Surgery of a curvature of the nasal septum
introduction
The curvature of the nasal septum, which in technical terms also Septal deviation called is a deformation of the nasal septum. There are congenital curvatures of the nasal septum and those caused by trauma. A very pronounced curvature in particular can be very annoying for those affected, as it hinders nasal breathing and can cause other complaints such as snoring, headaches and nosebleeds.
Curvature of the nasal sheath wall can only be corrected by surgery. This is usually carried out as an inpatient. In individual cases, however, outpatient interventions are also possible. In the case of a surgical correction of the curvature of the nasal septum, it is important that the result is both aesthetically satisfactory and that the function of the nose is not impaired by the operation.
The operation is carried out when the patient has severe discomfort and a high level of suffering. The aim of the operation is to restore nasal breathing and an aesthetic correction of the outer and inner nose. The symptoms should no longer exist after the operation.
The following article deals with the operation of a curvature of the nasal septum wall and explains interesting aspects, such as the operation procedure and the risks.
Indications
An indication, i.e. a reason, for an operation is only given when a curvature of the nasal septum is actually present. If so, there are various symptoms and clinical findings that warrant surgery.
In the following section you will find an overview of important indications for surgery:
1. A constant or intermittent obstruction to nasal breathing
2. An obstruction of nasal breathing with secondary diseases such as snoring, otitis media or mouth breathing;
3. Constant nosebleed that is difficult to stop (epistaxis);
4. Changes in the shape of the outer nose caused by the curvature of the nasal sheath wall;
5. If there is also a tumor of the nose;
6. To improve breathing mask therapy for obstructive sleep apnea;
7. Serious aesthetic impairment, even in the absence of a functional disorder of the nose;
8. Dysfunction of the nose, for example disturbance of the olfactory function, impairment of the voice
Procedure of the operation
There are many different specialized surgical techniques that are used to treat a curved septum. Individual surgical steps are adapted to the individual curvature.
In general, the operation proceeds as follows: The operation usually takes place under general anesthesia, which an anesthetist will explain in advance. The treating surgeon also clarifies the surgical procedure itself in advance.
No externally visible incision is required to straighten the nasal septum; access is usually through the nostrils. The surgeon works under the nasal mucous membrane and removes parts of the cartilage and bone from the nasal septum. These bent parts are straightened and then put back in their correct position. Finally, two plastic sheets are placed along the nasal septum to splint and support it.
The turbinates are often also made smaller. Turbinates are cavernous bodies located in the nose. Since they are very often enlarged in the case of a curvature of the nasal septum and thus additionally limit the function of the nose, a reduction in size is often useful. This can be done, for example, with a laser or with the help of electric current (electrocoagulation).
A piece of the mucous membrane or bone can also be removed.
At the end the incisions in the mucous membrane are closed with self-dissolving sutures. After the operation, the nasal cavity is filled with a so-called tamponade, which collects wound secretion and blood. In some cases, however, the tamponade can be dispensed with.
Read more about the topic at: Nasal septum OP
Outpatient treatment
As a rule, the operation of a curvature of the nasal septum is carried out under general anesthesia. However, there are individual cases in which an outpatient operation can be performed. However, the doctor must clarify with the patient individually whether this is possible.
An uncomplicated curvature of the nasal septum wall is a prerequisite for an outpatient operation. Furthermore, the patient must be in good general health and have good home care for the days after the operation. Since the patient is not allowed to drive himself after the operation, he or she has to be picked up by a person, for example a relative.
After the operation, daily follow-up care should take place in the operation center, which must be easily accessible for the patient. Since it is very important to take it easy after the operation, the patient shouldn't drive here either, but rather let himself be driven. It must also be ensured that the patient comes to the clinic immediately in the event of an emergency.
Very old people or people with many illnesses are therefore rather out of the question for an outpatient operation.
Duration of the operation
An uncomplicated correction of a curvature of the nasal septum usually takes about 30 to 40 minutes. The operation can take longer if it is a complicated curvature or if, for example, other malpositions of the nose have to be corrected. As a rule, however, a duration of one hour is not exceeded. This is usually followed by an inpatient hospital stay of 4 to 5 days.
costs
The costs for the operation of a curvature of the nasal septum are borne by the health insurance companies if there is a functional impairment. This is, for example, impaired nasal breathing or secondary diseases such as sinus diseases. Only cosmetic reasons cannot be asserted with the health insurance company, so that the costs have to be borne by yourself.
The cost of an operation is very different. For example, inpatient operations are more expensive than outpatient interventions. The costs also depend on the technology used and the surgical effort. Individual advice is therefore most useful. The follow-up treatments are also expensive, so that the costs can quickly skyrocket with a private bill. An approximate estimate in the lower four-digit range makes sense.
Risks
There are certain risks involved in using a curved nasal septum. During the operation, nerves, blood vessels, soft tissues, cartilage and bones can be injured. Furthermore, intolerance to the anesthetics is possible. Postoperative bleeding, wound infections and dry nasal mucosa can occur. There is also the possibility that, despite the operation, the functional and aesthetic result will not be optimal.
Nasal breathing is particularly difficult immediately after the operation. Headaches, sensory disorders of the nose, olfactory disorders and a feeling of pressure are possible. Days and weeks after the operation, there may be bleeding from the nasal septum (septal hematoma), a hole in the nasal septum (septal perforation) with sagging of the bridge of the nose, or an abscess. In general, however, the risks are limited with physical restraint and good aftercare.
In children it should be noted that the nose can continue to grow after the operation. Changes in shape and, in the worst case, deformities can occur. Therefore, it must be carefully weighed whether such an operation in childhood and adolescence makes sense. As with any operation, however, the following fact must be taken into account: Complications and risks are in principle always possible. However, serious complications are very rare.
