Nasal Septum Surgery: Teen Version

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KEY POINTS

• Nasal septum surgery is done to straighten or repair the nasal septum when you are 13 through 17 years old. The septum is the wall of bone and tough, flexible tissue (cartilage) between the 2 nasal passages in the nose.
• After nasal septum surgery, you should be able to breathe more easily, and you may have fewer infections, or nosebleeds if that was a problem.
• Every procedure or treatment has risks. Ask your healthcare provider how the risks apply to you.

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What is nasal septum surgery?

Nasal septum surgery is done to straighten or repair the nasal septum when you are 13 through 17 years old. The septum is the wall of bone and tough, flexible tissue (cartilage) between the 2 nasal passages in the nose.

Other names for this procedure are nasal septum reconstruction or nasal septoplasty.

When is it used?

This surgery is done to fix a deviated septum, which means that it is bent out of shape, pushed to one side, or crooked. It may be from a nose injury or it may be a condition you had at birth. It may be done to make it easier for you to breathe and to reduce the number of sinus infections and nose bleeds you get.

Your healthcare provider will examine you to diagnose the deviated septum. You may also have these tests:

• An endoscopy, which uses a slim, flexible, lighted tube passed through your nostrils to examine your nasal passages
• A CT scan, which uses X-rays and a computer to show detailed pictures of your nasal passages, that is used when you have a lot of sinus infections

Your healthcare provider will fix the deviated nasal septum because of these conditions:

• A blockage (obstruction) with stuffiness and trouble breathing through the nose especially during physical activity
• Sinus infections (rhinosinusitis) that keep coming back at least 4 times in a year
• Sinus infections that don’t get better with treatment, with symptoms lasting at least 12 weeks
  • You may have taken antibiotic medicine for at least 3 weeks and steroid medicine by mouth for at least 5 days or by nose spray for at least 3 weeks, if you can tolerate the medicines and are not allergic.
  • Symptoms may include:
    • Drainage
    • Trouble breathing
    • Pain, pressure, or a feeling of fullness in your face
    • Decreased sense of smell
• Nosebleeds that happen often

Your healthcare provider may plan to do nasal septum surgery:

• With other planned surgery:
  • To fix a blocked tear duct and form a new way for tears to drain (dacryocystorhinostomy or DCR)
  • To reshape your nose to help you breathe (septorhinoplasty)
• When you are not able to tolerate using a continuous positive airway pressure (CPAP) machine that uses air flow to keep your airway open while you sleep, even after trying decongestant and steroid medicines for at least 6 weeks

After nasal septum surgery, you should be able to breathe more easily, and you may have fewer infections, or nosebleeds if that was a problem.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• This surgery is usually an outpatient procedure, which means that you may be able to go home the same day or the day after surgery. Talk to your healthcare provider about where you will have your surgery.
• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure or when you leave the hospital. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Follow your provider's instructions about not smoking before and after the procedure. People who smoke may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Your provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do.

What happens during the procedure?

You will be given a local or general anesthetic to keep you from feeling pain. Local anesthesia numbs the part of your body where you will have the surgery. If you have local anesthesia, you may also be given medicine to help you relax. General anesthesia relaxes your muscles and puts you into a deep sleep.

Your healthcare provider will make a cut inside the lining of your nose. Your provider will reshape the septum so that it will heal in a more normal position. Your provider may put a splint in your nose to hold the septum in place.

After surgery, your provider may pack thin pieces of gauze into each side of your nose to control bleeding.

What happens after the procedure?

Sleep with your head up on at least 2 pillows. Limit your physical activity for a few days after surgery. This helps decrease swelling and the chance of bleeding.

Don’t push on or jar the nose while it is healing. Don’t blow your nose. It’s OK to draw a breath back into your nose and swallow.

If you have packing in your nose:

• Your loss of smell will decrease your appetite. You may prefer a liquid or soft diet, but you can eat whatever you feel like eating. It’s best to avoid hot and spicy foods because they may increase bleeding.
• You will be breathing through your mouth until the packing is taken out of your nose. This will make your mouth dry, so drink plenty of liquids.
• The packing will be removed in 1 to 7 days. After the packing is removed, don’t blow your nose for 48 hours. Also try not to cough too hard. Blowing your nose or coughing may start bleeding.

If you have a nosebleed, lean your head forward so the blood does not go down your throat, and put gauze over your nostrils. If the bleeding does not stop within 10 minutes, call your healthcare provider. You may need to go to the emergency room to have the bleeding stopped.

Follow your healthcare provider's instructions. Ask your provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may lose some of the feeling in your upper lip or teeth. Your front teeth may be numb because of stretching of the nerves that go from the base of the nose down into the front teeth.
• You may have an infection or bleeding.
• Your septum may develop a hole if it doesn’t heal properly.
• Rarely, the front part of your nose may be flatter than before surgery.

Ask your healthcare provider how the risks apply to you. Be sure to discuss any other questions or concerns that you may have.