Septoplasty in KPHB, Hyderabad

The operation is done at Sinocare ENT Hospital while you are fully asleep (general anaesthetic). It is done through the nostrils and takes thirty to sixty minutes. You come in the morning, and most people go home the same day. Soft splints sit inside the nose, not heavy packing. The splints come out at the hospital after about a week, which is also the first check-up. Desk work at about a week, and the gym at three to four weeks. The final airway comes at six to twelve weeks, once the lining settles.

• One side of the nose blocked all the time, or a block that swaps sides when you lie down
• Breathing through the mouth at night, waking with a dry throat, snoring
• Sprays and allergy tablets (antihistamines) that no longer make a difference, or never did
• Repeated sinus infections on the blocked side
• Nosebleeds from the bent edge
• A blockage that dates from an injury, sometimes years earlier

A bent septum on examination is not, by itself, a reason to operate. Almost everybody’s septum is bent to some degree. The question is whether your symptoms come from it. The most common mistake with this operation is doing it on someone whose real problem was allergy all along. That is why allergy is checked and treated first.

It is done entirely through the nostrils. There are no cuts on the face, and no bruising or swelling on the outside. The lining is lifted off the septum. The bent cartilage and bone are straightened, reshaped or removed. Then the lining is laid back down and held with fine stitches and soft splints. The shelves on the side walls of the nose (turbinates) are often reduced in the same sitting. On the wider side, the shelf has usually grown to fill the space. If it is left alone, it will keep that side blocked.

Thirty to sixty minutes, while you are fully asleep. Soft splints are used in place of heavy packing. This means you can breathe a little through the nose from the start, and taking them out is quick.

• A camera test of the nose at the hospital. A rigid or bendy camera shows the whole septum, the shelves and the sinus openings. A torch shows only the first two centimetres.
• A CT of the sinuses where sinus disease may also be present.
• An allergy check and a proper trial of medicine for anyone whose problem looks more like allergy than structure. Steroid nose sprays only work if used the right way for weeks. You are shown how to use them at the first visit.
• Blood thinners, aspirin and some supplements are stopped only on the advice of the doctor who prescribed them.

First 48 hours. The nose is blocked. With splints in, you breathe mostly through the mouth. Some mild oozing, a heaviness like a headache, and broken sleep. Keep your head up on two pillows. Ice over the bridge of the nose helps.

Day 5 to 7. The splints come out at the hospital. It is uncomfortable for about a minute. Breathing gets better the same day. Then it gets worse again for a week, as the lining swells in response.

Weeks two to four. Crusts form inside the nose. They are managed with salt water (saline) rinses several times a day. Saline is the part that shortens recovery most, and you are shown it before you go home. Most people are back at a desk job at about a week, and back to the gym at three to four weeks.

Six to twelve weeks. The lining settles fully, and the airway you have then is the one you will keep. Judging the result before then is judging swelling.

• The blockage is not fully cleared. Sometimes part of the problem was allergy, or the shelves. Then straightening the septum alone leaves that part behind. This is the most common letdown after this operation. The checks beforehand prevent it: allergy is treated first, and the shelves are reduced in the same sitting where they add to the block.
• Bleeding. Some ooze is normal for a day or two. Heavy bleeding is uncommon. If it happens, it is managed with a light pack.
• A hole through the septum (perforation). Uncommon. It can cause whistling, crusting and nosebleeds. Lifting the lining with care on both sides is what keeps it rare. Repairing one is harder than the first operation, which is why care is taken here.
• A change in the shape of the nose. Rare. It matters more when a lot of cartilage has to be removed, or the bend involves the front of the septum. That is why enough support is always left in place.
• Numbness of the upper front teeth or the tip of the nose, usually temporary.
• A weaker sense of smell, usually temporary.
• Infection, uncommon, treated with antibiotics.
• The bend coming back over years, above all in a septum that was very bent to start with.