What is the nasal septum?
The nasal septum is the structure which divides the nasal cavity into two. It comprises cartilage at the front and bone higher up and further back and is covered on both sides with nasal mucosa.
Why should Septoplasty be necessary?
Deviation of the nasal septum not only compromises the nasal airway but can also predispose to sinusitis where there is contact between it and the outer nasal wall. At points of contact the microscopic ‘cilia’ which clear nasal secretions stop working and infection can develop.
Deviation of the septum can also result in deviation of the nasal tip and correction of the septum is therefore necessary to straighten the nose.
Occasionally a defect in the septum can result in collapse of the nasal dorsum and a ‘saddle’ like appearance. This can be caused by a variety of medical conditions and nasal trauma but unfortunately is most often seen after surgery by a sinus specialist where the nasal mucosa has not been preserved and the underlying cartilage, deprived of nutrition from the mucosa ‘melts away’ to leave a septal perforation. Cocaine abuse has the same effect. Septal perforations can also cause an audible whistle, bleeding and crusting.
How is Septoplasty performed
Surgery by a sinus specialist to reposition a deviated nasal septum is known as a septoplasty. This is performed under general anaesthetic through small incisions within the nose.
Septal reconstruction using cartilage harvested from the ear and mucosal flaps to cover the graft occasionally requires an ‘open’ approach with a small incision crossing the skin between the nostrils. This incision tends to heal extremely well and is generally barely perceptible after a few weeks.
What’s new in Nasal Surgery?
- Endoscopic septoplasty allows a minimally invasive approach by a sinus specialist
- Suturing septum to avoid nasal packing
- Emphasis on cartilage preservation and meticulous care with mucosa to prevent perforation
- Biomaterials in septal reconstruction