What is a septoplasty?

A septoplasty is a procedure to straighten your septum (the cartilage and bone inside your nose that separates your nostrils).

What are the benefits?

Your nasal airway will be more open, which should relieve your symptoms of a blocked nose.

Are there any alternatives?

You cannot straighten your septum without surgery. Steroid spray and saline (salt water) nasal wash may help a little.

What will happen if I decide not to have the procedure or the procedure is delayed?

Your nose will continue to feel blocked but it should not get worse.

Contact your healthcare team if you experience:

• a runny nose
• a nose bleed
• pain
• a change in your sense of smell
• hearing loss

What does the procedure involve?

The procedure is usually performed under a general anaesthetic but a local anaesthetic can be used. The procedure usually takes about 45 minutes.

Your surgeon will make a cut on the lining of your nose over your septum and lift the mucosa away from the cartilage and bone. They will remove the parts of the cartilage and bone that are bent and they will put the rest back in a straight position.

Your surgeon may place some packing in your nose to prevent bleeding. The packing will either dissolve in a few days or will be removed a few hours after the procedure.

How can I prepare myself for the procedure?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health. Smoking stops your nose clearing mucus properly and this can increase the feeling of a blocked nose.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Regular exercise should help you prepare for the procedure, help you recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you may need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can occur?

The healthcare team are trained to reduce the risk of complications.

Any risk rates given are taken from studies of people who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, have other health problems or you smoke. Health problems include diabetes, heart disease or lung disease.

Possible complications of this procedure are shown below. Some can be serious and may even cause death.

General complications of any procedure

• Bleeding soon after the procedure or a week to 10 days later. You may need to have your nose repacked with a firmer pack or have a pack in the back of your nose. If the bleeding is heavy, you may need a blood transfusion.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Venous thromboembolism (VTE). This is a blood clot in your leg (deep-vein thrombosis – DVT) or one that has moved to your lung (pulmonary embolus).
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19. (coronavirus) symptoms for at least 7 weeks before the procedure.

Possible complications specific to this procedure

• Adhesions, where scar tissue forms deep inside your nose and can obstruct airflow.
• Developing a collection of blood (haematoma) or an abscess between the layers of your septum.
• Making a hole in your septum.
• Damage to nerves that supply the skin and the gum over your front upper teeth, leading to a numb patch or continued pain.
• Change to the shape of your nose with some loss of height of the bridge or shortening of the columella (the external strip of skin that runs down from the tip of your nose between your nostrils).
• Reduced sense of smell.
• Toxic shock syndrome, which is an infection of your bloodstream.
• The problem coming back. You may need another procedure to fix it.

Consequences of this procedure

• pain

What happens after the procedure?

You should be able to go home the same day.

If you had non-dissolvable packing in your nose, you will need to stay overnight and the packing will be removed the next morning.

It is important to avoid catching a cold, which could cause infection inside your nose. Your doctor may advise you to stay off work and away from groups of people for a few days or up to 2 weeks after the procedure, depending on the risk.

Do not exercise, have a hot bath or bend down for 2 weeks.

After 2 weeks, regular exercise should help you to return to normal activities sooner. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a full recovery and can return to normal activities.

Summary

Surgery will result in you having a straight septum, which should relieve your symptoms of a blocked nose.

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