Nasal septum repair operation: causes and indications



It is well known that the human body can receive the oxygen it needs in only two possible ways: by inhaling through the mouth or nasal cavity. Although nature has given us this choice, the most physiologically attractive is breathing through the nose.

So, passing through the nasal cavity, the inhaled air becomes the safest for the body.

The nose serves as a kind of filter, on the mucous walls of which about 80% of dust particles and various microorganisms in the inhaled air settle. Passing through the nasal passages, the air is warmed, approaching the usual temperature of the human body, and moistened.

But in some cases breathing through the nose can be very difficult, and in some cases completely inaccessible.

There can be several reasons:

• Allergic reactions to one or more irritants, expressed in the swelling of the nasal passages, preventing the free passage of air through them.
• Infectious diseases are leaders among the causes of difficulty in nasal breathing. Multiplying in the nasal cavity, pathogens cause swelling of the mucous membranes, narrowing the airway lumens.
• Foreign bodies in the nasal cavity. These include buttons, balls, peas, designer parts, and other small items that are mostly children’s nose, and various neoplasms, such as tumors, growths, or polyps.
• Physiological causes. The reasons for the deterioration of nasal breathing in this case are often two:
  1. Problems with the mucous membranes may be due to its underdevelopment, for example, premature babies or children of the first months of life. The same oppressed mucous can be the result of abuse of vasoconstrictor drugs. In all these cases, nasal breathing is extremely difficult and causes a lot of inconvenience.
  2. Anatomical deformations of the structures of the nasal cavity. The most common in this case can be identified the problem of a curved nasal septum. It should be noted that in most cases, people with such a diagnosis are prescribed an operation to correct the nasal septum, which helps to improve the patient’s quality of life.

Curved nasal septum provokes the development of a variety of symptoms, which can cause an appeal to the otolaryngologist. After conducting an appropriate examination and interviewing the patient, the doctor will be able to answer the question whether the nasal septum is indeed crooked and decide if a nasal septum is required in this case.

The indications for surgery to correct the nasal septum may be one or more of the following pronounced symptoms:



• Periodic than not justified nasal bleeding.
• Sensation of dryness in the nasal cavity, periodically accompanied by a feeling of tightness.
• Injuries that led to a change in the shape or symmetry of the nose. Often, it is precisely because of injuries that the cartilage and the bones of the nose, which constitute the nasal septum, radically change their position. The incision of the nose, which was not carried out in time, is fraught with an incorrect accretion of the septum and, as a consequence, hindered nasal breathing. Such cases are a direct indication to refer the patient for surgery to correct the nasal septum.
• Snoring quite often accompanies a person who has a curved nasal septum, as it interferes with the free flow of air during breathing.
• Inflammatory processes of mucous surfaces and sinuses of the nasal cavity, chronic rhinitis. Among them are the most familiar to all diseases such as sinusitis, pansinusitis and sinusitis. Their occurrence is associated with the difficulty of outflow of rejected mucous membranes, and during inflammation and purulent discharges due to the difficult passage of the nasal passages, resulting from difficult, non-physiological breathing in the presence of a curved nasal septum.
• Obstructed nasal breathing can be observed from either side of the nose or include both nasal passages. More often, difficult passage of air is observed from the side from which the cartilage is most deformed. If a person has a rather large nasal cavity, then the diagnosis made by him at an otolaryngologist's appointment can be a big surprise.
• Frequently repeated rhinitic allergic reactions, accompanied by sneezing, irritation of the nasal cavity, mucous discharge, absence or severe obstruction of nasal breathing.

All of the above symptoms often accompany the curved nasal septum, which is an indication for septoplasty .

Septoplasty is a nasal septum repair operation, during which the doctor with a surgical intervention aligns the deformed nasal septum. In this case, the correction is carried out with the fullest possible preservation of the bone and cartilage structure of the septum.

Many people simply cannot decide on the operation to correct the nasal septum due to fear. While suffering from persistent breathing problems, headaches, bleeding, and cold, they nevertheless avoid any interventions.

Those who are still tired of everyday problems with nasal breathing, but still have not decided to confide in experts, are advised to read the reviews of patients who have undergone nasal septum repair. Overwhelmingly, they describe how their lives have changed after the operation for the better. Many of them say that for the first time in years they have got rid of the nasal congestion, they re-smell, they have got rid of the usual snoring and much more.

Also, a person who decides to septoplasty is faced with the question of choosing a medical institution. Someone gives preference to public hospitals, where, according to the testimony of the doctor, surgery is carried out free of charge, relying on many years of experience and highly qualified surgeons. And some prefer private clinics, where the patient can be provided with greater comfort and attention of the staff.

The cost of the operation to correct the nasal septum in private clinics depends on the country and city in which it will be performed, the medical equipment of the hospital and the qualifications of the medical staff, the type of anesthesia and methods of surgical intervention, as well as on the additional services chosen by the patient.

The operation itself to correct the nasal septum on the territory of the Russian Federation will cost the patient the following amount:

• In Rostov-on-Don from 17,000 to 25,000 rubles.
• In Surgut, the same operation will cost an average of 19,000 rubles.
• In Vladimir for her will have to pay from 30,000 to 37,000 rubles.
• In Moscow, about 40,000 rubles.

In Ukraine, prices are slightly different from Russian. So, in Kiev, the operation to correct the nasal septum averages 7025 hryvnia.

Types of Nose Alignment Operations

Since only 5% of people have an ideally flat, nasal septum located on the site provided by nature, it is not surprising that the operation on the nasal septum is quite common.

The septum of the nose is curved on one or both sides. Curvature are C-shaped and S-shaped, may be located in the front or rear of the nose. The nasal septum can not only be bent in different directions, it can also be shifted away from the center. In particularly difficult cases, the curvature of the nasal septum can combine various types of defects.

So how is the operation performed to level the nose and nasal septum? In fact, there are several ways to achieve the desired. With each method, the surgical approach is obtained endoscopically, through the nasal cavity, which excludes incisions on the skin and, accordingly, subsequent scars and scars.

At the beginning of the operation on the nasal septum, the surgeon lubricates the patient's nasal cavity with a special vasoconstrictor solution. Thus, not only blood loss is reduced, but also the nasal passages are increased, which also facilitates access to the problem area to be corrected. After that, the doctor separates the cartilage plate from the outer shells.

Depending on each case, the surgeon may:

• To perform a resection (clipping) of the curved part of the cartilage.
• Remove the curved cartilaginous nasal septum entirely. Give it a perfect shape and place it back, securing it between the grafts of the perchondrium and the nasal mucosa with the help of typed connecting seams.
• In some cases, the partition itself may be completely flat, but at the same time shifted in any direction relative to the center. In this case, the surgeon at this stage of the operation to align the nose centers it and fixes it in a true harmonic position.

At this stage of the operation, the doctor may also perform additional surgical procedures, such as the removal of polyps or cysts, since the separation of operations may lead to complications .

Having brought the nasal septum into the proper form (usually it takes from fifteen minutes to an hour and a half), the surgeon fixes it tightly twisted turunda - gauze strands, tamponing the patient's nasal passages.

In some cases, for these purposes, silicone nasal splints are used, equipped with tubes, through which the patient can breathe immediately after the operation on the nasal septum.

These turunds and splints play the role of a kind of frame that holds the nasal septum in the correct position, allowing it to settle down much faster in the corrected state. Such support is necessary for two days. After this time, turunds are removed. After half a month, the patient can return to the usual way of life and go to work. The only thing he needs to remember is the ban on weight lifting and excessive exercise during the month after surgery.

Along with classical surgical interventions in modern medicine, operations are also performed on the nasal septum performed with the help of a laser.

However, this type of surgery is suitable only for a small adjustment of the nasal septum in the area of ​​cartilage. Using a laser curve, the deformed part of the septum is heated and instantly fixed in the desired position using silicone or gauze tampons. The whole operation takes only twenty minutes and can be performed under local anesthesia.

Also, a great advantage of this procedure is extremely low blood loss and a high probability of non-development of inflammatory processes in the postoperative period, since when the laser beam touches the tissues, any wounds appear to be “sealed” by the coagulation itself.

Reimplantation is another type of nose alignment surgery. This method is based on the restoration of the unrepairable septum by cartilage transplantation. Donor material can serve as the human nasal cartilage itself, collected literally piece by piece, and its cartilage tissue taken from other places. In most cases, the necessary material is taken from the ear of the patient, much less often it is necessary to resort to the removal of cartilage tissue from the lower ribs.

Septoroplasty is a paired operation in the nasal area, designed not only to correct the nasal septum of a person, but also to cosmetically improve the patient's appearance (reduction, increase, correction of a nasal back, humpback or asymmetry of the nose) using plastic surgery.

Ultrasound cristotomy is performed endoscopically with an ultrasonic scalpel. When ultrasound tissue dissection, the damaged capillaries are instantly baked and plugged at the dissection site. It serves as a guarantor of low blood loss and blocks access to infections. This type of surgery is most often used in complex operations when a large number of various deformities need to be corrected.

Comb in the nose: operation as a way of deliverance

During growth, the human body develops unevenly. Bones and cartilage grow at different rates. One of the consequences of such unevenness may be the formation of ridges and spines in the nasal cavity, which leads to difficulty in nasal breathing and many other problems.

Also, some traumatic effects, such as a nose fracture or a strong blow, can lead to a nose comb. The operation in such cases will help correct the situation and return the natural physiological nasal breathing to normal.

Ultrasonic cristotomy or laser removal is most suitable for the removal of the nose comb.

Nasal septum resection - pros and cons

Nasal septum resection is a special type of surgery. Being a classic for a little more than two hundred years, this type of operation is still widespread, although it has many drawbacks, especially compared to some more modern types of operations.

From the very name of the operation (resection from the Latin “clipping”) it can be concluded that it removes a significant part of the nasal septum.

Submucous resection of the nasal septum is quite simple in its execution.

1. Under general anesthesia, the patient is dissected from the mucous membrane in the anterior part of the nasal septum from top to bottom and forward.
2. As a result, the perchondrium together with the mucosa should be completely separated from the cartilage.
3. It is important to check the depth of the incision on both sides to avoid tearing the mucous membrane.
4. Next, the cartilage wall is almost completely removed. The surgeon leaves only its upper part.
5. The bone septum is also destroyed and removed.
6. As a result, the corrected nasal septum consists of the upper residue of the cartilaginous septum, two flaps of the mucosa, periosteum and perchondrium.
7. The surgeon, carefully connecting the restored partition, fixes the result with stiff turunds without stitches.

The resection of the nasal septum itself does not take much time. The simplicity and accessibility of the correction, which does not require the availability of expensive equipment, makes this type of treatment available in any public hospital free of charge.

It should be realized that for all the simplicity of this type of surgery, there are certain risks and disadvantages:

• It is necessary to be extremely careful with the nose after the operation, since the septum becomes rather weak, mobile and subject to external influences.
• Almost completely removing the bone and cartilaginous skeleton of the nose, a person may suffer from a change in its shape, in particular from a saddle-shaped retraction of the back of the nose.
• The processes of cellular nutrition of the mucous membranes in the case of resection of the nasal septum are severely disturbed, which leads to disruption of the functions of these tissues and causes dryness and periodic itching.
• The postoperative period for resection of the nasal septum is 14-18 days. In case of complications, the attending physician can extend rehabilitation.