Endoscopic Septoplasty

What is Endoscopic Septoplasty?

It is a minimally invasive technique that corrects the deviated septum under excellent visualization. It was introduced in 1991 by Lanza et al and Stammberger for the application of deformity of septum using an endoscope

 

In most cases, the deformed septum doesn’t cause any major issues. However, there can be some associated problems that require the person to undergo the endoscopic septoplasty-

  • Obstruction in one or both the nostrils

This makes it difficult for the person to inhale through the nostril or nostrils. When the person suffers from a cold, this is more evident as the nasal entries swell and become tight. 

  • Nosebleeds

Drying of the septum can lead to the risk of nosebleeds. (Read here: How to stop nose bleeds)

  • Noisy breathing while asleep

Especially evident in babies and young children, deviated septum or swelling of the intranasal tissues can lead to noisy breathing while the person is asleep.

  • Recurrent sinusitis

As the septum is deformed, the sinuses are unable to drain mucus properly. This eventually leads to mucus build-up that can get infected and ultimately, repeated episodes of sinusitis.

  • Recurrent otitis media

Due to uneven passage of the nose, the ears are unable to drain properly leading to fluid-up that can get infected. This is known as otitis media

Also read: Home remedies to treat ear infection

  • Isolated septal spurs

Isolated spurs of the bone can block the passage of the nose and make it difficult for the person to breathe.

What is the procedure of Endoscopic Septoplasty?

The whole procedure of septoplasty is performed under the influence of anesthesia. The whole procedure takes 30-90 minutes to complete. With the help of the O-degree scope, the ENT doctor makes an incision on one side of the nose. Sometimes, along with an endoscopic septoplasty, a Functional Endoscopic Sinus Surgery (FESS) is also performed. Once the deformity is corrected with a septoplasty, the sinus surgery can be done. 

Unlike the traditional septoplasty, in the endoscopic septoplasty, there is no lifting up of the submucosal lining.

Read More: How does the nose look before and after septoplasty?

What are the risks that can occur after Endoscopic Septoplasty?

In the medical literature, the following complications and risks that can occur after the septoplasty-

  • Bleeding 
  • Empty nose syndrome in which the nose becomes excessively dry
  • Unable to resolve associated sinus headaches
  • Damage to the eye
  • Damage to the skull base
  • Meningitis
  • Brain abscess
  • Leakage of spinal fluid
  • Numbing of the upper teeth permanently
  • Chronic pain
  • Unable to control sinusitis or nasal polyps (Know here: 11 Natural Remedies To Cure Nasal Polyps)
  • Not able to restore the sense of smell or taste

What are the benefits of Endoscopic Septoplasty?

The Endoscopic approach to septoplasty provides several benefits over the standard head light technique-

  • Adequate visualization
  • More space for inserting instruments during a FESS
  • Access to Paranasal sinuses and for other surgeries such as transseptal approach
  • Stopping of nasal bleeding after the surgery
  • Minimal lifting of the flap

Also Read: Cost of Endoscopy in India

How to recover after Endoscopic Septoplasty?

Once the procedure of endoscopic septoplasty is complete, here are a set of post-operative instructions you should follow-

  • For 1 week following the surgery, do not blow the nose. However, if you feel like sneezing then don’t hold it back.
  • If there is a nose bleed, tilt head back slightly and breathe gently through the nose. Dab the nose gently with a tissue. 
  • Use over-the-counter nasal sprays to help control nasal bleeding. However, use these only for 2-3 days or else you might have a stuffy nose
  • Go for a nasal wash with saline solution from the first day of the recovery itself. For best results, do this twice a day unless instructed differently. Eventually, this speeds up recovery. 
  • If you have a nasal splint, you do not need to irrigate the nose. Keep the nose moist with saline sprays.
  • Take at least 1 week off from work to recover after the surgery.
  • Limit exercise or any exertion for at least 2 weeks after the surgery. This involves no bending, lifting or straining.

Medicines for Pain-relieving

  • Take a dosage of pain medication about 45 mins before the first postoperative follow-up.
  • Do not take both Tylenol and prescribed pain reliever unless other specific instructions are made.
  • Do not consume aspirin or products that contain aspirin or non-steroidal anti-inflammatory drugs for the first week after the surgery.
  • Limit restarting topical nasal steroid or antihistamine sprays, including nasal washes.

What is the cost of Endoscopic Septoplasty?

Usually, insurance does not cover nasal surgery for cosmetic reasons. However, medical insurance can cover wholly or partially for surgery performed to correct or improve breathing function, structural deformity, or injury. The cost of Endoscopic Septoplasty is USD 1600.

Get in touch with the surgeons or insurance providers to know more about cost and coverage before the surgery.

Read More

References

  • http://medind.nic.in/ibd/t05/i3/ibdt05i3p240.pdf

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