From the Research
Septal resection is indicated for patients with symptomatic nasal obstruction due to a deviated nasal septum that has failed conservative management, and the procedure of choice is septoplasty, which can be performed simultaneously with septal perforation repair via an open approach, as shown in a study with a 93.6% perforation closure rate and 91.1% symptom relief 1. The workup for septal resection includes:
- A thorough history to identify the underlying cause of the septal deviation and any associated symptoms
- Physical examination with anterior rhinoscopy and nasal endoscopy to visualize the deviation
- Sometimes CT imaging to assess the extent of the deviation and rule out other pathologies The procedure involves:
- Making an incision in the mucosa covering the septum
- Elevating the mucoperiosteal flaps
- Removing or reshaping the deviated portions of cartilage and bone
- Repositioning the septum to the midline
- Reapproximating the mucosa with sutures Postoperatively, patients may have nasal packing for 24-48 hours and should use saline irrigations and avoid strenuous activity for 1-2 weeks. Potential complications include:
- Bleeding
- Infection
- Septal perforation
- Persistent symptoms Success rates are generally high, with most patients experiencing significant improvement in nasal breathing after healing is complete in 3-6 weeks, as supported by a study that showed acceptable symptomatic control was achieved in 90% of patients with septal perfoplasty 2. It's also important to note that endoscopic approaches are available for septal repair, and the choice of approach depends on the osteo-cartilaginous support, characteristics of the perforation, and the experience of the surgeon 3.