Septoplasty

Presented by

Surekha Kiran

Definition

• Excision and resection of the septum to correct any deviation as a result of injury or a congenital nasal deformity; to improve the functioning capabilities of the nose—to improve breathing

Relevant A & P: External nose—lateral and anterior views

Pathophysiology

• Nasal airway obstruction - Can lead to mouth breathing, chronic nasal infection, or obstructive sleep apnea.

• Nasal septal deformity

• Headaches caused by septal spurs

• Chronic and uncontrolled nosebleeds

• Chronic sinusitis associated with a deviated septum

• Tumor excision

Indications

• To improve breathing through the nose and also to prevent sinus infections.

• The procedure usually involves an excision of a portion of the cartilage and bone.

• An incision is made in the lining of the septum to reach the cartilage.

• The septum may then be stabilized with small plastic tubes, splints or nasal packs to prevent bleeding.

Goals of Septoplasty

Diagnostics

• Exams– Rhinoscopy: Direct

vision

• Preoperative Testing

Preoperative Care• Consent for surgery checked and

confirmed. • Routine evening care done. • Anesthesia evaluation with pre-

anesthesia checklist completed.• Preoperative Blood Works and

investigations• Pre-op V/S checked and recorded. • Nil by mouth• Patient reassured • Preoperative Medication

Post operative care

• Patient was propped in reclined position. • V/S checked as per protocol.• Patient was instructed not to blow in the nose.• Dressing was assessed for further bleeding.• Sips of water served and when tolerated, normal

diet served. • Pain assessed and analgesic given as prescribed.• Kept rested with siderails up in comfortable

position.• Nasal pack and ice Pack• Prophylactic antibiotics and Pain Medications• Dressing was changed and noted for further

bleeding.• Discharged with home meds instructions given.

• Potential complications– Hemorrhage– Infection– Other: Damage to….perforate septum, cause

weakened septum which could lead to future deformity

Postoperative Complication

•  Fear and anxiety r/t upcoming invasive procedure

• Alteration in comfort; pain r/t post septoplasty

• Potential for bleeding r/t post-op procedure 

Nursing Diagnosis

• To expect blood stained/ pinkish discharge for a few days

• That will be breathing through mouth until swelling is gone.

• Not to hit or move any part of the nose.

• Not to hold back a sneeze. Sneeze with the mouth open.

• To expect a crusting in the nose for not more than 6 weeks while the incision is healing.

• To avoid all moderate and heavy physical activity, including sport for ten days after the operation and avoid bending.

• Avoid smoky, dusty, hot and dry atmospheres

• Follow Up with appointment

Discharge Instruction