Breathe Freely: Surgery for a Deviated Nasal Septum

A deviated nasal septum is a common condition that can significantly impair quality of life by obstructing nasal breathing. In cases where conservative methods do not bring relief, surgical intervention known as septoplasty becomes an effective solution. This surgery aims to restore the correct anatomy of the nasal septum, ensuring a free passage of air and improving overall health.

What is a Deviated Nasal Septum and Why Does It Matter?

The nasal septum is a thin wall of cartilage and bone that divides the nasal cavity into two halves. Ideally, it should be straight and centrally located, ensuring an even flow of air through both nostrils. However, in many people, the septum is deviated, which can be the result of trauma or developmental anomalies.

A deviated nasal septum can lead to a number of problems, including:

• Difficulty breathing through the nose (unilateral or bilateral).
• Chronic nasal congestion.
• Frequent nosebleeds.
• Recurrent sinusitis and upper respiratory tract infections.
• Snoring and, more seriously, obstructive sleep apnea (OSA) [1].
• Dry mouth due to forced mouth breathing.

Obstructive sleep apnea (OSA) is a serious comorbid condition characterized by repeated upper airway collapses during sleep, leading to intermittent hypoxia (lack of oxygen) and sleep fragmentation [1]. Although a septal deviation is not the sole cause of OSA, it can significantly exacerbate it. Patients with OSA require a customized anesthetic strategy due to the expected difficulty of airway intubation and increased vulnerability to postoperative respiratory failure [1]. Improving nasal breathing after septoplasty can help alleviate OSA symptoms and improve general condition.

When is Surgery (Septoplasty) Indicated?

The decision to perform a septoplasty is made after a thorough assessment of the patient's condition. Surgery is recommended if:

• Symptoms of a deviated septum (difficulty breathing, frequent infections, snoring) significantly impair the quality of life.
• Conservative treatment methods (e.g., nasal sprays, antihistamines) do not bring the desired effect.
• Septal deviation is the cause or a significant factor worsening obstructive sleep apnea.
• It is necessary to improve access to the nasal cavity for other surgical procedures, such as for chronic sinusitis.

Diagnosis includes a physical examination, nasal endoscopy, and, if necessary, computed tomography (CT). CT can provide objective information about the degree of deviation and the state of surrounding structures [1]. The importance of thorough preoperative assessment and understanding individual anatomical features is emphasized in various surgical fields, as unusual anatomical variants can pose significant risks during procedures [3].

How is Nasal Septum Surgery Performed?

Septoplasty is usually performed under general anesthesia, although local anesthesia with sedation may be used in some cases. The duration of the surgery ranges from 30 to 90 minutes, depending on the complexity of the case.

Main stages of the surgery:

1. Anesthesia: The patient is administered medications to ensure complete pain relief and comfort during the procedure. For patients with comorbidities such as OSA, the anesthetic strategy is carefully planned [1].
2. Access: The surgeon makes a small incision inside the nose, usually on the mucosal lining of the septum, to gain access to the cartilage and bone structures.
3. Correction: The mucous membrane is carefully separated from the deviated parts of the septum. The surgeon then removes or reshapes the deviated parts of the cartilage and bone to straighten the septum. The goal is to create an even passage for air.
4. Reposition and Fixation: After correction, the mucous membrane is returned to its place. Special soft packs or silicone splints may be used to support the new shape of the septum and prevent hematomas, which are removed after a few days.
5. Completion: The incision is closed with absorbable sutures.

Modern septoplasty techniques are often minimally invasive, which contributes to a faster recovery.

Recovery After Septoplasty: What to Expect?

The recovery period after septoplasty usually takes a few weeks, although most patients can return to normal activities within just a few days.

• First days: Moderate pain, swelling, and nasal congestion are possible after surgery. Pain relievers are prescribed to ease the condition. If packs were placed, they are removed in 1-3 days.
• Nasal care: It is important to follow the doctor's recommendations for nasal cavity care, including saline rinses for moisturization and crust removal.
• Restrictions: For several weeks, it is recommended to avoid strenuous physical activity, heavy lifting, bending the head, blowing the nose, and wearing glasses that can put pressure on the bridge of the nose.
• Final result: Complete healing and formation of the new shape of the septum can take several months. Gradually, nasal breathing improves, and many patients note significant symptom relief.

Possible Risks and Complications

Like any surgical intervention, septoplasty carries certain risks, although serious complications are rare. These include:

• Bleeding.
• Infection.
• Numbness in the nose or upper lip area.
• Nasal septal perforation (formation of a hole).
• Recurrence of deviation or unsatisfactory aesthetic result requiring repeat surgery.
• Changes in sense of smell.

Discussing all potential risks and benefits with the surgeon prior to surgery will help make an informed decision.

Sources

1. Perioperative Airway Management in Treacher Collins Syndrome With Obstructive Sleep Apnea: A Case Report. (The American journal of case reports, 2026). https://pubmed.ncbi.nlm.nih.gov/42647449/
2. Retropharyngeal Internal Carotid Artery Presenting as Chronic Otalgia and Throat Pain Mimicking Laryngopharyngeal Reflux: A Case Report. (Cureus, 2026). https://pubmed.ncbi.nlm.nih.gov/42621603/

Disclaimer: The information provided in this article is for reference purposes only and should not be used for self-diagnosis or self-treatment. Always consult a qualified medical professional for an accurate diagnosis and individualized treatment plan.