Are you suffering from nasal congestion, nosebleeds and sleep apnea? A misalignment may be to blame.
Medical management may help reduce symptoms, including decongestants and nasal steroid sprays that reduce tissue swelling to improve airflow and drainage.
NYU Langone otolaryngologists–known as ear, nose and throat doctors–and plastic surgeons can perform procedures to reposition your septum and improve airflow.
Septoplasty
Deviated septum is a common condition that can result in nasal obstruction. This crooked portion of your nasal septum – made up of bone and cartilage that separates left from right nasal passages – can restrict airflow through your nose, leading to issues like nosebleeds, sleep disruption, congestion or altering facial appearance. Drs Karimi and Griffith are double board certified in both facial plastic surgery and otolaryngology (the study of ears, noses and throats) so have extensive experience treating patients suffering from defective nasal septums to help them breathe easier.
Crooked or shifted septa can be addressed surgically through septoplasty, in which your surgeon will straighten out your septum in its center position to improve breathing and alleviate nasal blockage and snoring. Furthermore, septoplasty may also be combined with rhinoplasty (nose job) procedures to address cosmetic concerns about its shape.
Crooked septa are often caused by trauma or birth defect; patients with septal deviations will typically have experienced some form of nose trauma in the form of broken nose or sinus injury at some point in their lives.
Septal deviations can often be treated successfully using medications and nasal sprays; for more severe cases, however, surgical correction is usually required. Septoplasty is an outpatient process which involves carefully excision/realignment of bone/cartilage inside your nasal cavity to correct its deviances.
Under general or local anesthesia, a surgeon makes an incision within your nostrils to access the area of nasal septum that needs repair. He or she typically uses endoscope for accurate repairs; however, in certain instances open surgery techniques may need to be employed instead. As much cartilage and bone as possible should be preserved by this method so as to maintain structural integrity and support.
Once your septum has been repositioned, the surgeon will secure it using sutures or splints that will remain in place for approximately one week to prevent nosebleeds and reduce risk of scar tissue formation. While typically removable, your doctor may leave them inside your nose until healing has sufficiently taken place for them to dissolve naturally over time. Patients are encouraged to rest at home during this period while avoiding strenuous activity.
Turbinate Reduction
A septum is a thin wall of cartilage and bone that separates the nasal cavity into right and left sections, and deviated septum refers to any deviation away from its centerline due to growing towards one nostril during childhood or due to facial trauma such as broken nose. Such deviated structures make breathing difficult, leading to increased mouth breathing which increases mouth breathing rates resulting in chronic sinus infections, snoring or sleep apnea.
At times, inferior turbinate hypertrophy may obstruct nasal airflow. Turbinates are bony structures located inside the nose covered by mucous membranes that move air from one nostril to the next and can become swollen in response to allergy medications, vasomotor rhinitis, colds or environmental irritants causing them to swell, leading to congestion or stuffiness and leading to the need for surgical reduction of these bony structures. While eliminating potential sources of inflammation or chemical exposure might help alleviate these symptoms temporarily, surgery may often be required in order to resolve them effectively.
At this procedure, an otolaryngologist removes the outer layer of turbinate to reduce its size and allow more air to pass through the nose. It can be performed as an outpatient with local anesthesia in adolescents and general anesthesia for adults.
Commonly combined with septoplasty procedures to address an irregular septum and improve its appearance, these two surgeries can make breathing easier, reduce snoring, and provide improved quality sleep.
No matter whether it be a crooked septum, snoring, or sleep apnea; visiting an otolaryngologist is vitally important. A simple sleep test will allow them to determine if a crooked septum may be contributing to your condition and if CPAP therapy would benefit. Visit our website now to schedule your consultation and start improving the quality of life; we proudly serve Los Angeles, California and its surrounding communities – and hope to hear from you soon! We hope to hear from you soon!
Endoscopic Surgery
Septoplasty, the common nasal surgery performed by an ENT specialist to realign bone and cartilage between your nostrils, is a relatively quick and painless procedure performed under general or local anesthesia according to your health history and preferences. A crooked septum may block either one or both nostrils causing breathing difficulty and difficulty with sleeping, making breathing difficult at nighttime or on certain occasions.
Your otolaryngologist will use an endoscope (a small, tube-like instrument) to examine the inside of your nose and nostrils, helping them understand what may be causing your symptoms. Should further testing be necessary, he/she may take tissue samples (biopsy). Expect some bleeding, swelling and discomfort following septoplasty surgery; your physician can provide medication to manage any adverse side effects.
Studies of patients undergoing septoplasty reveal that neglected nasal valve abnormalities are a key contributor to its failure, while insufficient caudal septal support often necessitates revision surgery [1].
Spreader grafts may also help improve the results of septoplasty by reinforcing strips of cartilage in the bridge of your nose to lift and reposition nasal bones and septum. [2]
Reshaping the septum may help nasal airflow but won’t eliminate sleep apnea altogether. But, it can improve daytime breathing while making use of CPAP machines easier during sleep.
If you’re curious to find out more about correcting a deviated septum to improve airflow, reach out today. We can connect you with Dr. Scolaro in Lubbock; he has been serving the South Plains community since 1990 as Medical Director of covenant High Plains Surgery Center campuses, serving on Texas Tech University Health Sciences Center School of Medicine as adjunct faculty professor, as well as being a fellow of American Academy of Otolaryngology (AAO). He’s widely respected for his expertise in nasal and sinus conditions while leading medical education of residents while being dedicated to excellence in surgical training training – learn more about his approach here.
Surgical Management
One can take several approaches to increasing nasal airflow through the nose and nasal valves. While a deviated septum is often responsible for nasal obstruction, other causes could include allergies, nasal polyps, autoimmune diseases or trauma causing difficulty with breathing. An otolaryngologist will use an endoscope to examine your nose in detail to ascertain the severity of any issues and potentially rule out other potential sources.
Mild cases of deviated septum can often be resolved with medications. Nasal steroids and antihistamines can reduce inflammation while nasal saline rinses temporarily clear stagnant mucus from your nose. Unfortunately, however, medications cannot directly straighten out cartilage or bone that obstruct your nasal passageway; if symptoms do not improve with medications alone then consulting with a surgeon about surgery (septoplasty).
Rhinoplasty remains one of the most frequently-sought-after surgical solutions for deviated septums; however, it does carry risks. Studies have demonstrated that septoplasty failure is relatively frequent due to overlooked or recurrent nasal pathologies, iatrogenic complications or residual septal deviation after surgery [2]. Residual deviation can occur anywhere along the septum’s dorsal, caudal or anterior areas [3, 4].
Dependent upon the severity of your deviated septum, corrective surgery might involve multiple operations to correct it fully. An otolaryngologist will use various techniques to repair both your septum and turbinates, such as spreader grafts (small reinforcing strips of cartilage that strengthen and correct an irregular septum), spreader grafts or spreader grafts in combination with nasal septoplasty can strengthen it and correct an uneven septum; additionally rhinoplasty procedures may also help altering its shape while improving breathing capacity.
Surgical site infections are the third most prevalent healthcare-associated infection in the UK. Their incidence increases with prolonged hospital stays, and multiple factors could contribute to its development – including antiseptic use, theatre ventilation systems, personnel movement protocols and antibiotic protocols, among other issues. It has yet to be proven conclusively whether laminar flow ventilation can prevent surgical site infections; more research needs to be completed in this regard before making a definitive determination.
