Submucosal Nose Resection for Deviated Septum Treatment

Submucosal Nose Resection for Deviated Septum Treatment

Tags : deviated septum Submucosal Nose Resection

The septum cartilage in the nose plays an important role in breathing and the shape of the nose. It divides the nasal cavity into passages. It is actually like a very thin wall running vertically in the middle of the nose. The septum performs several important functions related to breathing and the aesthetics of the nose

• Structural Support: The nasal septum provides structural support to the nose, helping to maintain its shape and stability. It acts as a framework for the external and internal structures of the nose, including the nasal bones, cartilage, and soft tissues.
• Airflow Regulation: One of the important roles of the nasal septum is regulating and directing the airflow through the nose. When a person inhales, the air passes through the nostrils and encounters the septum. The septum helps to guide the airflow and distribute it evenly through both nasal passages.
• Filtration and Humidification: As air passes through the nasal cavity, the septum, along with the nasal turbinates (small structures inside the nose), helps to filter out impurities, dust, and particles. It also aids in humidifying and moisturizing the inhaled air, ensuring that it reaches the lungs in a clean and appropriately humidified state.
• Warmth and Conditioning: The nasal septum, along with the nasal mucosa, helps to warm the inhaled air to match the body’s temperature. This conditioning process is important to prevent discomfort and potential damage to the delicate tissues of the respiratory system.
• Support for Olfactory Function: The nasal septum houses the olfactory epithelium, which contains specialized cells responsible for the sense of smell. The structure and integrity of the septum contribute to the proper function of the olfactory system, allowing individuals to perceive and distinguish different smells.

In cases when the septum is not behaving properly, such as a misaligned septum, it can disrupt one or all of the above functions leading to breathing difficulties and increased sinus problems. In cases where deviated septum needs major corrections, a submucosal resection of deviated septum is needed.  A deviated septum is a common problem and it affects about 80% of the population but only about 25% of the people face breathing difficulty because of the deviation. The misaligned septum is also one of the reasons behind a crooked nose.

Why is Submucosal Nose Resection for Deviated Septum Treatment Needed?

While a deviated septum can be asymptomatic or cause minimal problems for some individuals, it can also present certain disadvantages and challenges. Deviated septum correction is needed when the patient is experiencing any one or multiple of the following symptoms.

• Nasal Obstruction: The misalignment of the septum can narrow the nasal passages, making it difficult for air to flow freely through the nose. This can result in chronic nasal congestion, difficulty breathing through the nose, and a sensation of restricted airflow.
• Chronic Sinus Problems: A deviated septum can impede proper drainage of the sinuses. This obstruction can lead to the accumulation of mucus and bacteria in the sinuses, increasing the risk of chronic sinusitis. Symptoms may include facial pain, pressure, recurrent sinus infections, and post-nasal drip.
• Sleep Disruptions: Breathing difficulties caused by a deviated septum can disrupt sleep patterns. Individuals may experience snoring, sleep apnea, or other sleep-related disorders. These disturbances can result in daytime fatigue, reduced quality of sleep, and overall decreased well-being including dull skin and dark circles under the eyes with eye bags.
• Decreased sense of smell: A deviated septum may impact the passage of odor molecules to the olfactory receptors, leading to a decreased sense of smell. This can affect one’s enjoyment of food, appreciation of scents, and overall quality of life.
• Facial Pain and Headaches: In some cases, a deviated septum can cause facial pain, pressure, and headaches. The obstruction and inflammation associated with the condition can lead to discomfort in the nasal area and radiate to the surrounding regions.
• Speech and Voice Issues: In rare cases, a severely deviated septum may affect speech and voice quality. The altered airflow and nasal resonance can result in a nasal or congested voice, impacting communication and self-confidence.

If a deviated septum is causing significant symptoms or interfering with daily activities, it may be advisable to consult with an expert plastic surgeon to discuss the potential treatment options such as nasal septoplasty which can correct the septum position.

A deviated septum can be caused because of a birth defect, infections in the nose, or because of trauma or injury to the nose.

What is Submucosal Nose Resection for Deviated Septum Treatment

Submucosal resection is a surgical rhinoplasty technique used to remove or reposition the deviated portions of the nasal septum while preserving the overlying nasal mucosa. Sometimes the submucosal resection of a deviated septum is also done along with the cleft palate repair.

If the surgeon is not able to treat the chronic sinus and other breathing problems with normal treatment methods then they will recommend getting a septoplasty done to help the patient.

The submucosal nose resection for correcting the deviated septum is done in two ways

• One is by removing the extra septum layer tissue
• The other is by treating the enlarged turbinates.

The surgeon will do an endoscopy of the nose and examine the physical symptoms first to find out the extent of the deviation and the reasons for the issues in breathing. Thereafter the rhinoplasty surgeon will give the resection surgery options. If the turbinates need to be operated on, the surgeon will first give some medication to bring the swelling down and then check if the severity of the symptoms warrants a septoplasty. The common treatments used to ease the blood flow are decongestants, antihistamines, and nasal steroid sprays.

Submucosal Resection Operation Procedure

This procedure corrects the deviated septum by removing or trimming a portion of bone or cartilage from inside the nose. This procedure does not disturb the nasal linins in any way. During the surgery, the surgeon will make incisions inside the nose, and lift the mucopreichondrial flaps to expose the septal cartilage and bone. The next step is to remove the deviated portions of the septum i.e., the excess cartilage and bone, adjust the shape and alignment of the septum, and straighten it.  The incisions are then closed with the help of dissolvable stitches.

Since the natural nasal lining is not disturbed the healing time after submucosal resection of deviated septum is quite fast.  The procedure takes about 1.5 hours to complete.

If turbinate reduction is performed then care is taken so as to not to remove the turbinates fully so that the normal function of the nose is not disturbed. Once the surgeon is satisfied that the airways are clear, they will close the incision.  Sometimes the surgeon might place a splint to support the trimmed bone and cartilage. This procedure does not disturb the lining of turbinates instead just reduces their size. The whole procedure takes about seventy-five minutes to complete and is done with the help of a microdebrider.

Pre-submucosal resection of the deviated septum

Before you go for the surgery the surgeon will talk to you about your condition, the medications you are on, and if you have had any other previous surgeries. The physical examination and other important tests will give the surgeon an idea about your skin type and condition. The surgeon might also take some photos of the nose to recommend septoplasty changes. The last step is to discuss your expectations and what results can you get.

Postoperative care following submucosal resection

Postoperative care following submucosal resection surgery is crucial for a successful recovery. Here are important considerations for postoperative care:

• Diet: It is advisable to consume soft and cold foods during the initial stages of recovery. These foods are easier to chew and put less stress on the face. Cold foods can also help reduce the likelihood of nosebleeds, which are common after surgery.
• Resuming Activities: Within a day after the surgery, you can typically resume most of your daily activities. However, it is important to follow your surgeon’s instructions regarding any specific restrictions or limitations during the recovery period.
• Common Side Effects: Some common side effects after submucosal resection surgery include a burning sensation due to a dry nose, slight bleeding, and increased mucous secretion. These side effects are usually temporary and should subside as the healing progresses.
• Infection Prevention: To minimize the risk of infection, it is important to follow proper nasal hygiene practices as instructed by your surgeon. This may include saline rinses or sprays to keep the nasal passages clean.
• Packing Removal: The surgeon will remove any nasal packing once they are satisfied with the healing process. The timing of packing removal varies depending on the individual case and the surgeon’s preference.
• Bruising: External bruising is unlikely after submucosal resection surgery. However, it is possible to experience some swelling or discoloration around the nasal area, which should gradually improve over time.
• Improved Breathing: Following a successful submucosal resection surgery, you should experience an immediate improvement in your ability to breathe. You will likely notice that breathing becomes easier and more comfortable, without the presence of bleeding, pain, or discomfort.

It is important to closely follow your surgeon’s postoperative instructions and attend follow-up appointments as scheduled. By doing so, you can ensure proper healing, minimize complications, and optimize the long-term results of the submucosal resection surgery.

Cost of submucosal nose resection for deviated septum correction

The cost of submucosal nose resection, or septoplasty, for the treatment of a deviated septum in India, can vary depending on several factors. These factors include the location and reputation of the clinic or hospital, the surgeon’s expertise and experience, the complexity of the case, the type of anaesthesia used, and the facilities provided. On average, the cost of septoplasty in India can range from approximately INR 50,000 to INR 2,50,000 or more. However, it is important to note that these figures are approximate and can vary significantly. During the consultation, the septoplasty surgeon can assess the specific condition, discuss the treatment options, and provide an accurate estimate of the cost based on the individual’s needs and requirements.