Septoplasty and Turbinate reduction

Introduction

Septoplasty refers to an operation used to correct a deviated nasal septum. Deviations of the septum can lead to nasal obstruction.

Turbinates are structures on the side wall of the nose that encroach into the airway if enlarged. They act to warm and humidify inspired air, but if too big they may contribute to nasal obstruction.

Indications

The main indications for this procedure are:

  • Nasal Obstruction.
  • As an “access” procedure to allow sinus surgery, rhinoplasty or DCR to be completed.

Risks

Septoplasty and turbinate reduction carries the same general risks as all operations, including:

  • Pain.
  • Bleeding.
  • Infection.
  • Scarring.
  • Failure to resolve symptoms.

Specific risks of sinus surgery include;

  • Significant bleeding.
  • Septal perforation.
  • Septal haematoma or abscess.
  • Nasal adhesions.

Dr Morrissey can discuss these risks and other matters specific to you and your condition should you wish to make an appointment.

Treatment Alternatives

There are some topical nasal sprays which may help alter the size of the turbinates and improve nasal airflow. Dr Morrissey can discuss the alternatives to surgery as they relate to your situation.

Preoperative Instructions

Septoplasty and turbinate reduction is performed under a general anaesthetic. You will need to fast prior to surgery and should follow the provided instructions. If you have any queries or concerns please contact your Anaesthetist, admitting hospital or Dr Morrissey.

Procedure

Dr Morrissey performs the vast majority of his cases with a high definition endoscope to provide the best vision for the case.

For the septoplasty, an incision is made within the nose to expose the deviated cartilage and bone. This is then removed or re-shaped depending on the situation. The septum is closed with a dissolving stitch.

To reduce the turbinates a special instrument called a microdebridder is used to remove some of the soft tissue. Part of the bone holding the turbinate in the airway is removed to allow the remaining soft tissue to fall away from the airway.

Once completed, cautery is used to address any bleeding. In most cases, no nasal packing is needed.

Postoperative Instructions

General

During the first 2 weeks after surgery you will feel quite tired and ‘run down’. Your nose will feel very congested as if you have a cold or flu. To maximise recovery:

  • Avoid bending, lifting, or vigorous activity for 2 weeks;
  • No work, exercise or sport for 10 days (you may do some gentle walking);
  • You may gently blow your nose during the first 2 weeks. If you need to sneeze, then do so through an open mouth.

Posture

Try to keep your head up as much as possible. Keep your head elevated when resting, and sleep with 2 pillows if able. Avoid stooping over.

Bleeding

It is normal to have nasal ooze for the first 24 hours, which will reduce by half each day. Minor bleeding is expected for 3-4 days post-op.

Major bleeding is rare but can occur and is typically quite profuse. If this happens please attend the nearest hospital emergency department or call an ambulance.

Diet

There are no dietary restrictions and you may eat as soon as food is tolerated. A cool diet helps in the first few days to minimise bleeding.

Pain

The maximum discomfort will occur in the first couple of days after surgery. You may experience some headaches. Please take the pain medication as prescribed.

Appearance

Minor bruising and swelling is to be expected around the eyes and face, which may be more apparent in the mornings.

When to call the Doctor

Please call if you experience:

  • Any extreme swelling or bruising that is not settling;
  • Persistent pain not relieved by the pain medication;
  • Elevated temperature over 38.5°C; and
  • Bleeding that has not subsided after 20 minutes of applying gentle pressure to the side of the nose while sitting in an upright position with head bent forward (Oozing can be expected).

Medications

  • Saline nasal rinse (Flo or Sinus rinse): Please rinse your nose with the bottle prescribed (over a sink) 4 times a day.  Continue for 1 month. Refill sachets (x50 or x100) can be purchased from your local pharmacy.
  • Extra pain medication (Oxycodone / Tramadol): These are pain relief medications. Please take as prescribed. While taking Oxycodone and tramadol it is important to realise that you should not drive or operate heavy machinery. This medication can cause drowsiness and constipation
  • Antibiotics: Please take as directed, plus the repeat if prescribed.

Avoid Aspirin and Nurofen as they increase the risk of bleeding.

Follow Up Appointment

At the time you book your surgery a post-operative appointment will usually be organised. Please contact Dr Morrissey if you are unsure as to the appointment details.

Nasal splints and dressings (if used in your surgery) will be removed at this visit.

How to contact Dr Morrissey

For non-emergency issues please call (07) 4646 4275 for further instructions.

Dr Morrissey shares ‘on-call’ arrangements with other ENT surgeons and one is usually available to answer questions. After Hours the "On Call" ENT surgeon can be contacted via the Toowoomba Base Hospital on (07) 4616 6000.

Should your concerns not be addressed via a phone call please present to your nearest Emergency Department.

In the event of an Emergency call 000 or attend the nearest Emergency Department.

Related Information

Blocked Nose