Septoplasty Surgery — Explained by Dr. Rajesh Bhardwaj (Award-Winning ENT Surgeon)

Septoplasty At ENT Delhi

Septoplasty is the surgical procedure to correct a deviated nasal septum (DNS).

Nasal Septum and DNS — Deviated Nasal Septum

The Nasal Septum divides the nose into the right and left nostrils.

It is made of Cartilage (malleable tissue — anteriorly), and Bone (Posteriorly).

Though ideally the Septum should be straight there is some deviation to either side in some individuals.

Causes of Deviated Nasal Septum

• The child may be born with a deviated Septum due to pressures in the womb.
• Injury- while growing up, or as a child while playing games, or sometimes after and accident.
• Pressure of swelling like large growth/ polyp on one side of the nose can push the septum to the other side.

INDICATIONS OF SEPTOPLASTY

• Nasal Blockage
• Recurrent Nasal bleeding
• Snoring and sleep Apnoea
• As an approach or access to Nasal Surgery like FESS or skull base surgery
• To repair a nasal septal deviation

Anaesthesia for Septoplasty

1. Local Anaesthesia — after discussing with the patient — only Local Anaesthetic is used along with some sedation
2. MAC- Monitored Anaesthesia Care- the anaesthetist gives pain reliving drugs intravenously, along with sedation.
3. General Anaesthesia — Full General Anaesthesia where the patient is completely unconscious.

The decision regarding the type of anaesthesia to be used is taken following a discussion between the ENT surgeon and the patient.

METHOD OF SEPTOPLASTY

Septoplasty is a very commonly performed surgical procedure.

In the Operation Theatre, after cleaning and draping the patient 2 % Xylocaine with adrenaline is injected into the septum so as to lift a submucosal flap. Cotton patties with 4 % Xylocaine and adrenaline are sometimes placed in the nasal passage as well to help shrink the mucosal swellings.

Depending upon the nature of the deviation an incision is made on the Septum and mucosal flaps are lifted and joined together — the septum is now standing freely and unattached.

The Septum is then brought to the midline using various techniques, including thinning out duplicated parts, straightening and morselization as well as using a hammer and gouge to remove bony spurs.

Once the septum is brought to the midline parts may be sutured — either at the caudal (lower) end or sutures to approximate septal flaps together so as to prevent haematoma formation.

Nasal packs are placed in the nose which are kept in situ for a day or sometimes longer.

POST OPERATIVE PERIOD

1. The post operative period is usually uneventful — the patient takes rest for a day or two. We recommend to work from home for about 5–7 days or till the wound has healed.
2. Normal diet is recommended- simple regular home food.
3. Lying propped up in bed is usually helpful
4. There may be some pink/ blood soaked discharge from the nose for a few days
5. Do not blow nose
6. No steam inhalation in the immediate post operative period
7. Must come for regular follow up visits as asked for

COMPLICATIONS

Though a safe and well tolerated surgical procedure, Septoplasty can lead to some complications.

1. Bleeding — in the immediate post operative period, or sometimes after a week to 10 days- a well known complication called Secondary haemorrhage. Treatment is usually simple.
2. Infection — every surgical procedure can be followed by a local infection in the affected area- a good antibiotic is usually enough to treat this.
3. Nasal Septal Perforation- in spite of all precautions sometimes there can be a septal perforation due to flap necrosis.
4. External nasal deformity- sometimes, if excessive supportive tissue is sacrificed the nasal pyramid may be affected — usually in the form of a supra tip depression.
5. Recurrence- though airway improvement is predictable sometimes the septal deviation may spring back either as a result of fresh trauma or due to strong tissue.

MedFirst ENT Centre Advantage — Septoplasty with Health Insurance and TPA Support

MedFirst ENT Centre specializes in septoplasty and is committed to providing a seamless experience for patients seeking this medical care. They facilitate the financial aspects of septoplasty treatment through affiliations with leading insurance companies, with a dedicated Third Party Administrator (TPA) team well-versed in handling septoplasty claims. Whether patients require care under a group health insurance plan or individual/family health insurance for their septoplasty, MedFirst ENT Centre’s extensive network and TPA team ensure smooth processing of septoplasty health insurance claims, relieving patients of administrative burdens.

Understanding how health insurance policies and TPAs can assist in covering septoplasty costs is essential. Septoplasty, a procedure aimed at correcting a deviated nasal septum, is often a medical necessity to improve breathing and overall health. To ensure a smooth and cost-effective septoplasty experience, proactive measures include thoroughly reviewing insurance policies, selecting specialized ENT clinics within the insurance network, and collaborating with TPAs for efficient claims processing. This proactive approach ensures that patients can undergo septoplasty with confidence, knowing their insurance covers the procedure, providing peace of mind during the septoplasty journey.

ENDOSCOPIC SEPTOPLASTY

With the advent of the endoscope ENT Surgeons are now performing minimal access Endoscopic guided Septoplasty surgery. You must discuss this with your surgeon- not all septal deviations can be corrected by endoscopic septoplasty.

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