Septoplasty (Repair of Deviated Nasal Septum)
A septoplasty procedure is designed to repair and straighten the nasal septum. The septum represents the natural inside division between the two sides of the nose. Although not clearly visible, the nose septum plays a crucial role in both nasal function and appearance. Therefore, a septum that is misshapen and deviated can contribute to nasal breathing obstruction and certain nasal deformities. Once it is determined that the deviated nasal septum contributes to nasal breathing obstruction, medical treatment will not be able to correct it but surgical septal straightening may be indicated. A septoplasty is a procedure commonly performed by ENT surgeons and facial plastic surgeons. The septum is also frequently worked on during cosmetic rhinoplasty; for instance, to achieve the aesthetic goals, to improve the nasal airway or to harvest some cartilage for structural nasal grafting.
Most commonly, the septoplasty is performed to improve nasal breathing. Usually, it is performed through inside incisions and the procedure will not change the outer appearance of the nose. The surgeon will isolate the structural components of the septum (i.e., cartilage and bone) in order to re-position the septum into a more midline position. This can be achieved by removing parts of the cartilage and bone that hold the structure in a deviated position. Additionally, bone and cartilage can be re-shaped and repositioned without actually removing it. The inside nasal incisions are usually sutured with absorbable material. The use of post-operative nasal packing varies from surgeon to surgeon.
Septoplasty surgery can be performed under general anesthesia or conscious sedation (twilight sleep). The procedure may take about 30 minutes, although this may be shorter or longer depending on the complexity of the surgery.
Recovery after Septoplasty
During the immediate recovery, a patient will experience nasal obstruction. Once the swelling subsides, the improvement in nasal breathing will become apparent. A one-week recovery is usually expected.
The Straight Septum
Physicians who have inspected thousands of noses are often surprised that the appearance of the septum may not predict a person’s sense of nasal obstruction. In fact, there is probably nobody who naturally has an arrow-straight septum void of deviation. Therefore, the ultimate goal of a septoplasty is not a straight septum but improved nasal breathing. What is the difference? One has to determine BEFORE the surgery whether a septoplasty has a good chance of achieving better breathing. Understanding a patient’s nasal complaints, possible medical conditions contributing to nasal obstruction and a thorough nasal examination including assessment of other reasons (i.e. large turbinates, nasal valve collapse, sinus disease) are important steps in preparation for successful septoplasty surgery.
Is Septoplasty covered by Health Insurance?
Every health insurance has different inclusive and exclusive criteria for elective surgery coverage. In general, if a septoplasty is performed in order to improve nasal breathing, insurance company considers coverage. Functional rhinoplasty commonly includes repair of the nasal septum and may be covered by health insurance. Rhinoplasty as a cosmetic nasal reshaping procedure is rarely paid for by insurers.
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