This letter originally appeared in Dr. Hoffman's column on allHealth.com. |
Septoplasty and turbinatoplasty for nasal airway obstruction
Q: Can an operation really help someone breathe through their nose? I have been told that my septum is deviated.
A: Nasal airway surgery is indicated whenever there is an anatomic abnormality (such as a deviated septum) which causes nasal airway obstruction that is present all of the time, or very nearly all of the time. The septum is the structure that divides your nasal cavity into a left and right compartment. Its center is made up of cartilage and bone, which are sandwiched between two layers of soft tissue. Septal deviation occurs when the septum has shifted from the midline. Birth trauma, a broken nose, or even the simple vagaries of growth can lead to a deviated septum. The operation to correct a deviated septum, known as septoplasty, involves movement of all septal components back to the midline.
Turbinate hypertrophy can also contribute to nasal airway obstruction. Turbinates are sausage-shaped structures that are on the lateral wall of each nasal cavity. Turbinates warm, humidify and filter the air that we breathe. If they are abnormally enlarged (hypertrophic) they can obstruct the nasal airway. Because the turbinates perform a necessary function, they cannot simply be removed. Many different operations have been devised to make the turbinates smaller. The general term for such an operation is turbinatoplasty.
Quite frequently, septoplasty and turbinatoplasty are performed together in order to get the best possible nasal airway. This may be done under local anesthesia but is more commonly performed under general anesthesia. All incisions are within the nose; there are no facial scars from this procedure. It is a "same day" surgery, and the recovery time is typically 3 to 7 days. (It may take one month or more for the tissues within the nasal cavity to heal, but you should be able to return to nonstrenuous work in 3 to 7 days.)
If you have nasal airway obstruction due to septal deviation AND allergies, one conservative approach would be for your doctor to treat your allergies first, and then consider performing a septoplasty only if you continue to have significant nasal airway obstruction. If your doctor takes the opposite approach (ignores the allergies and straightens the septum) you may be very disappointed with the results. Swollen nasal tissues (from allergy) can obstruct a nose very easily– whether the septum is straight as a carrot or crooked as an elbow macaroni.