A common concern for patients recovering from nasal surgery, such as septoplasty, is the stability of the internal nasal splints placed inside the nostrils. These medical devices, typically made of flexible silicone or plastic, serve a specific function in the initial healing phase following a procedure to correct structures within the nose. While designed to remain in place, they can occasionally shift or, less commonly, fall out completely. Understanding the mechanism by which these splints are secured and the factors that contribute to their dislodgement helps manage expectations during recovery.
The Role and Initial Securing of Nasal Splints
Internal nasal splints provide structural support to the nasal septum and other internal tissues after surgical correction. They help maintain the new alignment of the septum, which is the wall of cartilage and bone dividing the nostrils, and are particularly important after a septoplasty. This internal stabilization is designed to minimize postoperative movement and prevent the formation of synechiae, or scar tissue adhesions, between healing surfaces. The splints also help compress the septum, which can be effective in reducing the risk of a septal hematoma, a collection of blood that can compromise the surgical outcome.
Crucially, internal splints are secured in place with a suture, typically a dissolving stitch, that passes through the splints and the nasal septum. This deliberate stitching is the primary mechanism that prevents them from simply sliding out of the nose. The splints themselves are thin, slightly curved devices that rest against the septum, offering support without the pressure associated with traditional nasal packing. Although this securing method makes complete spontaneous dislodgement uncommon, the splints must remain in place for the required healing duration.
Specific Reasons for Splint Dislodgement
While the securing sutures are designed to hold the splints firmly, displacement can occur, particularly if the suture fails or dissolves sooner than intended. Early on, post-operative swelling is significant, and as this swelling subsides, the internal dimensions of the nose change. This reduction in tissue volume can slightly loosen the fit of the splint, increasing the potential for movement.
Actions that increase pressure or movement within the nose are a common trigger for dislodgement or shifting. Excessive sneezing, forceful coughing, or vigorous nose blowing can generate enough internal force to strain the securing stitch or push the splint out. Accidental trauma, such as bumping the nose or rubbing it aggressively, can also directly destabilize the devices. More frequently than complete expulsion, a partial dislodgement where the splint shifts forward and becomes visible or rubs uncomfortably is reported by patients.
Immediate Steps If a Splint Falls Out
If an internal nasal splint shifts position or falls out completely, remain calm and avoid attempting to reinsert the device. Trying to push the splint back into place can introduce bacteria, cause trauma to the healing tissues, or inadvertently displace the newly corrected nasal structures. Contact the surgeon’s office or the medical team right away for guidance.
The necessity of replacement depends on how long the splint has been in place. If it falls out within the first 48 hours post-surgery, the concern is greater than if it occurs after a week. If the splint has fully come out, it should be stored safely in a clean container for the surgeon to examine. Patients should also monitor for any signs of increased bleeding or significant change in breathing, reporting these immediately to the medical provider.
The Standard Process for Splint Removal
The period for which splints remain in the nose is determined by the surgeon and the type of procedure performed, but it typically ranges from five to fourteen days. Their removal marks an important milestone in the recovery process, and it is always performed by the surgeon in the office. The removal procedure involves the surgeon first cutting the securing suture and then gently pulling the splint out of the nostril.
Patients often report a sensation of pressure or a brief tugging feeling, but the removal is generally quick and does not require anesthesia. Immediately after the splints are removed, patients may experience a temporary period of heightened congestion as the nasal lining reacts to the sudden absence of the device. Following removal, the surgeon will typically advise increasing the use of saline rinses to help clear any remaining crusting and keep the nasal passages moist during continued healing.