Surgeries performed to correct the curvatures of the septum, which separates the two nasal passages from each other and consists of cartilage in the front and bone in the back, are called "septoplasty". Since septum deviation is a very common problem in society, "deviation surgeries" to correct this problem are among the most frequently performed surgeries.
When deciding for septoplasty surgery, the patient's complaints and nasal congestion are affected by the patient's health and quality of life as well as the examination findings of the nose. Its negative effects on the patient are taken into consideration.
There is no alternative other than surgical treatment in patients whose nasal congestion complaint is determined to be due to septum curvature (deviation).
How is Deviation Surgery Performed?
Successful results can be achieved with standard closed technique septoplasty surgeries, which are performed through the nostrils and last for 20-30 minutes, usually by removing the curved cartilage and bone parts, in cases where there is no excessive bending in the cartilage part that forms the front half of the nose, which is not close to the back of the nose, and does not include the bone roof of the nose. . Although the large number of such standard surgeries being performed leads to the erroneous perception that deviation surgery is generally a "simple" surgical intervention, the frequency of encountering serious curvatures that require different surgical approaches is quite high, due to the genetic characteristics of our geography.
When is Open Technique Deviation Surgery Preferred?
In cases where the curvature in the nose is in the narrower upper part of the air passage of the nose or in the form of a vertical angulation, and in patients whose septum cartilage is severely deformed or who have had previous nose surgery. Since the curved parts require repair instead of removal, "open technique septoplasty surgery" should be preferred. Performing standard closed surgery on patients with such deviation problems often causes the surgery to fail, and if the patient undergoes surgery again, there will be a problem because there is not enough cartilage left in the nose for repair. The risk of this happening is quite high.
In cases where the external bone and or cartilage roof of the nose is crooked and in patients who are planned to undergo aesthetic nose surgery during the surgery for deviation, open technique surgery is also preferred. Although standard deviation surgeries are a part of ENT specialist training, achieving successful results in open technique surgeries often requires special training and experience in the field of nose surgery.
Nowadays, "open technique" is frequently preferred in surgeries performed only for aesthetic purposes. It is possible to correct the cartilage and bone curvatures in the most ideal and permanent way without changing its appearance. In patients with cartilage deficiency or deformity due to previous surgery, if there is not enough cartilage to create a flat and solid structure in the septum, cartilage pieces taken from the auricle or rib may need to be used in the nose.
Can Tampons Be Used in Deviation Surgery? ?
With the surgical techniques developed today, it is possible to perform deviation and aesthetic nose surgeries without tampons, which makes a significant contribution to the comfort of patients after surgery. In patients who do not undergo a procedure such as endoscopic reduction that requires the use of tampons in the lower nasal concha during the same surgery, surgery for deviation is performed without tampons.
Can Rhinoplasty Surgery Be Performed Along with Deviation Surgery?
If patients who need surgery due to deviation are also considering aesthetic nose surgery, the ideal approach is to perform both surgeries at the same time.
What Should Be Considered After Nose Surgery?
Deviation surgeries are preferably performed under general anesthesia and can be performed with a closed technique for 20-30 minutes with an open technique depending on the degree of the problem and the need to remove cartilage tissue from the ear or ribs. It takes around 1 to 2.5 hours depending on whether it is available or not. Patients generally stay in the hospital on the day of surgery and are discharged the next day after nasal cleaning.
It is usually sufficient for patients to come for check-ups 2 or 3 times after surgery. is happening. Cleansing sprays containing salt water and softening drops or sprays are used for drying and crusting that occurs for 2-3 weeks until the mucosal healing in the nose is completed.
The cause of cartilage curvature that does not require aesthetic intervention or is at a level that affects the appearance. In patients who do not undergo open technique surgery, there is no change in the external appearance of the nose after the surgery, and there is no swelling or color change around the face and eyes.
Patients must protect their nose from impact for 6 weeks after deviation surgery. They can start sports activities that do not have a risk of impact after two weeks and swimming after 1 month. There is no harm in wearing glasses for patients who have only had deviation surgery, regardless of the technique used.
What is Nasal Valve Insufficiency and How Is It Treated?
The angle areas at the junction of the midline septum at the entrance of the nose and the lateral nasal walls. Nasal valves are the areas where the air flow entering the nose is most intense and rapid. Stenosis, which occurs for various reasons in these regions and is called nasal valve insufficiency, is observed in two different types, internal (inside) or external (outside).
Internal insufficiency is usually caused by the curvatures in the upper front part of the cartilage septum, close to the back of the nose. It is caused by the narrowing of the air passage in the valve area. In the treatment, in addition to revealing this area and correcting the curvature with open technique deviation surgery, the valve area can be expanded to relieve air flow by using cartilage pieces when necessary.
The main problem in external nasal valve insufficiency is that the nasal wings collapse inward while breathing, narrowing the air passage. This problem is caused by the fact that the cartilage structures in the nose wings are structurally weak or inversely inclined, or are weakened due to aesthetic surgeries, traumas, aging, etc. and cannot withstand the vacuum effect created by the air flow. In order to prevent this collapse in the treatment, supporting the weak areas with cartilage pieces, correcting the angle of the cartilage causing the narrowing and preventing the collapse with the help of stitches. Such techniques are used.
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