Septoplasty

Overview

Septoplasty is surgery to fix a septum, the wall that divides the nose into two sides. It is made of soft cartilage and bone and is covered with a mucous membrane. A deviated septum is when the septum is not in the middle. This problem may be present at birth (congenital). Or it can happen from an injury or other less common causes.

The surgery is done entirely through the nostrils. During the surgery, the surgeon may reshape part of the septum or removed it entirely. Septoplasty may be done at the same time as other surgeries on the nose or sinuses. It is not done often in children because the cartilage is still developing.

Purpose

A deviated septum usually does not need treatment. When it does, the most common reason is a blockage in the nose. When one side of the nose is blocked, your child may have:

Frequent sinus infections
Bloody noses
Pain in the face or headaches
Noisy breathing while sleeping

A deviated septum may be present at birth (congenital). It can be caused by an injury or damage from medical treatments in the past.

Risks

The risks of septoplasty include:

Infection
Nosebleeds
Bruising or swelling of the face
Buildup of blood and swelling in the septum
A hole in the septum
Numbness of the teeth or nose
Changes in smell, taste, or voice
Leak of fluid that surrounds the brain and spinal cord
Infection of the covering of the brain and spinal cord
Reaction to the anesthesia

Preparation

Your child's healthcare provider will send you to an ear, nose, and throat (ENT) specialist. The ENT will ask you about your child's health history and symptoms. The provider will check your child's ears, nose, and throat. Your child may have diagnostic tests. He or she may have an anterior rhinoscopy or fiberoptic endoscopy. Both of these tests use special instruments to check the nose and nasal septum.

Each surgery is different based on the child, the position of the septum, and other things. The ENT will explain what to expect with your child's surgery. Make sure you talk with your child's ENT about:

Any medicines that your child should not take before surgery, including over-the-counter medicines
When your child should stop eating and drinking. For example, it is common not to eat or drink after midnight the night before surgery.
When your child needs to arrive at the hospital or facility
What to expect and how to care for your child after surgery
When can your child get back to normal activities, including returning to daycare or school

If your child gets sick before surgery, call his or her ENT. Surgery may need to be rescheduled.

During the Test

Your child will probably have the septoplasty as an outpatient. That means that he or she can go home the same day. The surgery usually takes about 1 to 1.5 hours and will go as follows:

Your child will get sleep medicine (general anesthesia).
The ENT will usually make a cut inside your child's nose. Some additional procedures require cuts outside of the nose.
The ENT will use a tool with a light and tools on the end (endoscope).
The ENT will cut through the mucous membrane and remove or reshape the septum.
The ENT will make other repairs to the nose or sinuses, if needed.
The ENT will stitch the cut closed. Gauze or cotton may be placed inside your child's nose.

After the Test

After the surgery, you can expect the following:

Your child will be watched while waking up from anesthesia. He or she will usually be able to go home in a few hours.
Your child will likely have pain and be sleepy. The ENT and staff will give you instructions about helping ease the pain.
Your child will have a follow-up appointment with the ENT. Call the ENT if you have any questions or concerns before the follow-up appointment.

Make sure you follow all instructions given to you by the ENT, hospital, or facility.