Septoplasty is a surgical procedure performed to correct a deviated septum, the wall of cartilage and bone that divides the nasal cavity. Following this correction, surgeons often place internal support devices to maintain the new structural position during the initial healing phase. While these devices are sometimes referred to as “stents,” they are most accurately described as internal nasal splints or packing. Understanding the function and expected duration of these temporary supports is a common concern for patients recovering from the procedure.
Clarifying the Purpose of Nasal Splints
These internal nasal splints are made from flexible, medical-grade silicone and are placed on both sides of the newly straightened septum. Their primary role is to provide mechanical support to stabilize the septal cartilage and bone as it begins to heal in its corrected position. This immediate stabilization prevents the repositioned septum from shifting during the critical first few days after surgery.
The splints also compress the septal lining. This pressure helps prevent a septal hematoma, which is a collection of blood between the cartilage and its overlying membrane. Additionally, by keeping the two sides of the nasal passage separated, the splints minimize the risk of synechiae, or the formation of scar tissue adhesions between the septum and the turbinates.
The Standard Removal Timeline
The duration internal splints remain in place is determined by the requirements of the initial healing process. The typical duration for internal nasal splints following an uncomplicated septoplasty ranges from five to ten days post-surgery. This timeframe is short because the main goals of stabilization and prevention of early complications are generally achieved within the first week.
The exact day of removal is scheduled to coincide with the first post-operative office visit. Some surgeons may opt for removal as early as three days, while others might prefer to wait the full seven to ten days, depending on the complexity of the initial septal deviation and the type of material used. A study examining removal times found little difference in patient comfort or complication rates when splints were removed after three, five, or seven days.
This relatively quick removal contrasts with external splints, which are used in other nasal surgeries like rhinoplasty and may remain for up to two weeks. Internal splints are temporary tools for early tissue setting, and they are removed as soon as the initial structural integrity is secured, allowing the long-term healing phase to begin.
Managing Comfort and Care While Splints Are In Place
While the splints are present, patients should expect a feeling of nasal congestion or blockage, similar to a severe cold, as the devices occupy space inside the nasal passages. Many silicone splints include a small central tube to allow for some airflow, but these can easily become obstructed by swelling, blood, or mucus. This blockage means patients often have to breathe primarily through their mouths.
Maintaining cleanliness is paramount for comfort and preventing infection during this period. Surgeons instruct patients to use saline sprays or irrigation systems multiple times a day to gently wash away crusting and keep the splints clean. This process reduces the buildup of dried blood and mucus, which can contribute to discomfort and odor.
Patients must adhere to several restrictions during this period:
Post-Operative Restrictions
- Avoid blowing the nose forcefully for at least the first two weeks, as this action could cause bleeding or shift the repaired septum.
- Minimize physical exertion; activities like heavy lifting or strenuous exercise are restricted to prevent an increase in blood pressure that could trigger a bleed.
- Notify the surgeon immediately if a splint shifts or falls out within the first 48 hours.
What to Expect During the Removal Procedure
The removal of the internal nasal splints is a quick procedure performed by the surgeon in the office setting. Before removal, the area may be treated with a topical decongestant and sometimes a numbing spray to minimize sensitivity and reduce the risk of bleeding. If the splints were secured with a suture, the surgeon will first snip this stitch, which is a rapid sensation often described as a minor tug.
The splints are then gently grasped with forceps and slid out of the nostril. Patients commonly report a sensation of pressure or a strange, slippery feeling rather than sharp pain, and the entire process usually takes only a few seconds per side. Although it can be briefly uncomfortable, anxiety about the removal is often worse than the reality of the experience.
Immediately following the removal, there is often an instant sense of relief and a sudden increase in the ability to breathe through the nose. This removal may also stimulate a temporary increase in watery drainage or minor bleeding as the nasal lining adjusts. The surgeon will often use a suction tool to clean out any remaining mucus or crusting.