Nasal Septum Reconstruction

What is nasal septum reconstruction?

Nasal septum reconstruction is surgery that straightens the nasal septum. The septum is the central wall that divides the 2 nasal passages in the nose.

Another name for this procedure is nasal septoplasty.

When is it used?

Reasons for doing this procedure are:

• The septum is deviated (bent out of shape) from an injury and it is hard for you to breathe through your nose.
• You have recurring sinus infections or pain due to a deviated nasal septum.
• The septum has a blood clot (hematoma) from an injury that does not allow you to breathe normally.
• You have been having a lot of nosebleeds.

How do I prepare for this procedure?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Find someone to drive you home after the procedure. Give yourself time to rest. Try to find people to help you with your day-to-day duties.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you are taking daily aspirin for a medical condition, ask your provider if you need to stop it before your surgery. If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery.

Follow any other instructions your provider may give you. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and during the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given a local or general anesthetic to keep you from feeling pain. A local anesthetic is a drug that numbs the part of your body where you will have the surgery. A general anesthetic will relax your muscles and put you to sleep.

Your healthcare provider makes a cut inside the lining of your nose. If you have a blood clot in the nose, your provider drains it. Your provider will reshape the cartilage so that it will heal in a more normal position. Your provider may put a splint in your nose to hold the cartilage in place. After surgery, your provider may pack thin pieces of gauze into each side of your nose to control bleeding. Sometimes this procedure will be combined with an operation on the bones of the nose if they also need to be fixed.

What happens after the procedure?

You may go home later in the day or you may need to stay overnight in the hospital. How long you stay depends on the extent of the operation, how you recover from the anesthesia, and how much pain you have.

You should sleep in bed with your head raised. You should limit your physical activity for a few days after surgery. This helps decrease swelling and the chance of bleeding.

If you have packing in your nose, your loss of smell will lessen your appetite. You may prefer a liquid or soft diet, but you can eat whatever you feel like eating. It’s best to avoid hot and spicy foods because they may increase bleeding.

You may need to leave the gauze packing in your nose for several days. Avoid all heavy activity for at least 1 week. Don’t push on or jar the nose while it is healing. Don’t blow your nose. It is OK to draw a breath back into your nose and swallow.

If you have packing, it will be removed in 1 to 7 days. After the packing is removed, don’t blow your nose for 48 hours. Also try not to cough too hard. Blowing your nose or coughing may start bleeding.

If you have a nosebleed, contact your healthcare provider. You may need to go to the emergency room if the bleeding lasts longer than 10 minutes. If you start bleeding, gently pinch your nostrils and lean your head forward so the blood does not go down your throat.

Ask your healthcare provider what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

You may breathe more easily. You may have fewer nosebleeds.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• A local anesthetic may not numb the area enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia.
• You may lose some of the feeling in your upper lip or teeth. Your front teeth may become numb because of stretching of nerves that go from the base of the nose down into the front teeth.
• Rarely, the front part of your nose may be flatter than before.
• You may have infection or bleeding.
• Your septum may develop a hole if it doesn’t heal properly.

You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You have a fever over 100°F (37.8°C).
• You have trouble breathing.
• You have a nosebleed that does not stop in 10 to 15 minutes despite efforts to stop it.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.