Septoplasty

It is indicated for patients suffering fromnasal obstruction due to a deviated septum or a protruding piece of bone or cartilage.) The deviation may be congenital, related to trauma, or simply age-related (cartilage may collapse over time).

Septoplasty is also highly effective in helpingsleep apnea patients when a nasal obstruction contributes to their breathing problem or prevents them from wearing their CPAP (sleep apnea machine).

Septoplasty can also be useful in treating snoring when nasal obstruction is a contributing factor.

After medical evaluation, septoplasty may also be useful for patients suffering from problems secondary to nasal obstruction, such as headaches, chronic nasal infections and discharge, and eustachian tube dysfunction. The evaluation process for these conditions can be more complex and delicate, however.

Some patients may have a deviated septum but not experience respiratory discomfort or infection. Septoplasty is not recommended for these patients.

A complete medical and ENT evaluation is necessary to determine if you are a candidate for septoplasty. After meeting with the nurse, you will have an ENT examination with or without endoscopy.

It's also common to test for environmental allergies, especially in patients with mild deviations, those who have had recurrent infections or suffer from recurrent headaches. This allows us to assess the presence of a medical condition that could not only interfere with healing, but also continue to cause congestion after surgery.

A sinus CT scan is requested prior to surgery, especially for our patients who have suffered from infection, loss of smell or trauma. This enables the surgeon to have a complete assessment of your nose and sinuses, and to offer to treat any medical conditions present in the same procedure. This enables comprehensive medical and surgical care.

Using a patient-controlled inhaler, Dr. Brousseau performs septoplasty under analgesia, without the need for general anesthesia. The entire procedure takes approximately 60 minutes. The patient need not fast the day before the procedure; in fact, it's important to eat on the morning of the procedure to be maximally fit.

Surgery is performed strictly through the nostrils, so there are no external scars or marks on the face. As the surgery is performed only at the level of the septum, there are no external cosmetic effects, and the external appearance of the nose is perfectly preserved.

The surgeon begins by applying decongestant and anesthetic to the mucous membrane of the nose. He then identifies the sites of obstruction and deviation. An incision is made in the mucous membrane of the nasal septum, usually on the left side, and the mucous membrane is lifted to expose the cartilage and septum bone.

Depending on where the problem lies, an incision is made in the cartilage and/or bone to mobilize the deviated piece. If it can be replaced, it is retained. If it is too crooked or obstructive to be retained, it is removed. If there is a deviation on the nasal spine, it may be necessary to use a small chisel to remove the obstructing piece of bone.

When both nostrils appear clear, Dr. Brousseau checks with you that you are breathing well and are satisfied with the clearance.

Dr. Brousseau uses no wicks in the nose. The patient can therefore breathe easily as soon as the procedure is completed.

During surgery, it is often recommended to reduce the inferior turbinates to maximize airflow into the nose. The inferior turbinates are mucosa-covered bony structures that play an important role in regulating airflow. We never remove the turbinates, but reduce (move) them to clear the nasal passages, taking care not to damage the mucosa and to maintain their function. Unfortunately, when the turbinates are removed or even amputated, patients can experience breathing problems and chronic crusting that can be very difficult to correct.

The primary aim of the surgery is to enable the patient to breathe more easily, while minimizing the risk of complications.

The most serious - and least frequent - complication of septoplasty is the creation of a perforation in the septum that allows air to recirculate between the two nostrils. Although rare, this complication is problematic because it makes breathing even more difficult, and is very difficult - and often impossible - to correct. That's why Dr. Brousseau prefers delicate work to aggressive correction.

Occasionally, although sufficient correction has been achieved during surgery, due to the structure of the nose, healing, memory of cartilage and bone, or postoperative accidental displacement, one side may become obstructed again. In the vast majority of these cases, revision surgery can be performed to improve breathing.

It's important to understand that the two nostrils can never be perfectly equal, and that the nose has a natural mechanism called the 'nasal cycle', which causes alternating breathing restrictions on each side. Surgery or revision is not indicated for this type of situation, as it is a normal phenomenon.

Other rare complications to consider are bleeding (most often identified and treated during surgery), infection (treated with antibiotics), adhesion (poor healing where the septum and side wall of the nose reattach, may require revision surgery).

Dr. Brousseau performs only minimally invasive procedures. This minimizes complications and reduces recovery time. Our patients can drive and return to work the same day immediately after surgery.

Dr. Brousseau does not use wicks during surgery. This allows our patients to breathe through their nose immediately upon awakening, and avoids a great deal of post-operative pain and discomfort.

To prevent inflammation, you'll receive a prescription for mild nasal sprays and a nasal lubricant.

If you have environmental allergies, it's very important to take your antihistamines every day to prevent inflammation and help healing.

After surgery, pain is usually very mild in the nose. Most of our patients use acetaminophen only for 24 hours, and we recommend the use of ice and cold water to relieve throat discomfort secondary to intubation during general anesthesia. It is recommended to avoid scraping to avoid irritating the throat.

We ask you to avoid lifting more than 25 pounds (12kg) for one week. You may, however, carry out your usual activities, including cardiovascular activities such as walking, jogging or cycling.

We ask you to pay special attention to your nose for 3 months after surgery. This is the time needed for the bones and cartilage to heal and solidify. You should therefore avoid any activity or movement that could displace your nose, such as blowing your nose, contact sports, wearing a hood or vest that's too tight, and so on.

Should you have any concerns, please don't hesitate to contact us by e-mail at info@eliemd.com so that we can help you.

Most of the time, you can get an appointment the week after you contact us and get a surgery date the week after your visit.

You do not need a referral from your doctor to consult Dr. Brousseau.