What is the Nasal Septum?
The nasal septum is a thin wall that separates the left and right nasal cavities, forming the central support structure of the nose. It consists of both cartilaginous and bony components. The anterior (front) part of the septum is primarily made of the septal cartilage, which provides flexibility and shape to the nose. The posterior (back) part is composed of bone, offering rigidity and structural support.
The septum is covered by a mucous membrane lining, which contains blood vessels and nerves essential for the normal functioning of the nasal passages. Any deviation or deformity of the septum can disrupt the normal anatomy and lead to functional problems.
Function of the Septum
The nasal septum plays several critical roles:
- Airflow Regulation: By dividing the nasal cavity into two separate airways, the septum helps regulate and direct airflow, ensuring efficient breathing through both nostrils.
- Structural Support: It provides the necessary support for the external shape of the nose, contributing to its aesthetic appearance and integrity.
- Filtration and Humidification: The septum supports the mucous membranes that trap dust, allergens, and pathogens, while also humidifying and warming the inhaled air before it reaches the lungs.
- Olfaction: Proper airflow facilitated by the septum is essential for the sense of smell, as it directs air to the olfactory receptors located in the upper nasal cavity.
Any deviation of the septum can compromise these functions, leading to symptoms that may necessitate surgical correction.
How Do I Know If I Need a Septoplasty?
A deviated septum can result from congenital factors, injury, or trauma to the nose. It is a common condition, but not all deviations cause symptoms. When the deviation is significant, it can obstruct one or both nasal passages, leading to:
- Chronic Nasal Congestion: Persistent stuffiness that does not respond to medications.
- Difficulty Breathing Through the Nose: A feeling of obstruction, particularly noticeable during physical activity or when lying down.
- Frequent Nosebleeds: Dryness and irritation of the nasal mucosa due to turbulent airflow can lead to bleeding.
- Sleep Disturbances: Snoring, mouth breathing during sleep, or sleep apnoea due to obstructed nasal passages.
- Reduced Sense of Smell and Taste: Due to impaired airflow to the olfactory receptors.
If you are experiencing these symptoms, especially if they persist despite medical treatment, it may indicate the need for a septoplasty. An evaluation by Dr Turner can help determine the underlying cause and appropriate treatment options.
Combining Septoplasty with Rhinoplasty Surgery?
For many patients, concerns about both the function and appearance of their nose often coexist. Functional rhinoplasty is a comprehensive surgical approach that integrates septoplasty and rhinoplasty to address internal structural issues affecting breathing, as well as the external appearance of the nose.
The benefits of combining septoplasty and rhinoplasty include:
- Comprehensive Correction: Simultaneously addressing nasal function and aesthetics.
- Single Recovery Period: Minimizing downtime by undergoing one combined surgical procedure instead of two separate operations.
- Enhanced Results: Achieving a harmonious balance between the form and function of the nose for optimal outcomes.
Dr. Turner underscores the importance of combining rhinoplasty with septoplasty for patients who have a deviated septum and are also concerned about the cosmetic appearance of their nose. Addressing both issues in a single procedure not only simplifies the surgical process but also optimizes the overall outcome.
Patients who initially undergo septoplasty to correct a deviated septum and improve breathing often decide later to pursue rhinoplasty to refine the shape of their nose. However, this sequential approach can create significant challenges. During septoplasty, cartilage from the septum is frequently removed or reshaped. This complicates future rhinoplasty procedures, as the reduced availability of cartilage can lead to instability and less predictable results.
In such scenarios, additional cartilage may be required to support the rhinoplasty. Surgeons often need to use grafts from alternative sources, such as rib cartilage or cadaver cartilage, to rebuild and strengthen the nose. This increases the complexity of the surgery, extends recovery time, and heightens the risk of complications.
For these reasons, Dr. Turner strongly recommends combining septoplasty with rhinoplasty for patients who have both functional and aesthetic concerns. A combined procedure streamlines the treatment process, minimizes risks, and ensures the best possible results for both the functionality and appearance of the nose.
Turbinate Reduction
Turbinates are bony structures covered by mucous membranes inside the nasal passages that help humidify and filter the air we breathe. Enlarged turbinates, a condition called inferior turbinate hypertrophy, can worsen nasal obstruction, often occurring alongside a deviated septum.
In functional rhinoplasty procedures (combined rhinoplasty and septoplasty), Dr Turner recommends turbinate reduction is performed six months afterward to allow the nasal shape to heal fully and ensure the best results.
Suitable Candidates for Septoplasty Surgery?
Dr Turner will conduct a thorough medical assessment, including a review of your symptoms, medical history, and a physical examination. This ensures that septoplasty is appropriate and that you are well-informed about the potential outcomes.
Suitable candidates for septoplasty surgery should meet the following criteria:
- Physical Health: Be in good overall health with no underlying medical conditions that could interfere with the wound healing process.
- Emotional Well-being: Have realistic expectations and a positive mindset regarding the outcomes of body lift surgery. As of 1st of July 2023, patients are required to have a psychological evaluation to ensure they are suitable to proceed with surgery.
- Non-smoker: Smoking or vaping dramatically interferes with the healing process and increases the risk of complications. Therefore, candidates are required to cease smoking for a minimum 6 weeks before surgery.
Septoplasty Surgery: What to Expect
Septoplasty is procedure performed under general anaesthesia in a fully accredited facility with the support of a qualified anaesthetist. Depending on the complexity of the procedure it may take 1 to 2 hours, and generally you are discharged the same day.
The surgery involves incisions made inside the nasal cavity, ensuring there are no visible external scars. Through these internal incisions, the mucous membrane covering the septum is carefully lifted to expose the underlying cartilage and bone. Deviated portions of the septum are then straightened, trimmed, or repositioned to improve nasal function. In some cases, cartilage grafts may be used to provide additional support and stabilization.
Once the septum has been corrected, the mucosa is repositioned, and absorbable sutures are used to close the incisions. To support the healing septum, soft silicone splints or nasal packing may be placed inside the nose, and external dressings may be applied if the procedure is combined with rhinoplasty.
