Deviated Septum
Septoplasty
A deviated septum is a physical abnormality of the cartilage and bone that divides the nasal cavity. When it causes nasal obstruction, septoplasty is a surgical treatment option designed to straighten the septum and improve nasal airflow.
Performed by Dr. Price Sonkarley, board-certified otolaryngologist.
When It May Be Considered
Symptoms Associated With a Deviated Septum
All septums have some natural deviation. Septoplasty is generally indicated when a deviated septum is causing symptoms such as these.
Nasal Obstruction
Persistent difficulty breathing through the nose, often worse on one side.
Snoring & CPAP Intolerance
Snoring, or difficulty tolerating CPAP therapy because of nasal blockage.
Sinus Pressure & Infections
Sinus pressure, pain or recurring sinus infections associated with nasal blockage.
Cosmetic Deformity
A visible external deformity of the nose associated with septal deviation.
Understanding the Condition
What Is a Deviated Septum?
The nasal septum is the wall of cartilage and bone that divides the nasal cavity in half through the midline. A deviated septum refers to abnormalities in that cartilage and bone.
A septum can become deviated from trauma, or it can be congenital — present from birth — and gradually increase nasal obstruction over time.
A deviated septum can be diagnosed through physical examination with a nasal speculum, nasal endoscopy or CT imaging.
Your surgeon will often treat nasal obstruction with topical nasal medication such as a nasal steroid spray (for example Flonase®) or a nasal antihistamine (for example Astepro®) before recommending a septoplasty. Because a deviated septum is a physical abnormality, no medication can permanently correct it — only surgery or physical manipulation can correct it.
The Procedure
How a Septoplasty Is Performed
A septoplasty is typically done as an outpatient day surgery under general anesthesia. In particular cases it can also be done in the office under local and topical analgesia.
During a septoplasty, a small microincision is made in the left nasal cavity. Through this incision the cartilage and bone of the septum are accessed, and the deviated (crooked) parts are removed or remodeled. The microincision is then closed with absorbable suture.
Adjacent tissue called the turbinates is often reduced at the same time. This is typically done with a small needle using radioablation in a tissue-preserving technique.
Most septoplasties don't require any packing. Instead, a malleable silastic splint is placed at the conclusion of surgery. These splints have small straw openings so you can breathe while your septum heals, and they are typically removed 3–7 days after surgery.
The entire process can take as little as 30 minutes, though more complicated cases can last up to an hour or more.
How Treatment Generally Works
Evaluation & Diagnosis
Dr. Sonkarley evaluates your nasal breathing with examination, nasal endoscopy or CT imaging when appropriate, and reviews medical treatments already tried.
Preparation
You receive an instruction packet for your surgery site, including fasting and anesthesia protocols. Discuss blood-thinning medications and supplements before scheduling, and obtain any required surgical clearance.
Septoplasty
Through a small microincision inside the nose, the deviated cartilage and bone are removed or remodeled. Turbinate reduction may be performed at the same time.
Splints & Recovery
Silastic splints with straw openings are placed and typically removed 3–7 days later. A nasal endoscopy visit is scheduled about three weeks after surgery.
Patient Education
Understanding Septoplasty
Educational video content about the nasal septum and septoplasty. Videos are general education and not a substitute for your physician's advice.
Deviated Septum & Septoplasty Overview
Patient education
Manufacturer educational content is provided for general information. Treatment recommendations should be discussed with your physician.
What to Expect
Before Surgery
Discuss when to stop blood-thinning medications or supplements such as aspirin, Excedrin®, Plavix®, Eliquis®, warfarin, fish oil or ginkgo biloba — always with guidance from your prescribing physician. You may be asked for a surgical clearance note. Fasting generally begins the midnight before surgery. A couple of sprays of Afrin® (oxymetazoline) the morning of surgery can help reduce bleeding during the procedure.
The First Few Days
For the first 3–5 days you may experience light nose bleeding, tenderness and occasionally teeth numbness. While your splints are in place you will feel intranasal pressure, and many patients prefer to sleep reclined rather than lying flat. Keep the splints' straw openings clean with saline flushes, Q-tips or pipe cleaners so they don't become blocked with clots.
Getting Back to Normal
Avoid strenuous activity such as swimming, running, weight lifting or pickleball for 1–3 weeks. Most patients return to work once the splints are removed (typically 3–5 days). Antibiotics are usually prescribed for the first three days, and occasionally steroids. After the splints are removed, begin NeilMed® sinus rinses or nasal lavage to accelerate healing and flush out mucus and clots. There are no diet or drinking-straw restrictions, and no flight precautions once the splints are out. A follow-up nasal endoscopy is performed about three weeks after surgery.
Follow the individualized medication and preparation instructions provided by ENTCare SWFL and your prescribing physician. Individual experiences vary.
Frequently Asked Questions
Explore Other Treatment Options
Nasal Valve Collapse Treatment
Featuring LATERA®
For difficulty breathing through the nose associated with nasal valve collapse.
Chronic Rhinitis Treatment
Featuring RhinAer® & ClariFix®
For persistent runny nose, congestion and post-nasal drip.
Struggling to Breathe Through Your Nose?
Request an appointment with Dr. Price Sonkarley to find out whether a deviated septum may be contributing to your symptoms.