviated septum is diagnosed by the otolaryngologist specialist in the office. The diagnostic approach includes the following:
The surgery that will provide the complete and permanent solution to the deviated septum is the Septoplasty which, according to the prestigious medical journal The Lancet, is the most frequent otorhinolaryngological surgery performed on adults. Any conservative treatment with topical sprays and nasal irrigation provides only temporary and partial relief from symptoms and is not a reliable option. During the operation, an incision is made inside the nose therefore is not visible. Through the incision the Surgeon approaches and corrects all the cartilaginous and bony structures of the septum that are responsible for its deviation. The incision and the septal mucosa are sutured with absorbable sutures that do not require removal. At the end of the operation there is no swelling or bruising while the external shape of the nose remains unchanged. Nowadays, the simultaneous use of endoscopes (endoscopic septoplasty) offers great precision in our manipulations and, therefore, in the result.
The straightening of the deviated septum is performed under general anesthesia and usually lasts 30 to 60 minutes, depending on the severity of the problem. Before the operation, a pre-operative check-up (blood tests, evaluation by a cardiologist and anesthesiologist) is necessary, which, in most cases, is done on the day of the surgery. The patient is then transferred to the operating room where the septoplasty takes place. After the procedure is over, the patient is taken to their room where they stay for at least 6 hours. After this period of time and depending on their wish they can return to their home or alternatively they can spend the night in the clinic and be discharged the next day.
Sometimes, difficulty in breathing through the nose is not only due to a deviated septum. Other conditions that can co-exist are:
In these cases, septoplasty should be combined with:
In some cases, the nasal septum can be extremely deviated, parts of it may be missing or ossified due to a violent injury, while deviation may also drag the nasal bones along creating the so-called ‘crooked nose’. In these cases, the classic straightening of the nasal septum is not sufficient. To achieve the desired result, we must combine the septoplasty with open or closed rhinoplasty. Thus, we can reconstruct a straight septum using cartilage grafts from the auricle or ribs, and also realign the nasal bones. Moreover, in cases where, as along with the breathing problem, there are aesthetic issues that worry the patient, e.g., a hump or a thick or droopy tip can be corrected in the same surgical time as the rhinoplasty procedure.
In several cases, the straightening of the nasal septum can be combined with rhinoplasty, so as to restore both the function and the aesthetics of the nose simultaneously.
6 to 8 hours after the surgery or the next day the patient is discharged. They receive a short antibiotic treatment while nasal irrigation with a special solution and the use of a special healing ointment for a few days are recommended. As mentioned above, all sutures are absorbable and do not need to be removed. The post-operative check-up takes place at regularly scheduled appointments at the clinic.
Septoplasty is a painless surgical procedure. General anesthesia ensures the absence of pain during the operation, while little or no painkillers are usually required afterwards. Also, there is no external swelling, no bruising, and no change in the external appearance of the nose.
You may have heard descriptions from people who have undergone nasal septum straightening surgery who report how much pain or discomfort they felt when the nasal packing was removed. It is true that in the past the materials used for this purpose were very bulky and remained in the nose for a long time, making their removal a traumatic experience.
In our practice, we either do not use any tamponade at all, replacing it with special absorbable sutures on nasal mucosa, or we place a very light tamponade which we remove shortly before the patient is discharged. In this way, we minimize or even eliminate any discomfort that could be caused, so you no longer need to worry about this (previously) unpleasant experience.
A necessary precondition before someone undergoes Septoplasty is that the formation of the septum, nose and facial features in general has been completed. In women this happens at the age of 16-17 years and in men at the age of 17-18 years. As for older ages, there is no upper limit. So, any person who has difficulty in breathing, snores, or has sleep apnea due to a deviated septum, can undergo septoplasty.
Lately, there is a lot of talk about the use of Laser or Ultrasound in straightening the deviated septum. These are two technologically advanced methods that offer very good results when used in the right cases, that is, in cases with mild and moderate deviation of the septum. In contrast, in more severe cases, the use of the classic surgical method of straightening the nasal septum is the only option. And this, because it is the only technique that enables the treatment of even the most demanding cases and ensures an excellent result that will last over time. In addition, it is the most technically demanding method for the surgeon and for this reason the latter must have appropriate training and experience. It should be noted that Lasers, Ultrasound and Radio Frequencies are routinely used and are very effective in shrinking Hypertrophic Nasal Turbinates. It is considered necessary that the patient be properly informed and discuss with their doctor how the surgery will be done.
If the operation is done properly, as mentioned above, the septum will remain straight forever, allowing free breathing for the rest of the patient’s life.
Again, this is a myth that is unfortunately reproduced very often as this only applies to the mildest nasal septum deviations that are treated with Laser or Ultrasound. In all other cases, which are treated with the classic surgical method, the nasal mucosa inevitably swells due to the manipulations that have been done. Thus, immediately after the operation or immediately after the removal of the very light packing that may have been placed, the patient can breathe perfectly, but this only lasts for a few hours. Subsequently, the swelling of the nasal mucosa makes nasal breathing difficult. So, for the first week the breathing through the nose is moderate and the patient breathes roughly like when they have a cold/sinusitis. Nasal rinse, a special nasal gel as well as the cleaning that will be done in the doctor’s office will help to improve the flow of air through the nose. From the 8th postoperative day onwards, the swelling decreases significantly and gradually subsides completely. The patient breathes better and better, while the final result is noticeable in about 6 weeks after the operation. In the meantime, the nasal breathing is already very good.
Immediately after Septoplasty and for a few days, the patient should follow some simple post-operative instructions. Specifically, the following are recommended:
Septoplasty has a short recovery and the patient’s return to work is rapid. Thus, if it is an office job, it is possible to return to it as early as the third day after surgery. In the case of heavy manual work that includes weightlifting or sudden changes in the ambient temperature it is good to let a period of 10 to 15 days pass before you resume work.
The cost of Septoplasty includes the following:
The final cost of the Septoplasty depends on the following parameters:
In any case, you should discuss the exact cost of the operation with your doctor so that you are informed in advance. It remains a fact that with the right choice of surgeon you can get an excellent result at a very reasonable price.
Deviated septum is a pathological condition that affects many people. Its consequences make their presence felt daily and affect their quality of life negatively. However, there is a definite solution given by Septoplasty. With this operation, every anatomical defect of the area is restored, and the patient acquires a normal breath that gives him energy and well- being.
The nasal septum or nasal septum is a normal anatomical structure inside the nose which plays a very important role in proper and unobstructed nasal breathing. It consists of bone and cartilage and ideally separates the nasal cavity into two equal parts.
There are many causes that can be responsible for a crooked septum such as: injuries, heredity, genetic factors and even pressure on the nose area during childbirth.
People with a crooked septum face a number of difficulties in their daily lives, depending on the degree of the problem. Some of the symptoms of crooked septum are difficulty breathing during the day and during sleep, dryness of the nasal and oral cavity, snoring and frequent upper respiratory tract infections.
You should visit an ear, nose and throat specialist, who will carry out a number of tests to determine the extent of the problem and suggest the appropriate treatment. He will first take a history of the patient and then perform an endoscopy of the nose to get a detailed view of the nasal cavity. Finally, he will check the nasal breathing using a special flowmeter.
The solution in this case is surgery. The aim is to straighten the nasal septum, which in most cases is combined with shrinkage of the nasal cones. It is performed under general anaesthesia and takes about 30-60 minutes.
As before any surgery, it is necessary to do a pre-operative check-up before the operation to straighten the nasal septum. More specifically, blood tests, chest X-ray, cardiac tests and an assessment by the anaesthetist are done. In addition, the patient should be fasted for the previous 6-8 hours and if he/she is taking any medication, he/she should inform his/her doctor.
