By definition, it is the name of the operation in which the anatomy of the middle compartment and outer roof of the nose is intervened. Of course, this operation is evaluated in two different categories in terms of its purposes and results.
In fact, it is a combination of two different operations. Septoplasty is the name of the operation in which the curvatures of the cartilage and bone wall that partially support the roof in the middle part of the nose are corrected. Rhinoplasty is a visual (aesthetic) correction operation of the roof of the nose, adhering to certain proportions.
The patient's wishes and complaints should be carefully analyzed and the operation should be planned accordingly. The fact that the inner chamber of the nose is in the midline ensures that the intranasal air circulation flows without experiencing turbulence, and the surgeon intervenes accordingly. Intervention in the roof is achieved by a facial facial analysis and finding the point where the patient's wishes intersect. The anatomical structure of the patient may not be suitable for every surgery, so a joint decision should be made for the best possible result by talking to the patient and performing facial analysis with advantages and disadvantages.
Although the patient's intranasal curvatures can be easily understood with the help of a normal nasal speculum during the examination. It is sometimes useful to visualize the inside of the nose endoscopically for ease of explaining the pathology and the procedure to the patient. In patients with suspected accompanying chronic sinusitis, paranasal sinus tomography is planned to rule out the diagnosis of possible sinusitis.
Nasal roof and external appearance analysis is more comprehensive. Facial proportions, skin analysis and gender cause different planning. The patient's cartilage framework and supports should be analyzed especially well. ***** Postoperative edema (swelling) is more common in patients with thick and oily skin. In patients with thin skin, the slightest irregularities may be noticeable, so transition points should be camouflaged. While the skin is thicker at the tip of the nose, it has the thinnest skin thickness at the exact cartilage-bone transition point. At the root of the nose, the skin is thin but the subcutaneous tissue is abundant.
Gender is important in terms of the support of cartilage and bone structures. Most of the time, the bone and cartilage skeletons of female patients are more delicate and prone to damage. Age factor was also taken into account A plan should be made. A much better anatomical and surgical plan is obtained in a young patient who has completed cartilage development. Although the age limit varies, performing an aesthetic intervention under the age of 17 poses a risk in terms of cartilage development. However, septoplasty can be performed if there is a functional need.
Septorhinoplasty Before Surgery:
* A detailed anamnesis from the patient. (story) is taken. From time to time, the patient's psychological state also plays an important role in observation.
* The patient's physical examination is performed in detail, taking into account the conditions described above.
* The patient's wishes must be well understood and the patient is suitable for surgery. interventions should be planned.
* The patient's facial analysis should be discussed.
* After the patient decides on the operation, tests are planned for preliminary preparation for this surgery to be performed under general anesthesia. (Blood tests, ECG and AC evaluation. .) chronic diseases should be questioned. Especially allergic diseases such as seasonal allergies may require delaying the surgery for a while.
Septorhinoplasty Surgery Process:
* The patient is asked to fast for 8 hours before the operation.
>* Surgery can be planned as open and closed technique. In open technique operation, the mastery of anatomy and therefore pathology (abnormalities) is greater. In surgeries performed with the open technique, a horizontal incision is made in the middle section separating the nostrils, and a very thin suture material is used after the surgery, aiming to minimize scars.
* The operation duration may be between 2 and 4 hours.
* In revision (re-operation) cases, it may be necessary to take cartilage tissue from the auricle and ribs, depending on the support condition of the cartilage structure. This may extend the operation time by 45-60 minutes.
* Since the anatomy cannot be predicted in revision cases, it may be inevitable to make changes in the plan during the operation.
* During the surgery, creating a new cartilage skeleton with the help of suitable cartilage pieces and stitches. are combined as follows. If there is growth in the flesh structures called turbinates inside the nose during the surgery, it is reduced with RFC (radiofrequency surgery).
* At the end of the surgery, silicone corrugated tampons are used to control bleeding and to ensure that the tissues adhere to the appropriate anatomy places as soon as possible. is used.
* After the surgery, a thermoplastic plaster is placed on the patient's nose to protect it from external influences and to prevent edema (swelling) from increasing too much.
Septorhinoplasty Post-surgery:
* Surgery At the end, when the patient goes to the room, ice is applied to the junctions of both cheeks and nose for 15 minutes every hour, but not too heavily. After the patient fully recovers from anesthesia (3rd hour after arrival in the room), a cold and soft diet is started orally.
* The patient's blood pressure, pulse and bleeding controls are taken during follow-ups.
* The patient is given a cold and soft diet. It is stated that the patient should not bring his/her hand to his/her face and should not touch the thermoplastic cast.
* The patient is 7-8 days after the surgery. It can be sent to your home on time. However, if deemed necessary, the patient may be hospitalized for 24 hours for monitoring.
* Home care is important. First of all, the patient should protect himself from trauma and should not lie face down. The patient continues to apply ice for 20 minutes every 2 hours at home for another 24 hours. Ice applications reduce facial bruises and also reduce bleeding and pain. Bruises on the face under and around the eyes 2. day reaches its maximum. With the removal of intranasal tampons on the 2nd day, it recovers rapidly and remains almost nonexistent within 10 to 12 days.
* The patient will be prescribed medications to use at home after the surgery. These include antibiotics to prevent post-operative infections, analgesics for pain, and antihistamines to prevent sneezing attacks. If sneezing occurs, the mouth must be open and the pressure should not be directed to the nose.
Control:
* When the patient arrives on the 2nd postoperative day, the intranasal silicone tampons are removed and the intranasal crust and clots are cleaned without much difficulty. In addition to the medications used, solutions are prescribed to the patient to clean and moisturize the inside of the nose.
* Although the patient is relieved by removing the tampon, the nose becomes slightly swollen and clogged in response to the surgery. Solutions will help open this blockage. At the end of the 2nd day, you can take a shower so that no more water reaches the face area.
* After removing the tampon, the nose should not be cleaned by blowing. Tap water should not be drawn into the nose.
* The thermoplastic plaster on the nose will be removed at the end of the 1st week. Rine patch application will be made. During this period, the patient will begin to massage the nose area at appropriate angles. There is no longer any need for medication other than washing and moisturizing solutions.
* Since the skin edema still continues when the patches on the nose come off at the end of the 2nd week after the surgery, sunscreens with at least an SPF of 30 should be used to protect the skin from direct sunlight.
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* The use of sunglasses or optical glasses is suspended for 4-6 weeks. Sports activities can be started in the 3rd week without causing trauma to the nose area.
* Post-operative 1-3-6 and 12-month follow-up checks are planned. As can be seen from here, the post-operative process and follow-up takes a long time.
I wish you days full of health.
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