What is nasal septum repair?

The nasal septum is the wall between the nostrils that separates the two nasal passages. It supports the nose and directs airflow. The septum is made of thin bone in the back and cartilage in the front. A deviated septum means that the cartilage or bone isn't straight. A crooked septum can make it hard to breathe. It can also lead to snoring and sleep apnea.

The septum can bend to one side or the other as a part of normal growth during childhood and puberty. Also, the septum can be deviated at birth (congenital) or because of an injury, such as a broken nose. Very few people have a perfectly straight septum.

Before surgery, the doctor may use a thin, lighted tool (endoscope) to look at your nasal passages and to see the shape of your septum. In some cases, the endoscope may be used during surgery. You will receive local or general anesthesia for the 60- to 90-minute operation, which is usually done in an outpatient surgery center.

The septum and nasal passages are lined with a layer of soft tissue called the nasal mucosa. To repair the septum, the surgeon works through the nostrils, making an incision to separate the mucosa from the cartilage and bone. The doctor trims or straightens the bent cartilage and then replaces the mucosa over the cartilage and bone.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. Do not lie flat. Raise your head with two or three pillows. This can reduce swelling. Try to sleep on your back for the month after surgery. You can also sleep in a reclining chair.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation. Also, try to sit and stand as much as you can.
• For 1 week, try not to bend over or lift anything heavier than 10 pounds. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• You can take a shower or bath. Avoid swimming for 6 weeks.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 1 week or until your doctor says it is okay.
• You may drive when you are no longer taking prescription pain pills and feel up to it.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Do not take aspirin, aspirin-containing medicines, or anti-inflammatory medicines such as ibuprofen (Advil, Motrin) or naproxen (Aleve) for 3 weeks following surgery unless your doctor says it is okay.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over- the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Incision care

• You will have a drip pad under your nose to collect blood. Change it only when it has bled through. You may have to do this every hour for 24 hours after surgery. When bleeding stops, you can remove it.
• If you have packing in your nose, leave it in. Your doctor will take it out.

Ice and elevation

• To help with swelling and pain, put ice or a cold pack on your nose for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
• Sleep with your head raised up. You can also sleep in a reclining chair.

Other instructions

• Do not blow your nose for 1 week after surgery.
• Do not put anything into your nose.
• If you must sneeze, open your mouth and sneeze naturally.
• Use saline (saltwater) nasal washes to help keep your nasal passages open and wash out mucus and dried blood. You can buy saline nose sprays at a grocery store or drugstore. Follow the instructions on the package. Or you can make your own at home. Add 1 teaspoon of salt and 1 teaspoon of baking soda to 2 cups of distilled or boiled and cooled water. Fill a squeeze bottle with the nasal wash. Then put the tip into your nostril, and lean over the sink. With your mouth open, gently squirt the liquid. Repeat on the other side.
• You can wear your glasses when you wish. Do not wear contacts until the day after the surgery.

This is a common nasal surgery, and most people recover well.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

All surgery has a small risk of infection or bleeding. This surgery also carries a small risk of a hole (perforation) forming in the septum. A perforation rarely requires treatment. More surgery may be needed if the perforation causes discomfort or an infection develops.

Other risks include a small change in the shape of your nose or a continued blockage in your nose.

After surgery, you may have a nasal splint or pack placed in your nostrils to stop bleeding and keep the septum straight while it heals.

You probably will get instructions on how to care for your nose while it is healing. For example, you may be told not to blow your nose and to sneeze with your mouth open to avoid pressure changes.

You may have some swelling of your nose, upper lip, cheeks, or around your eyes after nasal surgery. You may have some bruises around your nose and eyes. Your nose may be sore and will bleed. This may last for several days after surgery.

The tip of your nose and your upper lip and gums may be numb. Feeling will return in a few weeks to a few months. Your sense of smell may not be as good after surgery. But it will improve and will often return to normal in 1 to 2 months.

You will have a drip pad under your nose to collect mucus and blood. Change it only when it bleeds through. You may have to do this every hour for 24 hours after surgery.

You will probably be able to return to work or school in a few days and to your normal routine in about 3 weeks. But this varies with your job and how much surgery you had. Most people recover fully in 1 to 2 months.

You will have to visit your doctor during the 3 to 4 months after your surgery. Your doctor will check to see that your nose is healing well.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take 1 to 2 hours.