From the Research
The incidence of nasopalatine nerve injury during septoplasty is approximately 2.8%, as reported in a study published in the American Journal of Rhinology in 2008 1. This complication is uncommon because the nasopalatine nerve, which provides sensation to the anterior palate and behind the upper incisors, is typically not directly in the surgical field during standard septoplasty procedures. When injury does occur, patients may experience numbness, altered sensation, or pain in the anterior palate and upper front teeth. Most cases of nasopalatine nerve injury are temporary, with sensation typically returning within 3-6 months as the nerve regenerates. Permanent injury is rare, and the risk increases when septoplasty involves extensive work near the nasal floor or when combined with other procedures like maxillary surgery. Surgeons minimize this risk by maintaining careful dissection planes, particularly when working near the nasal floor junction with the premaxilla. Another study published in Laryngo- rhino- otologie in 1995 reported a similar incidence of palatal sensory impairment after septoplasty, with 32% of patients experiencing disturbances of sensitivity, although this study did not specifically focus on nasopalatine nerve injury 2. However, the most recent and highest quality study on this topic is the one published in 2008, which provides the most accurate estimate of the incidence of nasopalatine nerve injury during septoplasty 1. It is essential for patients undergoing septoplasty to be informed about this potential complication during the consent process, though it should be emphasized that permanent sensory changes are uncommon. Other studies, such as those published in Auris, nasus, larynx in 2012 3, Acta oto-laryngologica in 2018 4, and A&A practice in 2020 5, do not provide direct evidence on the incidence of nasopalatine nerve injury during septoplasty, and therefore, are not considered in this recommendation. The key to minimizing the risk of nasopalatine nerve injury is careful surgical technique, and patients should be aware of the potential risks and benefits of septoplasty before undergoing the procedure. In summary, the incidence of nasopalatine nerve injury during septoplasty is approximately 2.8%, and surgeons should take careful precautions to minimize this risk.