Nose & Sinus

Septoplasty / Sinus surgery

When is sinus surgery required?

Many sinus problems will settle down with medical treatments such as sprays, rinses and antibiotics. For those that do not sinus surgery can be useful. Sinus surgery is also used to remove tumours and benign growths such as polyps.

What is done during sinus surgery?

Most sinus surgery is performed via the nostrils using a small rigid camera (an endoscope) and specialized instruments. This is called functional endoscopic sinus surgery (FESS). This surgery gently opens the natural drainage pathways of the sinuses into the nose to allow them to ventilate. It is also possible to remove polyps and tumours from the nose using similar techniques. FESS is often combined with septoplasty (straightening of the nasal septum) and turbinoplasty (reduction of the inferior turbinate bone) to improve your ability to breathe through your nose.

What Is A Septoplasty, Septorhinoplasty? | My ENT Specialist
Septoplasty Sinus Surgery | My ENT Specialist

What is a septoplasty / Septorhinoplasty?

Septoplasty is surgery to straighten the septum of the nose. (The nasal septum is the dividing wall that separates the right and left side of your nose, and it is comprised of bone, cartilage and mucous membranes.) Straightening a deviated septum can improve your ability to breathe through your nose.

A septoplasty is performed under a general anaesthetic. During the surgery, the surgeon makes a small cut on the inside of the nose, which is accessed via the nostril. He then lifts the mucous membrane up off the nasal septum. Septal cartilage is necessary at the front of the nose to provide support but further back deviated cartilage and bone can be removed leaving the layers of mucous membrane to form the dividing wall. Dissolving stitches are then used to close the incision and then passed backwards and forwards from one side to the other to hold the layers of the nose together (quilt suture).

Sometimes the deviated part of the septum is right at the front of the nose or is too severe to be treated by septoplasty alone. In these cases a septorhinoplasty is the best operation. This is done through a cut in the skin in the columella under the nose, the skin is then lifted up off the cartilages and bones of the nose. The septum can then be accessed by splitting the nasal cartilages down the middle. Septorhinoplasty is also the operation we perform if cosmetic changes to the outside of the nose are being performed. After septorhinoplasty you will have 3 small stitches under the nose and a plastic dressing on the nose (a splint).

What is a turbinoplasty?

Turbinoplasty is a minor procedure to reduce the size of the inferior turbinate bones, which are the curved bones on the outer walls of the nose. They are important as they warm and humidify the air that we breathe. They can become swollen mostly due to allergic rhinitis, and can result in a blocked nose.

During a turbinoplasty, the inferior turbinate bones are accessed via the nostrils. After lifting the mucous membrane that covers the bones, the inferior turbinates are gently reduced in size with a small shaving instrument.

How effective is septoplasty/ turbinoplasty?

In most cases, septoplasty and turbinoplasty significantly improves nasal obstruction.

How long will I take to recover from septoplasty and sinus surgery?

This surgery can be performed as a day procedure in most cases. Pain after surgery is usually mild, and can be treated with simple painkillers such as ibuprofen or paracetamol. Dissolvable packs are left inside the nose after the surgery. Mild bleeding is common in the first few days after surgery, but usually resolves on its own. Generally nose blockage is improved fairly soon after surgery but the nose will feel congested for several weeks.

It is advisable to stay off work for one week after septoplasty and turbinoplasty surgery (two weeks after septorhinoplasty). You should avoid nose blowing as you can blow air into the tissues of the face and eyelids. It is advisable to use a saline rinse 3-4 times a day for the first 2 weeks after surgery. After Septorhinoplasty you will need to have your stitches removed and your splint taken off one week after surgery.

Does sinus surgery have any complications?

Most of these procedures are quite minor and are often carried out as day surgery. Like any surgery there may be some complications although these are rare. The main complication of any nose surgery is bleeding in the first week after the procedure. This is generally self limiting and we may recommend they you use a nasal decongestant spray such as Otrivine. Occasionally it is more severe and can mean a return to the operating theatre to cauterise the area that is bleeding.

When the septum heals it may leave a small hole or Septal Perforation. Generally these do not cause any symptoms but rarely whistling when breathing, crusting and bleeding may result. Changing the shape of the septum or removing cartilage can result in a change in appearance of the nose although generally this is very mild.

Septoplasty Sinus Surgery | My ENT Specialist

Complications after FESS and turbinoplasty are similar to septoplasty and include bleeding, infections and crusting. There are some more serious complications of sinus surgery but these are exceptionally rare (1:16000-1:60000) and will be discussed with you prior to surgery.

Septorhinoplasty can leave a small scar. The tip of the nose can remain swollen for a few months after septorhinoplasty surgery. Occasionally patients who have had a septoplasty or septorhinoplasty experience numbness or tingling at the tip of the nose, or in the upper incisor teeth. This is caused by nerve irritation, and usually resolves within a few months.