Being unable to breath through the nose effectively is a concern for many people. Normally, inspired air passes through the nose before it reaches the lungs and in that process, it has been properly warmed, humidified, and cleaned. The importance of effective nasal airway breathing cannot be over emphasized. The physiologic cleaning and filtering function of the nose is important for proper pulmonary function and overall good health. Mouth breathing bypasses those important functions and can lead to a host of health problems. A nasoseptoplasty can often correct the problem.
Nasal Obstruction
Everyone has had a cold or allergies at some point in their lives and had difficulty breathing through their nose. There are many problems both acute and chronic that can cause nasal obstruction. Difficulty breathing through the nose, whether it is from disease, the way you were born, or from trauma, should be assessed and corrected. Dr. McMenamin is an experienced otolaryngologist as well as a cosmetic surgeon and can evaluate you for the specific cause of the nasal obstruction. Structural abnormalities of the nose that are contributing to the inability to breathe normally can usually be remedied with medical or surgical treatment.
Deviated Septum
Trauma to the nose and abnormal growth of the cartilage that separates the nose are two common reasons for internal nasal obstruction with nasal trauma being the most common. Contact sports such as skateboarding, snowboarding, skiing, and bicycling have increased the incidence of nasal fracture resulting in crookedness and deviation of the septum. This has given rise to an increase in trauma to the nose, increase in nasal fracture, and subsequently an increase in nasoseptal deviation and crookedness. Often, this results in chronic nasal obstruction and decreased nasal airflow. Less often, trauma from birth can cause internal nasoseptal airway obstruction that persists to adulthood.
A very common cause of septal deviation is unusual nasoseptal growth. If there is not enough room in the nose for the septum to grow normally, it will become crooked and buckle inside the nose. This leads to a deformity of the cartilage and bone of the septum and the obstruction of airflow through the nose.
The Surgery
Your surgery will be performed in the comfort and safety of our fully accredited operating room. It is performed under local anesthesia with monitored IV sedation. We do not use intubation (a tube put down your throat) to help you breathe. You will be made very comfortable and slip in and out of sleep during the procedure. This anesthesia technique decreases your risk of post-op nausea and vomiting, as well as other risks associated with general anesthetics.
During the surgery, a topical anesthetic is applied inside the nose to numb it. Then, a local anesthetic is injected to completely numb the nose. You are sedated during this process and may not remember it.
Dr. McMenamin uses an incision hidden inside the rim of the nostrils. He has over 25 years of experience performing this surgery with very successful results. The soft tissue is elevated away from the septum and the abnormal cartilage and/or bone is removed and/or straightened. Sutures are used to close the incisions.
At the completion of your surgery, Dr. McMenamin may apply tape and a plastic "cast" to stabilize your nose during the healing process depending on the amount of work needed and if a rhinoplasty was performed at the same time. You will also have soft, flat silastic “splints” to stabilize the inside of your nose. Following that, your nose will have some packing inserted to further stabilize the tissues and prevent bleeding. A gauze pad will be taped under the nostrils to catch any drainage. Additional surgery on the outside of the nose may require additional dressings.
You will leave our office with extra gauze pads, pain medication, post operative instructions, and Dr. McMenamin’s home phone number. Occasionally, you may be on antibiotics for 5 – 10 days depending on the amount of surgery done. We will be seeing you back for a post operative evaluation the day after your surgery.
Home Care
Directions for post operative care will be provided to you in writing and verbally. For nasoseptoplasty surgery, we recommend the following:
Take Tylenol on a regular basis as directed on the bottle whether you are having pain or not starting as soon as you get home. Do not take the prescription pain medication for the first 24 hours to prevent nausea. Remember, your nose is going to be numb when you first go home.
Stay elevated even to sleep. This will discourage swelling and therefore minimize pain. A recliner chair works best. If you don’t have one, we recommend you borrow one or rent one.
Start icing. Detailed instructions will be given to you by the office staff, however, we want you to ice 20 minutes out of every hour around the clock for 3 days and 12 hours out of the day for the second three days.
Minimize facial movement. Don’t do a lot of talking, laughing, and chewing. We recommend a soft diet. Cold things are better as they cool from the inside of the mouth.
Drink plenty of a variety of fluids and watch salt in your diet. Salt causes you to retain fluid and swell more.
Change the drainage pad as needed. The more fluid that comes out, the better.
There will be additional instructions as you go through your recovery. Nasal irrigation with salt water and the use of other nasal medications will be explained to you. Expect to have swelling, bruising, and mild to moderate discomfort that will resolve with time. Being able to breathe normally through your nose is well worth the short time for recovery.
With septoplasty alone, most patients are able to return to work in about one week. Everyone heals at different rates and tolerates the discomfort and inconvenience of surgery differently.
We hope this information has answered many of your questions regarding nasoseptoplasty (septoplasty). If you have other questions, please feel free to call us. (916) 564-8888
