Septoplasty. What is it, nasal septum surgery, laser, indications

Many patients of otolaryngologists, faced with a choice - an operation or further suffering - sometimes do not know what to be guided by in such a complex issue.

Studying the intricacies of the upcoming intervention, thorough preoperative examination, strict adherence to preparation recommendations and unquestioning fulfillment of the doctor's prescriptions in the postoperative period will help to decide on the right step and achieve the desired success.

Septoplasty - what is it?

For patients who fully feel the influence of a deviated nasal septum, doctors advise such a way out as septoplasty. What it is and how it can affect the quality of life is very important to know when giving consent to the operation.

Septoplasty is a plastic surgery to correct a deformed nasal septum. The essence of the operation consists either in the correction of cartilage or bone tissue, or in their partial removal. In this case, external incisions are not made, all manipulations are performed through the nostrils. Depending on the complexity of each specific case, local anesthesia or general anesthesia is applied.

Along with septoplasty, there is also such a type of surgery as rhinoplasty. These two concepts have significant differences. In the first case, the need for an operation is dictated solely from a medical point of view, because the curvature of the nasal septum is a pathology that leads to poor health.

And rhinoplasty, although it is a surgical intervention, is a purely aesthetic procedure to change the shape of the nose. There are, of course, cases when it is necessary to combine these manipulations, then we will talk about rhinoseptoplasty.

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Indications for the operation

When prescribing a referral for septoplasty, ENT is guided by the following patient complaints:

• most often, and first of all, it is difficulties with breathing through the nose, it happens on one side, it happens on both;
• rhinitis, sinusitis, turning into a chronic form;
• congestion in the ears, otitis media, up to hearing impairment;
• increased incidence of nosebleeds;
• heavy snoring;
• headaches;
• decreased or complete absence of smell.

All these symptoms, if not taken in time, lead to more serious consequences. Deterioration of oxygen supply to brain cells, which causes drowsiness, chronic fatigue. The air inhaled through the mouth enters the respiratory tract cold, polluted, and the mucous membrane dries out. All this increases the risk of getting glossitis, bronchitis, pharyngitis and pneumonia.

How to Prepare for Septum Septoplasty

Septoplasty, despite its apparent simplicity, is a serious operation.What it is - the otolaryngologist surgeon must describe to the patient in great detail. He also appoints additional consultations with other specialists, among which should be: a plastic surgeon, a therapist and an anesthesiologist.

The plastic surgeon who monitors the patient before, during and after septoplasty, determines what exactly needs to be corrected and how it will happen, makes such an explanation in the detailed plan of the operation.

For the anesthesiologist, for the correct selection of anesthesia, it is important to know about the patient's injuries and infectious diseases, the presence or absence of allergies. The therapist examines the general condition of the patient: pulse, blood pressure, laboratory test results, the presence of chronic diseases, and on their basis gives permission for septoplasty with his personal signature.

Not later than 10 days before the operation, the following should be carried out:

• hardware examination (x-ray of the nose, ultrasound of the abdominal cavity, fluorography of the lungs;
• blood tests (for blood group and Rh factor, HIV infection, Wasserman reaction, hepatitis, coagulability, and general analysis);
• general urine analysis.

If the patient has chronic diseases, it is necessary to consult a narrow specialist in this area.

A week before the scheduled day of the operation, all physical activity is excluded: hard work, sports activities, dragging weights, running. A ban is introduced on products that thin the blood: fatty fish, some types of berries and fruits, onions and garlic, linseed and olive oil, cereals containing a large percentage of magnesium, green tea, ginger, coffee.

Special recommendations apply to women: the day of the operation is assigned to them about a week after the end of menstruation.

During the 4 days preceding septoplasty, and 6 days after it, it is necessary to undergo a special course of therapy to prevent swelling in the postoperative period: twice a day before or after meals, 20 drops of lymphomyositis and traumeel.

The last meal is allowed at least 8 hours, and drinks - 6 hours before the operation. Upon admission to the hospital on the day of surgery, the patient must present the results of all studies in the original no more than 10 days ago.

How is septoplasty performed

Septoplasty - what it is and how it is performed - will help you understand the description of its five types.

Thread resection

This is the alignment of the septal bone with special threads securing it.

Special fibers are implanted into the cartilage tissue to reinforce the curved bone.

Endoscopic septoplasty

A modern technique in which minimal tissue dissection is performed, which has a beneficial effect on healing and shortens the postoperative recovery period. Endoscopic septoplasty, in turn, is divided into three types:

• Vasotomy - the intersection of the vessels connecting the mucous and bone tissues of the nose.
• RR technology - using a laser, the cartilaginous membrane is stratified, followed by removal or straightening of the curved part of the septum.
• Autocartilage reimplantation - fixing the rearranged curved part of the cartilage in a new place with silicone inserts.

Laser septoplasty of the nasal septum

Laser septoplasty of the nasal septum is considered the most bloodless. To carry it out, a laser scalpel of the desired size is selected, with its help the cartilaginous membrane is heated to a certain temperature at which the cartilaginous tissue becomes plastic, like clay. Special instruments straighten and hold the cartilage until it retains its correct shape.

Radio wave septoplasty

Radio wave septoplasty uses the ability of the Surgitron apparatus to emit high frequency radio waves.

Under the influence of high-frequency radio waves, the possibility of severe bleeding is excluded, there is a powerful antibacterial effect, thanks to the perfectly flat edges of the incisions, rapid tissue fusion occurs, which means that the rehabilitation period is shortened as much as possible, and there is also an almost complete absence of postoperative pain.

Ultrasonic septoplasty

Under the influence of high-energy ultrasound, the cancellous substance of the bone is destroyed, tissue dissection, coagulation of blood vessels, which create the same effects as with radio wave septoplasty. This method is effective in eliminating spikes and ridges.

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Postoperative period - recovery after septoplasty

Immediately after the operation, tampons are inserted into the nostrils, and ice is applied to the bridge of the nose for half an hour. The recovery period, depending on the method used, lasts from one to two to three weeks.

For a maximum of three days after the operation, tampons must be in the nose. In the same period, it is recommended not to strict bed rest, refusal of hot food, exclusion of all kinds of stress. Given the need to breathe through the mouth, there should be a certain amount of fluid next to the patient in the postoperative period.

Drug treatment consists of taking Tsiprolet for five days (500 mg 2 times a day) and Erius - within 10 days (1 tablet per day), with severe pain - no more than 3 times a day, 1 tablet of Nurofen. After the final removal of the tampons, Aquamaris is injected into the nostrils as often as possible for speedy healing, softening and detachment of the resulting crust.

The swelling subsides in 1-2 weeks after septoplasty, which is an average indicator. This is a period when a rise in temperature, release of ichor is possible, and softened thread residues fall off along with a crust. These symptoms, according to the surgeons, are quite normal phenomena and they do not indicate a complication.

For a month after the septoplasty, sports and hard work are strictly prohibited.

Possible negative consequences

Provided that the operation is carried out correctly and the recommendations of specialists are followed, the occurrence of negative consequences in the postoperative period is extremely rare.

• One of the most common complications is bleeding, to prevent which tampons are needed, removed 2 days after surgery.
• Hematoma is the second most common negative reaction of the body to surgical intervention. When the tampon is heavily soaked in blood, the nasal passages are drained to eliminate the likelihood of hematoma.
• If septoplasty is performed carelessly, a surgical instrument can damage the mucous membranes, which leads to perforation of the septum. This operation requires the doctor to be very precise and accurate so that such a complication does not arise.
• A less common consequence is a septal abscess.
• A change in the outer shape of the nose can be caused by high resection of the quadrangular cartilage. This defect may appear at a later date - after the puffiness subsides and all tissues return to normal.

The risk of complications increases significantly with uncontrolled drug use, alcohol abuse, smoking, with long-term use of certain medications, the presence of scars from previous operations, diseases that were not identified during the preliminary examination.

Prevention of complications

The first preventive measure will be a careful selection of the clinic, consideration of the reviews of former patients.The next stage is the transition to a healthy lifestyle a month before the operation - giving up bad habits, balanced nutrition, exclusion from the diet of foods that thin the blood.

In the most detailed way, the therapist should be notified about the state of health, the presence of chronic diseases, infectious diseases and surgical operations.

It is very important to undergo a complete examination prescribed by the attending physician and otolaryngologist surgeon, perform all procedures the day before and on the day of the operation, pay special attention to the postoperative course of treatment and rehabilitation.

The appearance of any unusual symptoms, painful sensations, excessive bleeding, dizziness, nausea should be immediately reported to the medical staff.

Contraindications

A categorical contraindication to septoplasty is a minor age, since the formation of the osteochondral skeleton of the nose may be impaired.

Additional therapeutic measures will be required to relieve acute conditions, exacerbations of chronic diseases, especially diabetes mellitus, cardiovascular system, and respiratory organs. The refusal to perform septoplasty is unambiguously poor blood clotting indicators.

Price for septoplasty

The prices for septoplasty in different clinics differ significantly. This largely depends on the method used, devices, materials and instruments, methods of anesthesia, the inclusion in the cost of a bed and food.

The lowest price is 11.5 thousand, the highest is about 100 thousand rubles. The last figure contains, in addition to the operation itself, general anesthesia, a 2-week hospitalization with food and supplies. To this figure it is necessary to add the cost of laboratory and apparatus examination.

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Where is the best place to do septoplasty - recommendations for choosing a clinic

A responsible approach implies any intervention, including septoplasty. It is important that this is such a simple, but still operational impact. Such an important decision as choosing the right clinic will save patients from trouble.

It is desirable that the hospital is not multidisciplinary, narrowly focused in the field of otolaryngology. First of all, you need to decide which method is suitable for eliminating the problem, and contact a surgeon who specializes in operations of this type.

If price matters, you should consider in detail all the options offered. The price list must necessarily describe what services and materials are included in this price.

For greater confidence in the favorable outcome of the surgical intervention, it is useful to inquire about the reputation of the medical institution, find out its history, staff composition, the number of similar operations carried out in it per month. The main criterion in determining the place of treatment is the qualifications of the attending physician, his track record, patient reviews.

Septoplasty results (before and after photos)

If all the conditions are met in the days preceding the operation and several weeks after it, in most cases the outcome of the intervention is positive. The main goal - free breathing, sound sleep, the absence of upper respiratory tract diseases - is achieved in most cases.

A positive side effect is always visible on the face - the appearance of the nose after a properly performed septoplasty always improves. Humps, curvature, asymmetry disappear.

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