Septoplasty Surgery in Hyderabad, India | Cost & Procedure Benefits

Contraindications are the conditions in which septoplasty is usually avoided. Contraindications of septoplasty may include the following medical conditions:

• Large septal perforation: A significant hole or opening in the septum creates a link between the right and left nasal cavities. 
• Malignant lymphomas: Group of blood cancers in the lymphatic system.
• Monoclonal T or B cell proliferations: Abnormal and uncontrolled growth of either T lymphocytes or B lymphocytes.
• Wegener granulomatosis: Rare autoimmune disorder where the blood vessels become inflamed in various organs.
• Cocaine abuse
• Concurrent diseases such as 
• Rhinosinusitis: A condition that is characterized by inflammation of the nasal cavity and sinuses
• Vasculitis: Inflammation of the blood vessels
• Cases where sufficient medical treatment has not been attempted
  

Septoplasty benefits include improving symptoms caused by a deviated septum, such as difficulty in breathing due to the restricted airflow. The benefits of the septoplasty procedure mainly revolve around improving the airflow through the nasal passages, which may result in several benefits that include:

• Treats breathing problems
• Reduces snoring
• Allows the sinuses to drain better 
• Improved sense of smell
• Reduced nasal congestion
  

An appropriate candidate for deviated nasal septum surgery (septoplasty) will be selected based on the patient's symptoms and physical examination. Before deciding to perform septoplasty, a surgical ENT or plastic surgeon may consider the following:

• Patient Evaluation: The patient's complete medical history and nasal symptoms are considered, which are important factors in assessing other sinus or overall issues such as allergies.

• Medication history and surgical history: Surgeons prefer to obtain more patient information to thoroughly assess the patient's condition. This includes surgical history, whether the person has had any previous nasal or sinus surgery, reactions to anaesthetics or bleeding conditions, and medication history, especially drug history such as nasal decongestants and corticosteroids and any recreational drug use.

• Physical examination: Patients may be thoroughly examined. A complete neck and head examination will be performed. Flexible nasendoscopy may be carried out to look for signs of sinonasal disease (including rhinosinusitis – inflammation of the sinuses or nose) or masses in the posterior nasal space, especially when the results of the anterior rhinoscopy does not match with patient symptoms, where it detects the problems in the back of the nose when the front of the nose looks normal.
• Nasal Examination: Scoring systems such as the Nasal Obstruction Symptom Evaluation (NOSE) scale would be used to grade the nasal obstructive symptoms to better understand the severity of the symptoms. Nasal septum deviation symptoms often include nasal congestion, noisy breathing, nosebleeds, facial pain, snoring, and chronic sinusitis.
• Internal nasal examination: When examining the nasal septum, the surgeon will look at the quality of the mucosa (to assess the signs of inflammation) and the size and nature of the turbinates, especially the inferior turbinates. If the patient has poor access because of overly large turbinates, the surgeon may recommend turbinoplasty to access the septum easily. The surgeon will palpate (feel) the septum to evaluate the size, location, and nature of the deviation and observe specifically whether it is bony or cartilaginous and whether there are any bony spurs, septal perforations, or dislocations.
• External nasal examination: An external nasal examination will be made to observe any external deformities, check the movement of the nostrils during breathing, and evaluate the degree of the nasal tip support. Cottle's maneuver also performs to assess internal valve stenosis (narrowing in the internal nasal valve) to evaluate both external and internal problems of nasal structures and function. If previous septoplasty has been performed, septal palpation with a cerumen curette or cotton-tipped applicator will be used to determine how much cartilage or bone remains inside the septum.

• Cosmetic considerations: The surgeon will discuss the patient's functional issues (breathing issues), aesthetic concerns, and goals to plan the septorhinoplasty.

• Surgical Plan: The surgeon calculates the deviation angle to find its type and considers it before planning the surgery. Deviated nasal septum types are mainly classified into four categories based on the degree of their deviation includes Type I (normal)—naso septal angle less than 5°, Type II (mild deviation of nasal septum)—naso septal angle from 5° to 10°, Type III (moderate)—naso septal angle from 10° to 15°, Type IV (severe)—naso septal angle more than 15°. A thorough examination may assist in choosing whether surgery is required, the difficulty level, and the best technique and approach that would be most suited for the patient. Based on that, the surgeon plans the surgery.

• Patient Expectations: The surgeon discusses the patient's expectations to manage them by discussing the realistic outcomes.

• Risk Assessment: As per the patient's age and overall health condition, the surgeon analyses the risks of the surgery and tries to minimize them. Before septoplasty, the surgeon talks with the patient about the benefits and risks of the surgery.

Goals of the Surgeon

Goals of the surgeon in performing nasal septoplasty:

• To separate the right and left nasal cavities
• To enhance the adequate or proper airflow (breathing)
• To preserve the dorsal and tip support of the nose
• To eliminate the secretions
  

Before performing a nasal septoplasty, anaesthetics or surgeons review the patient's medical history to decide the best type of anaesthesia, the following are the other preparations:

• Enquiry about medications the patient has been taking, such as drugs, supplements, or herbs. The surgeon will ask patient to stop taking any medicines that make it hard for the patient's blood to clot two weeks before the surgery.
• Stoppage of smoking is recommended before the surgery to decrease the chances of developing complications and to improve long-term health because smoking stops the nose from clearing mucus properly and may increase the feeling of a blocked nose.
  

During the procedure

Surgical correction of nasal septum defects is the only way to improve airflow through the nose. Many surgical approaches and techniques have been used, such as endoscopic septoplasty and open septoplasty procedures.

Most of the simple septoplasties will be performed by most ENT surgeons. Rhinologists or facial plastic surgery specialists will perform revision or more complex procedures with or without rhinoplasty. However, plastic surgeons also perform septoplasties. The following are the nasal septoplasty procedure steps:

• Most patients will receive general anaesthesia for septoplasty, but in some patient’s local anaesthesia is given. Septoplasty may take about 1 to 1 ½ hours. Most patients might go home within the same day.

• The area that is blocked by cartilage or bone will be repositioned or taken out to fix the problem. This procedure repairs or fix a bent, crooked, or deformed nasal septum blocking the nose's airway.

• The entire procedure takes place inside the nose. Initially, the surgeon makes an incision (cut) inside one side of the wall of the patient nose and lifts the mucosa membrane (a thin membrane that covers and protects the septum) to reshape the septum bone and cartilage.

• Surgeons may remove parts of the bent bone and cartilage and put the rest back in a straight position. Afterward, surgeons move the mucosa back to its position, and the incision site will be sutured with absorbable material (dissolving stitches) that may dissolve or disappear on its own over time.

• On both sides of the nose, splints or soft packing (packed with cotton or spongy materials) will be inserted to hold the shifted septum tissue in place to prevent nosebleeds and reduce the risk of scarring.

• Typically, the splints remain for one to two weeks or are usually removed after a week in the hospital. After surgery, it is common to have some swelling or drainage and small amounts of bleeding. However, these septoplasty side effects are normal and generally fades within a few days.

After the procedure

After the procedure, the medical team will care for the patient until the anaesthesia wears off. Most of the patients may go home on the same day as surgery. The surgeon gives a list of post-operative instructions to manage swelling, bleeding, and pain.

It is recommended to avoid lifting heavy weights and exercise during recovery because these activities may cause increased blood pressure and heart rate, which could lead to additional pain, swelling, and bleeding.

However, it is advisable to visit the hospital if the patient experiences any of the following issues: that includes;

• Pain
• Hearing loss
• A change in the sense of smell
• Runny nose