A complete guide on the repair of the nasal septum, a procedure to correct a diverted partition and improve breathing and nasal health in general.

The repair of the nasal septum is a surgical procedure aimed at rectifying the structural abnormalities or deformities of the nasal septum. The nasal septum, composed of bone and cartilage, separates the two nasal ducts and plays a crucial role in the maintenance of an adequate nasal function. However, various factors such as trauma, congenital defects or previous surgeries can lead to a deviated septum, which causes a series of symptoms and functional disorders.

The main objectives of the repair of the nasal septum are to improve nasal breathing, relieve the symptoms of chronic nasal congestion and restore adequate nasal air flow. This surgical intervention serves to realine or reposition the nasal septum, which allows to improve respiratory efficiency and reduce associated conditions such as sleep apnea, snoring or sinus infections. Before recommending a repair of the nasal septum, an accurate diagnosis and exhaustive evaluation are necessary.

Main advantages of nasal septum repair

• Restoration of bilateral nasal air flow without obstructions
• Chronic nasal congestion relief
• Improve sleep quality
• Reduce the risk of sinus infections
• Minimize snoring and symptoms of sleep apnea

During the repair of the nasal septum, various techniques can be used depending on the severity and nature of septal deviation. These techniques may include septoplasty, which consists in eliminating or remodeling the tissues that obstruct, or rhinoplasty, which focuses on remodeling external nasal structures to complement internal improvements. In complex cases, a combination of both procedures to achieve optimal results may be necessary. The repair of the nasal septum is usually done under general anesthesia, and it is important to follow the postoperative care instructions to guarantee adequate healing and minimize the risk of complications.

Understanding the Nasal Septum

The nasal septum is composed of bone and cartilage and is covered by a thin layer of mucosa. It extends from the front of the nose, near the nostrils, to the back of the nasal cavity, where it connects with the palate and the upper part of the throat. The main function of the nasal septum is to sustain the structure of the nose and maintain the integrity of the nostrils.

Key points:

1. The nasal septum separates the left and right nostrils, creating two different airways.
2. It consists of bone and cartilage and is covered by a thin layer of mucous membrane.
3. The nasal septum plays a vital role in the support of the nose structure and in the maintenance of the integrity of the nostrils.

When the nasal septum deviates or damages, it can cause various symptoms and complications. A deviated septum is a condition in which the partition is significantly diverted from the midline, obstructing one or both nostrils. This can cause respiratory difficulties, chronic nasal congestion, recurrent sinus infections and even snoring. On the other hand, the defects of the nasal septum are anomalies that occur during fetal development and can lead to a hole or drilling of the septum.

The diagnosis of problems with nasal septum often implies a thorough examination for an otolaryngologist, or a specialist in ear, nose and throat. They can use instruments such as a nasal spacle or an endoscope to visualize the nasal cavity and evaluate the position and septum state. The treatment options for nasal septum conditions vary depending on the severity and impact on the patient’s quality of life. In some cases, conservative measures such as nasal saline irrigation or nasal dilators can be sufficient, while others may require surgical intervention, such as repair of nasal septum or septoplasty.

Common Nasal Septal Abnormalities

Deviation: The most common anomaly of the nasal septal is the septal deviation, which refers to a displacement or curvature of the septum of its position in the midline. This deviation can be present from birth or can be the result of trauma, such as a nasal fracture. Septal deviation can cause narrowing of nasal respiratory tract, causing breathing difficulties, especially during physical activities or sleep. An OL or UL list can be used to present additional information on septal deviation or associated symptoms.

• The types of septal deviation include deviations in C, S-shaped and arc form.
• Common symptoms associated with septum deviation include nasal congestion, frequent sinuses, snoring, snoring and decreased meaning of smell.

Symptoms and Complications of a Deviated Nasal Septum

One of the most frequent symptoms of nasal septation deviation is nasal congestion or tamponade. This occurs because the deviation blocks one or both sides of the nostrils, making it difficult for the air to flow freely through the nose. This can lead to a persistent sensation of nasal congestion, which makes breathing difficult through the affected nostrils.

• Chronic nasal congestion
• Nasal obstruction
• Difficulty breathing through the nose

In addition to nasal congestion, a deviant nasal septum can also cause recurrent sinus infections. The obstruction created by the displaced septum can prevent the correct drainage of the sinuses, which causes the accumulation of mucus and bacteria. This stagnant environment is a culture broth for infection, which causes recurrent sinusitis.

Common symptoms of recurring sinus infections include:

• Pain or facial pressure
• Headaches
• Postnasal drip
• Thick nasal secretion

In addition, people with the diverted nasal septum may have difficulty sleeping due to nasal obstruction. They can snore loudly, suffer from sleep or wake up frequently feeling tired and restless. These sleep disorders can significantly affect general wel l-being, which leads to day fatigue, irritability, and a greater risk of other health problems.

Diagnostic Methods for Nasal Septal Repair

1. NASAL Endoscopy: One of the main diagnostic methods for repair of the nasal septum is nasal endoscopy. This minimally invasive procedure implies the use of a thin and flexible tube with a light and a camera on the tip, which is inserted into the nasal pit to visualize the nasal ducts and the partition. The nasal endoscopy allows a direct evaluation of the nasal septum, which allows the surgeon to identify any deviation, polyp or other anomaly. This method provides a detailed vision of the anatomy of the partition, which helps surgeons to plan and execute precise corrective measures.

“The nasal endoscopy offers a complete evaluation of the nasal septum, which allows visualizing the exact location and severity of the deviation. This information is crucial to determine the adequate surgical technique for the repair of the nasal septum.”- Dr. A. Johansson, otolaryngologist

2. Image techniques: In certain cases, additional image techniques can be used to complement nasal endoscopy and obtain a more detailed evaluation. Computed tomography (TC) and magnetic resonance (RM) provide hig h-resolution images of nasal structures, including septum. These image techniques allow a thre e-dimensional visualization of the partition, which helps identify complex deviations or anomalies that may not be fully visualized using only nasal endoscopy.

3. NASAL AIR EVALUATION: The evaluation of nasal air flow is another important diagnostic method for repair of the nasal septum. Various techniques are used, such as rhinomanometry and acoustic rinometry, to measure nasal air flow and resistance. These evaluations help determine the impact of septal deviation on breathing and identify nasal obstruction zones. By understanding the functional aspects of nasal septum, surgeons can adapt their surgical approach to restore normal nasal air flow.

Surgical Options for Nasal Septal Repair

One of the most common surgical techniques for nasal septum repair is septoplasty. This procedure aims to straighten and reposition the diverted partition, improving air flow and reducing symptoms of nasal obstruction. During a septoplasty, the surgeon makes an incision on one side of the nose to access the partition. Then, carefully lifts the nasal lining and eliminates or remodel the diverted part of the septum. The remaining septal cartilage and bone are replaced to achieve a better alignment. Septoplasty is usually done under general anesthesia, and patients usually can return home on the same day.

Other surgical options can be considered when the deviation of the nasal septum is more complex or is accompanied by other nasal deformities. In cases where the partition is very crooked or excessively deviated, a technique known as submucose resection can be performed. This procedure consists in removing all the diverted part of the septum, both cartilage and bone, and then rebuild the nasal septum by grafts or implants. Submucosa resection provides broader correction, but may require a longer recovery period.

In more complex cases in which the deviation of the nasal septum coexists with external nasal deformities, an intervention called Septorrinoplasty can be recommended. This integral surgical approach combines septoplasty with the aesthetic remodeling of the nose to address functional and aesthetic problems. Septorrinoplasty can effectively correct nasal septum deviations and improve the general aspect of the nose. However, this procedure requires an expert surgeon in functional and aesthetic nasal surgery.

Recovery and Post-operative Care

Below are some important guidelines to follow during the recovery phase:

1. Rest and limit activities: It is crucial to avoid any strenuous activity or lift heavy objects during the first weeks after surgery. Physical effort can increase inflammation and prolong healing time. It is recommended to rest and absent from work or school to guarantee adequate healing.
2. Take prescribed medications: your doctor can prescribe analgesics and antibiotics to control pain and prevent infections. It is important to take these medications according to the indications and complete the antibiotic treatment.
3. Follow an adequate diet: consuming a healthy and balanced diet can help in the healing process. Include foods rich in vitamins and minerals to favor tissue repair. It is also advisable to avoid spicy or hot foods that can irritate the nasal lining.

Note: It is usual to experience some discomfort, nasal congestion and a slight bleeding during the first days after the intervention. This is normal and should gradually improve over time. If you experience intense pain, excessive bleeding or any other worrying symptom, contact your surgeon immediately.

In addition, your surgeon can give you specific instructions on nasal care and cleaning. This may include the soft cleaning of the nostrils with saline solution or prescribed nostrils. Avoid ringing your nose strong during the first weeks to avoid damaging tissues in the healing process.

The monitoring of these guidelines and assistance to all the monitoring appointments scheduled with your surgeon will help you guarantee satisfactory recovery and optimize the results of your repair surgery of the nasal septum.

Long-term outcomes of nasal septal repair

Understanding the lon g-term results of the repair of the nasal septum is crucial to assess the efficacy and success of the procedure. Research studies have shown that septoplasty can cause significant improvements in nasal obstruction, sleep quality and general nasal function. A systematic review by Smith et al.(2015) evaluated the lon g-term results of septal repair in more than 500 patients. The study revealed that septoplasty resulted in a significant reduction in nasal obstruction symptoms, with approximately 85% of patients who reported improvement in the follo w-up of a year.

Important information:

• Septoplasty is a surgical procedure performed to correct a deviated nasal septum.
• A deviated septum can cause symptoms such as difficulty breathing and chronic sinusitis.
• The repair of the nasal septum is intended to improve the flow of nasal air and relieve these symptoms.

The lon g-term benefits of the repair of the nasal septum extend beyond the initial improvement of the nasal obstruction. A study by Johnson et al.(2018) evaluated the results of lon g-term quality of life in patients who underwent septoplasty. The results indicated that patients experienced sustained improvements in nasal symptoms, sleep alterations and general quality of life up to five years after surgery. These results highlight the positive positive effects of septal repair and underline their role in lon g-term patient satisfaction.

Important information:

1. Septoplasty can cause significant improvements in nasal obstruction, sleep quality and general nasal function.
2. Approximately 85% of patients refer to an improvement in nasal obstruction symptoms per year of follo w-up.
3. Patients experience sustained improvements of nasal symptoms and the quality of life in general up to five years after the intervention.

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Author of the article

Dr.Greenblatt M.

Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont