Ear Nose & Throat Sydney
Dr  Narinder Singh  MBBS (Syd) FRACS (ORL-HNS) - Consultant ENT Specialist Surgeon - Clinical Lecturer University of Sydney
Ear Nose & Throat Sydney, Dr Narinder Singh
Ear Nose & Throat Sydney, Dr Narinder Singh Ear Nose & Throat Sydney, Dr Narinder Singh
 
Ear Nose Throat

Septoplasty

What is the Septum?

The septum divides the nose into two halves: left and right.

A normal septum should be completely straight, dividing the nose equally

What is a “Deviated Septum”?

If the septum is bent to one side, it is called a “Deviated Septum”, “DNS” (Deviated Nasal Septum) or “septal deviation”.

Septal deviation is abnormal and can result in a blocked nose.

What problems are caused by septal deviation?

Septal deviation reduces airflow through the nose.

This can cause many different problems, including some or all of the following:

  • Blocked nose
  • Stuffy nose
  • Nasal congestion
  • Reduced oxygen intake
  • Mouth-breathing
  • Snoring
  • Noisy breathing
  • Poor-quality sleep
  • Waking up feeling tired
  • Waking up with a dry mouth
  • Waking up feeling thirsty and having to drink water
  • Sore throats
  • Tiredness during the day
  • Sleepiness during the day
  • Dark circles under the eyes
  • White patches on the teeth (from drying out whilst mouth–breathing)
  • Crooked teeth (from blocked nose in childhood)
  • Unhealthy gums
  • Dry, cracked lips
  • Nose bleeds (from drying out of the nose lining due to turbulent air flow)
  • Sinus problems (discharge, post-nasal drip, sinus pains, headaches, reduced sense of smell)
  • “Nasal” voice

But my nose doesn’t seem blocked to me! Surely, I can’t have a septal deviation if I don’t feel blocked?

Most people with septal deviation have had it all their life. They don’t realise just how blocked their nose is because they have never known what it feels like to breathe normally! If you recognise some of the symptoms listed above, there is a good chance you may have a septal deviation, without realising it

What is wrong with mouth-breathing?

Humans are designed to breathe through the nose NOT the mouth.

The nose does 4 key things to the air we breathe:

  1. Warms the air
  2. Adds moisture to the air (Humidification)
  3. Filters out dust and allergen particles
  4. Detects bacteria and bugs

These things are NOT done by mouth breathing. Mouth breathing results in un-processed, un-filtered, cold, dirty, dry air entering the lungs.

Mouth-breathing is only meant to occur as a short-term backup “Plan B”, for example, when we are running fast.

Fixing mouth-breathing by fixing a deviated septum can have significant health benefits.

How can I find out if I have a septal deviation?

Always see your GP first. Your GP will look inside your nose and may order some tests or prescribe some medications. If your GP cannot fix your nasal problems, ask your GP for a referral to see Dr Singh and make an appointment.

How can Dr Singh find out if I have a septal deviation?

Dr Singh is a nose and sinus specialist. Dr Singh uses special tests to find out if you have a septal deviation.

What tests can Dr Singh perform?

Dr Singh will examine your nose using special instruments.

Dr Singh will pass a super-fine camera into your nose to look at the septum and turbinates (the nose is made numb first using a special numbing spray). You can watch the camera on a TV monitor and see for yourself if you have a septal deviation.

What other tests can be ordered?

Some other tests that Dr Singh or your GP may order include:

  • CT scan - This can show the anatomy of your nose and sinuses. Unfortunately, CT is NOT a very accurate way to diagnose septal deviation. Most radiologists (Xray doctors) UNDERESTIMATE the degree of septal deviation. The most accurate test is to have Dr Singh examine the nose with a special camera.
  • Skin prick tests – These can show if you have allergy (Allergic Rhinitis)
  • RAST blood tests – These can show if you have allergy (Allergic Rhinitis). Blood tests are not as accurate as skin prick tests but are easier to perform.

Despite all the tests and high-technology available, the single most accurate tool is your doctor’s skill, knowledge and experience!

Can my septal deviation be fixed?

Yes.

Almost every case of septal deviation can be treated.

How is septal deviation treated?

The treatment used will depend on Dr Singh’s examination findings.

Simple septal deviation is treated with septoplasty, along with inferior turbinoplasty.

Complex septal deviations or revision operations may require a Functional Rhinoplasty operation.

Some patients ask for the shape of their nose to be corrected at the same time. This requires a Rhinoplasty operation.

Patients with other sinus or nasal problems often undergo septoplasty as part of their operation. Examples include:

What is a septoplasty?

Septoplasty is an operation to straighten a deviated septum.

How is septoplasty performed?

Dr Singh performs septoplasty while you are asleep (general anaesthesia). There are no cuts on the outside of the nose. The shape of the nose is not changed (unless you choose to undergo rhinoplasty at the same time). There is no bruising and no plaster (unless you choose to undergo rhinoplasty at the same time).

Are there any alternative treatments to surgery?

Yes. There are always options and it is always your choice as to whether to have surgery. In general, you can try other options first and choose surgery if nothing else works. Non-surgical options include:

  1. Do Nothing. If your problem is not severe, you may choose not to have any treatment at all.
  2. Simple treatments (Saline rinse). Try rinsing the nose 2-4 times a day with salty water from your pharmacy.
  3. Medications. Try Nasal steroid sprays and antihistamine tablets/ sprays from your pharmacy or from your GP. They work best for people with allergy but may sometimes help people without allergy.

We recommend that you see your GP first and consider trying these non-surgical options. Then see Dr Singh when you are ready for surgery. There is a long waiting list to see Dr Singh and it is best if you see Dr Singh for surgery after the non-surgical treatments have failed.

Are there any risks to surgery?

Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks... but we still cross the street. Dr Singh will explain the risks of your operation and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.

What should I do next?

See your GP. If your GP is unable to fix your nasal problems, ask your GP for a referral to see Dr Singh

I have already seen a doctor – I was told nothing could be done for my nasal problems. What should I do?

Most cases of septal deviation can be fixed or improved. Dr Singh is a nose and sinus specialist and has expertise in difficult and complex cases.

Consider asking your GP for a referral to see Dr Singh.

I have already seen a surgeon and had a septoplasty operation on my nose. It didn’t work! What should I do?

Most cases of septal deviation can be fixed or improved. Dr Singh is a nose and sinus specialist and has expertise in performing revision surgery where previous septoplasty has been unsuccessful.

We recommend that you return to see your original surgeon first. If nothing further can be done and you still have symptoms, consider asking your original surgeon or your GP for a referral to see Dr Singh. Dr Singh always works together with your GP and your other specialists to achieve your best health outcome.



DISCLAIMER: The material on this page represents general information only and is NOT medical advice. For specific medical advice about your individual circumstances you must consult a trained medical practitioner. Always see your GP first. If your GP is unable to resolve your health problem, ask your GP for a referral to Dr Singh. Dr Singh always works together with you and your GP to achieve your best health outcome. IMPORTANT: Do not try to diagnose your medical problem by yourself! Do not rely solely on information found on the internet. Always see your GP first.



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