Category Archives: Septoplasty

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Septoplasty and Turbinate Reduction Surgery

Harmony in Breathing: Exploring the Intersection of Septoplasty and Turbinate Reduction Surgery

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You are not alone if you have trouble breathing through your nose or feel congested. About 80% of the world’s population has the same problem, and the reason for that is the deviated septum and enlarged turbinates caused by it. The septum and turbinates are the two most essential components of the nose that ensure regular and comfortable airflow.

 

Septoplasty in India is often combined with turbinate reduction surgery to make breathing easier and relieve various issues, such as chronic congestion, sleep apnea, recurrent and chronic sinus infections, nosebleeds, and facial pain. Let us first examine the functions of the septum and turbinates.

 

What is the septum?

The septum is a thin wall-like structure made of cartilage in the front and bone at the back, and it is covered with mucosa (like the inner lining of your cheek). The septum wall separates the left and right nostrils of the nose. The septum plays a vital role of 

  • maintaining the shape of the nose 
  • ensuring a regular airway. 
  • Protect the nasal structures from trauma
  • Olfaction, which allows us to perceive and distinguish the various smells

The septum can be bent or deviated because of many reasons, such as trauma, accident, or hereditary reasons, and lead to breathing issues coupled with facial pain, congestion, post nasal drip, snoring, etc.

 

What are turbinates?

The turbinates are very tiny cone-shaped bones inside the nose. They are also called nasal conchae. They are curled structures that are bony as well as spongy. They are covered with hair-like structures called cilia that trap the external particles. There are three types of turbinates – inferior, middle, and superior. They play a super important role in regulating airflow for the lungs to work efficiently and also

  • Warm and moisten the air we breathe to ensure it is at body temperature as it reaches the lungs.
  • Keep out the debris and bacteria from the nose and enter the lungs and body.
  • Prevent nasal dryness, infection, and irritation.
  • Help us smell.

 

The turbinates can change in size to control airflow. When we are resting, the turbinates often swell to reduce airflow, and when we are involved in strenuous activities, they constrict to increase the airflow volume in the lungs. The inferior turbinates become inflamed and enlarged because of allergies or other conditions, resulting in blocked airways in the nasal passage and difficulty breathing. 

 

The symptoms of enlarged turbinates are similar to those of a deviated septum, such as chronic sinusitis, nasal congestions, difficulty in breathing, frequent headaches, sleep apnoea, mucus production, and more. 

The relation between deviated septum and turbinates is significant. 

  • A deviated septum reduces the size of one side of the nostril, causing an imbalance in the airflow in the nasal passages. The turbinates on the other end of the uneven airflow swell and become inflamed to compensate for and balance it. If the septum is deviated to the left, then the turbinates on the right will become inflamed. This causes turbinate hypertrophy, where the turbinates are swollen and congested. 
  • A deviated septum also causes nasal obstruction and airflow resistance, further contributing to the turbinates’ swelling and congestion. 

 

The combination of deviated septum and inflamed turbinates also increases the risk of chronic sinusitis. The swollen turbinates obstruct mucus drainage, causing repeated sinus infections and disruptions in daily life. This also exacerbates snoring, sleep apnoea, and sleep disturbances, leading to daytime fatigue and cognitive impairment. 

Septoplasty with turbinate reduction surgery (rhinoplasty)

Depending on the severity of symptoms and individual patient factors, the surgeon will recommend a rhinoplasty and deviated septum surgery in India. 

 

Septoplasty Procedure

Septoplasty, or deviated septum surgery in India, corrects the crooked septum. 

  • It is a surgical procedure done under general anesthesia.
  • An incision is made inside the nose, and the surgeon will lift the membrane covering the septum.
  • The septum (excess cartilage removal or bone trimming) is modified for necessary straightening. 
  • Once satisfied with the reshaping. The surgeon will reposition the membrane to cover the septum and close the incisions using dissolvable stitches.
  • The process takes 30 to 90 minutes, and no visible scarring exists. 

 

Turbinate Reduction Surgery 

The rhinoplasty can be quickly done along with septoplasty surgery to reduce nasal obstruction. There are two types of Rhinoplasty.

  • Intraturbinoplasty is when the surgeon creates a tunnel inside the turbinate and removes the submucosal tissue. 
  • Extraturbinoplasty is the surgery to reposition the turbinate and clear the airway obstructions. 

 

Turbinoplasty Techniques Used

 

Microdebrider rhinoplasty or turbinate resection: The surgeon creates a small incision inside the turbinate. Then, using a small endoscopic camera and a high-speed device called the Microdebrider, the surgeon will remove a partial portion or all of the tissues inside the turbinates and suction them out. The outer layer remains intact. As the nose heals, the turbinates shrink naturally. This is an exact and effective procedure that is followed by septoplasty. It is a long-term turbinate reduction solution with the least side effects. 

 

Turbinoplasty out fracture technique: This type of turbinate reduction is a surgical procedure done to reduce the size of nasal turbinates by repositioning them outwards. The incision is made inside the nose. The mucosal lining is lifted, and the bone is carefully fractured using a nasal bone spreader or bone scissors; the surgeon will then reposition the turbinate outwards, i.e., away from the nasal septum. The repositioned turbinate is secured using a dissolvable suture to prevent it from moving back to the septum. This process increases the space in the nasal airway and reduces obstruction. 

 

Radiofrequency ablation: Radiofrequency turbinate reduction is done with the aid of an endoscope. The endoscope delivers radiofrequency energy to the inflamed turbinates. The heat from the energy creates lesions inside the turbinate tissues, leading to scar tissue formation. As the tissue heals, the turbinates reduce in size. This is a minimally invasive procedure. However, the turbinates can grow back over time. 

 

Coblation: The CTR, or Coblation Turbinate Reduction, is like the radiofrequency reduction but has lower temperatures to avoid damaging the nearby tissues. The procedure removes or dissolves the turbinate tissue in a controlled manner. There is no damage to the surrounding tissues. 

 

Cauterization: This turbinate reduction uses a heated probe to close off some of the turbinates’ blood vessels. This reduces the blood flow to the turbinates, which shrink naturally. 

 

Partial resection: This procedure involves removing a small piece of the turbinate and hard and soft tissues. 

Turbinate reduction surgery is quick and takes about 10 to 30 minutes to complete. 

In India, Septoplasty and turbinate reduction have long-term results in reducing congestion, alleviating and eliminating snoring, and improving and stabilizing the nose’s structure and shape. 

 

Recovery And Healing Post Rhinoplasty And Deviated Septum Treatment

Since both procedures are done together, it dramatically reduces the healing time, and septoplasty cost in India with turbinate reduction is less than paying for two procedures individually. Tips for quick and whole healing

  • Do not disturb or try to move or remove the soft packing and splints placed post-surgery. These are necessary to hold the nasal tissue in place, reduce the scarring, and ensure good nasal shape. 
  • Stay away from driving for a few days after the operation.
  • Avoid exercising, heavy lifting, and other activities that increase the blood pressure and heart rate. Increased breathing can put a strain on the sutures and cause extra bleeding, pain, and swelling. 
  • Take the medications as prescribed. 
  • For the first few months of healing, use the nasal saline douche (salt water) as directed by the surgeon. 

 

Septoplasty Surgery Cost In India

 

The combined cost of septoplasty and turbinate reduction surgery (often performed together as a single procedure) in India can vary depending on several factors, including the location, the reputation and experience of the surgeon, the type of hospital or clinic, the specific techniques used, and any additional services or facilities provided.

 

These estimates often include surgeon’s fees, hospital charges, anesthesia fees, preoperative consultations, postoperative care, medications, and any additional tests or services required. The actual cost will vary depending on your condition, such as the severity of the obstruction, the type and complexity of the procedure, the healing treatments needed, the health of your skin, and other factors. Discuss with your insurance provider about insurance coverage of the cost of septoplasty surgery in India.

Remember that it is essential to prioritize safety, expertise, and patient satisfaction when selecting the clinic and surgeon for the best, longest-lasting, and safest results. 

 

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Breath Freely with Septoplasty | Rhinoplasty Surgeon India

Breath Freely: Exploring Septoplasty in India with Dr. Debraj Shome

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Breathing freely is something that we all expect naturally. Even a slight irritation in the nose disrupts the routine. Not to mention other issues like snoring, labored breathing, etc. that come along with nasal blockages. If you too are suffering from long-term sinuses or a deviated septum, then a septoplasty done by India’s favorite rhinoplasty surgeon, Dr. Debraj Shome, is the answer to all your troubles.

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Understanding Perforated Septum Symptoms And Treatment Options

Understanding Perforated Septum Symptoms And Treatment Options

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In the complex structure of the nose, the septum plays an important role in lending the nose shape, ensuring proper breathing, and maintaining the airways. You see your septum every day from the front when you look in the mirror. But what happens when the septum becomes weak or has perforations? It can cause breathing issues. A whining sound when breathing is the most common indication of septal perforation.

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What is the Difference between Septoplasty and Sinus Surgery?

What is the Difference between Septoplasty and Sinus Surgery?

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Our uniqueness is our individuality. Each human is different in his or her own way. These differences can be in how we perceive things, how we appear to ourselves and the others, how we carry ourselves and how our features and parts of body differ from one other. One such distinctive feature is our nose. The nose is made up of the bones, cartilage, skin and tissues.

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Seven differences between submucous resection and septoplasty

Seven Differences Between Submucous Resection and Septoplasty

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Submucous resection and septoplasty are simple but highly technical rhinoplasty procedures aiming to correct the deviated septum. A deviated septum is a widespread problem; many people can go through their life without it being a bother. However, some do feel severe symptoms of the deviated or crooked nose septum and both functional and cosmetic aspects necessitating surgical intervention by an expert rhinology surgeon.

What is the nasal septum?

The septum is a vital cartilage piece that ideally should divide the insides of the nose into two equal compartments. However, when bent, it can cause crookedness in the nose and other problems.

You may not even know you have a deviated septum; however, a few septals can be problematic when they cause any of the following symptoms.

  • Obstruction in the nostrils (one or both): When the septum blocks a nostril, it can make it difficult to do normal breathing. This blockage becomes more pronounced when you suffer from a cold or a nasal allergy because the nasal passages swell and narrow.
  • Nose bleeds: because of the crookedness, the nasal septum can become dry and increase nosebleeds.
  • Pain in the face: This symptom is usually observed in cases of deviation. The surfaces within the nose touch cause pressure to one side of the face, leading to pain.
  • Snoring and noisy breathing when sleeping: A deviated septum in your nose causes the airways not able to pass the air properly, and it causes loud and bothersome breathing during sleep.
  • Alertness towards the nasal cycle: the natural nasal process compromises obstruction on one side and then to the other. Because of nasal obstruction, people with a deviated septum are often aware of this cycle.
  • Preferring sleeping on one side: People with narrow nasal passages tend to sleep on one side to optimize breathing through the nose and make sleeping and everyday work more comfortable.
  • Nasal congestion: Sometimes, it feels like there is always something inside the nose, and it feels uncomfortable. This can also cause the problem of sleep apnea, in which the breathing automatically starts or stops.
  • Sinusitis: Inflammatory changes in the nasal canal and the sinus tissues make it difficult for nostrils to drain correctly; hence, the fluid accumulates in the sinus cavity, leading to chronic pain and pressure, leading to sinusitis.

The deviated septum can be caused because of many things, such as congenital disabilities, injury, or trauma to the nose because of rough play or contact sports. In adults, the most common cause of a deviated septum is a direct injury to the nose. The deviated septum can worsen as we age, leading to more issues. The two most common nose surgeries done to alleviate the deviated septum symptoms are septoplasty and submucosal resection. The selection of the surgery depends on the type of deviation. Septum deviation is classified into five types.

Surgical management of the deviated septum is a challenging surgery that needs the best rhinologic surgeons who are experts in aesthetics and functional failures caused before and post-surgery. In the last few years, the surgery for a deviated septum has seen many modifications to preserve the septal framework. The diagnosis for both submucous resection and septoplasty needs a detailed analysis of the nasal skeleton and its shape with the rest of the facial structure.

Both surgeries aim to correct the septum inside the nose to promote better breathing and make the nose straighter. This makes both work and personal life better for the patients. However, they differ in various aspects, such as

  • Surgical technique: The septoplasty aims to straighten the deviated septum, and the resection technique removes the extra tissues (enlarged nose’s inferior turbinates) from the septum to open up the airways. SMR (submucous resection) removes the deviated septum or decreases the sign of external deviation. In SMR, the surgeon accesses the septum by elevating the flaps on both sides, but in Septorhinoplasty, the flaps are lifted from the concave side of the nose.
  • Type of surgery: SMR is a radial surgery with a large amount of tissue excavation and removal, whereas septoplasty is a conservative surgery with minimum tissue removal.
  • Endonasal or external: Submucous resection to correct the nasal deviation is performed through an open rhinoplasty, and septoplasty or the Septorhinoplasty can be done through open nose surgery.
  • Age of surgery: SMR can only be done on children above 17 when the bones and cartilage have stopped growing, whereas septoplasty can be done on children also to give them immediate relief.
  • Cartilage: The septoplasty aims to preserve as much nose cartilage as possible, but in SMR, the nose loses most of this cartilage.
  • Revision rhinoplasties: Since the submucous resection removes most of the nasal cartilage, it is difficult to perform another surgery after this type of deviation correction, however in cases of Septorhinoplasty, the rhinoplasty surgeon can do another surgery
  • Changes to the external structure of the nose: SMR does not change the nose’s appearance, but Septorhinoplasty can give you a straighter-looking nose.

Submucous resection for correcting deviated septum procedure

The SMR is a highly successful procedure that reduces the size of the inferior turbinate in the nose. The primary function of turbinates is to keep the air we breathe humidified and warm and make breathing easier. Each side of the nose has tree turbinates. When the turbinate near the bottom of the nose enlarges, it can cause breathing difficulties. Also, when the deviated septum cannot be treated in other ways and is causing disruptions in the patient’s everyday life, then SMR becomes the suitable option for a long time and immediate relief. Here are some essential things to know about submucous resection surgery of nasal septum

  • It is a one-day procedure; in most cases, there is no need to stay in the hospital overnight.
  • The surgeon will use local or general anesthesia, and the surgery takes only about 1.5 hours to complete
  • The surgeon makes small incisions in the nose and then slices up the extra tissue. This operation does not disrupt the mucus lining.
  • Then the surgeon will close the incisions, and you are on your way to recovery. There is no visible external scar on the outside of the nose.

When does a rhinoplasty surgeon recommend submucosal resection?

SMR is not a necessary surgery for a deviated septum, but a nose surgeon will recommend an SMR if you want relief from

  • Chronic sinus infections that have not responded to traditional treatments
  • Nose bleeds because of septal deviation
  • Difficulty in breathing because of a crooked septum

This surgery can also be combined with routine sinus surgery to give the surgeon better access to other parts of the nose. SMR is also done as a part of cleft palate repair.

Cost of septoplasty and submucous resection of the nasal septum

Since both surgeries do different corrections, their price is different than each other. the cost of SMR and septoplasty is dependent on

  • Surgeon’s expertise and experience
  • Location of the clinic
  • Any further corrections are done alongside it if necessary.
  • Anesthesia and hospitalization fees

When the procedure is done for functional reasons, it is generally covered by insurance; therefore, you should talk to your insurance provider and check.


About Dr. Debraj Shome

Dr. Debraj Shome- Facial Plastic Surgeon in Mumbai, India

Dr. Debraj Shome – Founder, The Esthetic Clinics, is a top facial plastic surgeon. Dr. Shome is currently a Consultant at the best Mumbai hospitals like Saifee Hospital, Breach Candy Hospital, Nanavati Hospital & Apollo Spectra Hospital in Mumbai, India. He has 40+ research papers in the best international journals, numerous presentations at conferences & many awards such as “Best Plastic Surgeon in Mumbai”, “Best Plastic Surgeon in India”, Best Cosmetic Surgeon in India”, “Best Cosmetic Surgeon in Mumbai”, “Breakthrough Innovator in Facial Plastic Surgery” etc. A celebrity plastic surgeon, Dr. Shome believes plastic, reconstructive & cosmetic face surgery can allow you to lead a more fulfilled life….Read more

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