Deviated septum (septoplasty) at Bournemouth Hospital

A deviated septum is when the wall of bone and cartilage dividing the two sides of your nose is off-centre or crooked. Septoplasty is the surgery used to correct it when it's causing troublesome symptoms.

What conditions does septoplasty treat?

Most people have a slightly off-centre septum without any symptoms. If the deviation is more pronounced, it can cause:

• difficulty breathing through the nose, often worse on one side
• nosebleeds
• frequent or chronic sinus infections
• facial pain or headaches
• noisy breathing or snoring during sleep
• a reduced sense of smell
• postnasal drip or a runny nose.

What are the benefits of septoplasty?

Correcting a deviated septum can significantly improve breathing, sleep quality and exercise tolerance, and once it's fixed, it's almost always fixed for life. Because the surgery is carried out through the inside of your nose, there are no visible cuts or scarring afterwards.

If you need or want other nasal procedures, these can often be combined with your septoplasty in a single operation, reducing the number of times you need surgery.

Are there different surgical approaches?

Septoplasty can be carried out using a traditional or an endoscopic technique, both using special surgical instruments; either way, your surgeon works through the inside of your nose, so there are no cuts on the outside.

Depending on your needs, septoplasty can be combined with other procedures during the same operation, such as rhinoplasty to reshape the outside of your nose, endoscopic sinus surgery, turbinate surgery, or nasal valve repair.

What happens before septoplasty?

Your doctor will examine your nose using a light or an endoscope, and you may need a CT scan or nasal endoscopy for a more detailed view. Before surgery is considered, non-surgical treatment is usually tried first, typically at least 6 weeks of a saline nasal spray alongside a nasal steroid spray, sometimes combined with decongestants or antihistamines.

If your symptoms continue despite this, your consultant may recommend septoplasty. As it's usually day case surgery, you'll need to arrange for someone to drive you home afterwards.

What happens during septoplasty?

1. You're given a general anaesthetic, so you're asleep for the whole procedure.
2. Your surgeon makes a cut inside your nose; there are no cuts on the outside.
3. They reposition your septum to the centre of your nose, which may involve cutting or removing parts of the cartilage or bone.
4. If needed, rhinoplasty or another nasal procedure may be carried out at the same time.
5. Your nose may be packed with dressing to control any bleeding straight after the operation.
6. The operation usually takes 60 to 90 minutes, depending on the extent of the deviation.

What does recovery look like?

In hospital

Septoplasty is usually day case surgery, so you'll go home the same day. Any nasal packing is only temporary and will be removed before you're discharged. Your nose will feel blocked for a few days, and any pain can usually be managed with over-the-counter painkillers such as paracetamol.

At home

Rest and take things easy for the first couple of days, though you don't need to stay in bed, and most people take about a week off work. Avoid strenuous activity for the first few weeks, don't blow your nose until your follow-up appointment, and sleep with your head slightly raised to help with any swelling.

Some relief in your symptoms can be noticed in as little as 3 to 4 weeks, though it can take up to 12 months to see the final result.

What are the risks and complications?

As with any surgical procedure, there are risks, including:

• bleeding, pain, infection or scarring
• a change in the shape of your nose
• septal perforation, an opening in the septum
• a decrease in your sense of smell
• your symptoms returning, meaning the procedure may need to be repeated.