Septoplasty
is a surgical procedure to correct a deviated or crooked nasal septum. Patients
often complain of nasal block and congestion, which can disturb their sleep.
They may also have symptoms of rhinitis such as runny nose, sneezing and
postnasal drip. Some patients have a deviated nasal septum as a result of
trauma or blow to the nose.
Turbinate
surgery refers to a procedure performed to reduce the size of the enlarged
nasal turbinates, which often contribute to the nasal block and congestion.
There are many methods how the ENT surgeon reduce the size of the turbinates.
Regardless of the surgical method used, the turbinates may slowly increase back
in size if patients do not take care of their allergies.
The ENT surgeon may put the patient on a trial of medication which include nasal sprays and antihistamine to control their allergies. If the nasal block is still not relieved or minimally relieved with medication then septoplasty and turbinate surgery should be considered. However in severely deviated nasal septum especially post trauma, medication often bring little improvement. Septoplasty can also be indicated for recurrent epistaxis.
Complications
of septoplasty and turbinate surgery are uncommon however patients should be
aware of the possible complications including bleeding, infection, nasal
crusting, numbness and septal perforation.
General care after septoplasty and turbinate surgery
The nose may
be packed after surgery and patients are warned to breathe through their mouth
upon waking up from surgery. The nasal pack is usually removed the following
day after surgery. Following nasal pack removal, patients should expect
bloodstained nasal secretions for a few days. Patients should not blow their nose for about 10-14 days. When sneezing, patients should keep their mouth open to reduce built-up
pressure in the nose.
Patients
may also experience swelling and pain around the nose including numbness of the
upper teeth; which usually resolve in a few weeks.
Patients
are advised to take light soft cool diet when awake after surgery. Hot food and
drinks are to be avoided for a few days after surgery.
Patients
should rest with their head elevated on 2-3 pillows to reduce swelling around
the nose area. Patient should also avoid straining and lifting heavy objects to
reduce risk of bleeding.
Medications
that can thin the blood, such as Aspirin and Warfarin, should be avoided until
advised by the ENT surgeon.
The ENT
surgeon would often prescribe nasal douching where patients will flush the
nasal cavities using saline irrigation for a few weeks. This will ensure good
healing and prevent formation of dried crusts or blood clots. Patients will
also be prescribed with a course antibiotic that should be completed.
Patients
are also expected to take some time off until the doctor says it is safe to
return back to work. Patient should refrain from smoking or exposure to smoky areas as this can impair healing and cause further irritation to the nose.
When should you see your ENT surgeon urgently?
- Continuous
bleeding despite nasal compression and ice
- Increasing swelling over the nose
and eyes
- Persistent high grade fever >38 Celcius
- Severe pain or headache
not relieved by the pain medication given.
