Septoplasty is a surgical procedure aimed at correcting a deviation of the nasal septum, when this causes nasal obstruction. It is a functional and not cosmetic operation, unlike rhinoplasty.

Septoplasty is a restorative operation to correct a deviation of the nasal septum.

As a reminder, the nose is made up of different structures: the clean bone of the nose is the hardest part, at the very top of the nose, of the cartilage which forms the lower part of the nose and of the fibrous tissue at the level of the nostrils. Inside, the nose is divided into two nasal cavities separated by cartilage: this is the nasal septum, also called the nasal septum.

Sometimes this partition is not very straight. This deformation of the inner lining of the nose can affect the cartilage and / or the bones of the nose. It can be congenital (present at birth), appear or increase during growth or be due to a trauma to the nose (impact, shock).

Septoplasty will therefore consist in remodeling and / or partially removing the deformed parts of the nasal septum, in order to “straighten” it. It is sometimes associated with a turbinoplasty, an operation consisting in removing a small part of the turbinate, a bone formation covered with mucous membrane which is sometimes also the cause of nasal obstruction.

In the event of a strong nasal deviation, the septoplasty can be associated with a rhinoplasty, that is to say an operation of cosmetic surgery (to improve the appearance therefore) of the nose. This is called rhinoseptoplasty.

Septoplasty is a functional surgery, as such it can be covered by social security under certain conditions (unlike rhinoplasty which cannot be).

The operation, which lasts between 30 minutes and 1 hour 30 minutes, takes place under general anesthesia and more and more often under endoscopy.

Septoplasty is usually done by natural means, that is, the nasal passages. We speak of an endosanitary incision. There will therefore be no visible scar. In some cases however, mainly when the deviations are complex, a skin incision may be necessary. Minimal, it will be located at the base of the nose.

The surgeon begins by inserting a wick soaked in xylocaine naphazoline into the nasal cavities, which will have the effect of retracting the nasal mucosa. Then, it carefully peels off the mucous membrane in order to reach the cartilaginous structure of the septum. He will then be able to remodel the nasal septum without planing and, if necessary, removal of small bone or cartilage growths at the origin of the deviation.

Once the septum becomes straight again, the surgeon will generally place a silicone tab in each nasal cavity. Like a splint, this tab will keep the nasal septum in the correct position, make the mucosa adhere better to the nasal septum and thus promote healing.

Septoplasty is indicated in case of deviation of the nasal septum. Almost 80% of adults have some degree of deviation of the nasal septum, most often without consequence. But sometimes, it can lead to medical and / or aesthetic complications:

• nasal obstruction which may cause difficulty in breathing, snoring;
• sinus or even ear infections, migraines;
• aesthetic discomfort when associated with an external deformation of the nose.

Operative suites

Rarely significant postoperative bleeding may occur.

Septoplasty is a painless operation. For the first few weeks after the procedure, the nose may bruise and remain swollen, with some difficulty in breathing. Some patients suffer from transient tearing associated with irritation of the tear ducts, a temporary disorder of the sensitivity of the teeth of the upper jaw.

Regular cleaning of the nose is recommended in order to avoid stagnation of secretions in the nose. The silicone tabs will be removed 8 to 10 days after the operation.

The first month, it is recommended to limit your sports practice.

The risks of the operation

Septoplasty presents various secondary risks:

• a subsequent perforation of the septum, which may cause wheezing when breathing, the formation of crusts, small hemorrhages;
• scar adhesions which may be responsible for persistent nasal obstruction;
• a deformation of the tip of the nose, which can be corrected surgically.

Other complications, more serious but very rare, can occur:

• a serious infectious complication such as meningitis or abscess due to cerebrospinal fluid leakage;
• odor disorders:
• an oral-nasal fistula.

The results

The nose returns to its more or less normal appearance about ten days after the operation, but nasal comfort and benefits are obtained after a month. Breathing will be all the more facilitated the greater the deviation.