A deviated septum is a common condition where the thin wall of cartilage and bone, which separates the two nasal passages, is off-center or crooked. This misalignment can range from minor to severe, potentially narrowing one or both of the air passages inside the nose. While an estimated 80% of the population has some degree of deviation, a significant bend can obstruct airflow, leading to various health issues. When these symptoms become persistent and disruptive, surgical correction is often necessary to restore proper nasal function.
Identifying the Surgical Specialist
The physician who typically performs surgery to correct a deviated septum is an Otolaryngologist, commonly known as an Ear, Nose, and Throat (ENT) specialist. These specialists complete rigorous training focused on the disorders and surgery of the head and neck, including the nasal passages and sinuses. Their expertise centers on both the function and the anatomy of the upper respiratory tract. The ENT specialist is primarily concerned with improving airflow and resolving the functional problems caused by the septal deviation.
Some Facial Plastic and Reconstructive Surgeons also perform this procedure, often combining the functional correction with aesthetic adjustments to the external nose. The most important factor is selecting a surgeon who has extensive experience with the procedure, regardless of their specific title.
Symptoms and Indications for Septoplasty
Surgical intervention is generally pursued when a deviated septum causes persistent and disruptive symptoms that do not respond to non-surgical treatments like decongestants or nasal sprays. The most common indication is chronic nasal obstruction, which makes breathing difficult, especially during physical activity or when lying down. Restricted airflow can impair the natural drainage of the sinuses, leading to frequent or recurrent sinus infections (sinusitis).
The disruption of airflow can also cause the nasal lining to dry out, resulting in regular nosebleeds. Sleep quality is often compromised, with patients experiencing loud snoring or worsening symptoms of obstructive sleep apnea.
The Septoplasty Procedure
The surgical correction for a deviated septum is called septoplasty, a procedure designed to straighten the cartilaginous and bony partition. It is typically performed as an outpatient procedure, meaning the patient can return home the same day. The surgeon works entirely through the nostrils, making an incision inside the nasal passage to access the septum without leaving an external scar. The surgeon first lifts the mucous membrane, the thin lining covering the septum, to expose the underlying crooked cartilage and bone.
The deviated portions of the septum are then carefully trimmed, reshaped, or repositioned to align them in the center of the nasal cavity. In some instances, misshapen pieces of cartilage or bone may be removed and then reinserted in a straightened configuration to maintain structural support. Once the septum is centered, the mucous membrane is laid back over the straightened structure and secured with dissolvable stitches. The entire process usually takes between 30 and 90 minutes and is performed under either general anesthesia or local anesthesia with sedation.
Post-Surgical Care and Recovery
Following septoplasty, patients are monitored briefly in a recovery area before being discharged home to rest. To support the newly positioned septum and control bleeding, the surgeon may place soft splints or packing material inside the nose. These are removed during a follow-up appointment. Initial discomfort is common and usually managed effectively with over-the-counter pain relievers such as acetaminophen, though stronger medication may be prescribed.
For the first few weeks, patients must avoid activities that increase blood pressure in the nose, such as strenuous exercise, heavy lifting, or bending over. Patients are instructed not to blow their nose for at least one to two weeks to prevent bleeding and disruption of the healing tissue. Sleeping with the head slightly elevated for the first few days helps reduce swelling and drainage. Nasal saline rinses often become a part of the post-operative routine to keep the nasal passages clean and moist. While the initial period of downtime is typically about a week, the internal cartilage and bone can take up to several months to stabilize completely.