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The wall the separates the left and right sides of your nose is called the nasal septum. In the front of your nose it is made of flexible cartilage. Farther back in your nose, it is made of bone. Almost no one has a perfectly straight nasal septum. Minor abnormalities are very common and usually don't cause any problems.
People benefit from a septoplasty when they have all of the following:
The most common reason for a septoplasty is when a patient doesn't breath well though one or both sides of the nose. When a significant deviation is present, correcting this abnormality can improve the airflow.
- a significant nasal septal abnormality
- symptoms that typically result from nasal septal deviations
- medications have not adequately relieved the symptoms
When a nasal septal deviation interferes with sinus drainage, it can be a contributor to repeated infections or chronic infections. In conjunction with endoscopic sinus surgery, correcting significant septal deviations can help improve drainage. In some cases it is necessary to correct septal deviations during sinus surgery to help access the sinus cavities and ensure adequate sinus drainage.
Sinus pain can be caused when the septum is deviated such that it touches the side wall of the nose or indents one of the turbinates. Pain from a septal deviation may be felt in the ear, on the side of the face, near the eye, or in the throat.
The nasal septum is made of cartilage in the front and bone deeper in the nose. Each side is also covered by the mucous membrane on the surface. A small incision is made through the covering layers near the front where you can touch with your finger. In some cases, an endoscope is used to begin the operation farther back, skipping over the front part. Special instruments are used to lift up the membranes and to access the crooked area of the bone or cartilage directly. All of the work takes place with an attempt made to avoid making any unwanted holes in the mucous membrane that covers the septum.
Once certain crooked portions are removed and others are repositioned and special straightening techniques are used, then the covering layers are returned to their original position. Dissolvable sutures are used to sew the membranes down to the septal bone and cartilage. In some cases, it is necessary to place foam type material in the nasal passages on each side. This places additional pressure on the membranes so that they will heal down to the bone/cartilage. This "packing" may stay from 1 to 3 nights. If the membranes do not heal directly to the septal bone, blood can accumulate under the layers which is not very good for the healing process. Packing is needed in about one third of the septoplasties seen in my practice.
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They are important.
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