I. Questions before septal surgery Many netizens have questions about many issues related to deviated septum and often ask.
1.How does the deviated septum arise and do all deviated septum need surgery?
2. Can the deviated septum be cured without surgery, but by simply taking medicine?
3.Is the deviated septum treated by laser, microwave or plasma?
4.After the surgery of deviated septum, the condition did not improve, why?
5.What should be done for deviated septum? At present, what is the best method? Is there an incision on the face?
6.What kind of anesthesia is used for septal surgery? Is the surgery painful?
The above questions are described as follows.
1.How does the deviated septum arise and do all deviated septum need surgery?
There are 3 main causes of nasal septal deviation.
①Congenital: It has been reported in the literature that some newborns are born with deviated nasal septum, and Zebra often finds that many children at a very young age already have deviated nasal septum in their clinical work.
(ii) Due to trauma: When learning to walk, limb collisions during sports, and nasal trauma from various causes can lead to nasal septal deviation.
③Due to development: The nasal septum mainly consists of 2 bones and 1 cartilage. During development, the hardness, toughness and growth rate of each bone vary, and deviation can also occur gradually. Bamboozled In our work, we found that certain adolescents who have been seen for a long time before and after puberty will gradually develop deviated nasal septum. As for the cause of each septal deviation, it is often difficult to determine accurately due to the lack of long-term observation and exact medical history. However, the cause of septal deviation is not necessarily related to surgery or not, so it is not necessary to investigate deeply.
The reason why there is nasal septal deviation but no nasal congestion is because the regulation function of the mucosa of the inferior turbinate is still in the compensatory period. Therefore, nasal septal deviation can exist for a long time, but may not necessarily have rhinitis, and can be temporarily not operated. However, if the septal deviation is accompanied by nasal congestion, rhinogenic headache, recurrent rhinorrhea, and purulent discharge, it is often necessary to undergo surgery. In short, some septal deviations can be operated without surgery, but not all septal deviations do not require surgery.
2, can deviated nasal septum be cured without surgery, but by simply taking medicine.
Many patients are afraid of surgery, plus surgery requires routine hospitalization, which takes about 7-10 days and costs a lot of money at once, so they often hope to cure the deviated septum through simple medication, while the overwhelming advertisements of various newspapers, television and the internet and certain so-called reports in the name of news, driven by various interests, are constantly misleading people. However, nasal septal deviation is a deviation of bone or/and cartilage, and it is impossible for drugs to change the morphological abnormality of bone and cartilage. Simple drug treatment can only temporarily relieve symptoms such as nasal congestion, bleeding and headache to a certain extent, but it is impossible to completely eliminate various related symptoms caused by abnormal nasal septum morphology. Moreover, once the nasal septal deviation is accompanied by long-term or/and severe nasal congestion symptoms, it means that the adjustment function of inferior turbinate begins to lose its compensations, and if not corrected in time, the loss of compensations will become more and more serious. To improve the symptoms and recover completely, septal surgery is often difficult to avoid. In short, medication is unlikely to change the deviated nasal septum, at least at present, there is no evidence that medication can replace surgical treatment.
3. Is deviated septum treated with laser, microwave or plasma?
Many people often ask if nasal septal deviation is treated with laser, microwave or plasma during consultation, which is ludicrous to hear. What is laser, what is microwave, and what is plasma, and how can they be used to treat a deviated septum? It is puzzling to know where these ridiculous claims come from. Deviated septum is an abnormal bone and cartilage form, which cannot be corrected by laser, microwave or plasma. This statement is purely subjective without scientific basis, do not hearsay, to blackmail.
4.The condition of deviated septum did not improve after surgery, why?
Many people ask why their symptoms do not improve or are not satisfactory after septal surgery. There are two reasons for this: (1) medication factor: many patients and doctors put all their hopes for improvement on surgical treatment and ignore the systematic and comprehensive medication before and after surgery. ② Surgical treatment factors: It is undeniable that in some cases, it is the surgeon’s surgery that is not done properly. As to what kind of factors led to the lack of final improvement of symptoms, specific analysis of the problem is needed and cannot be generalized. Of course, in rare cases, it cannot be ruled out that there are psychological factors affecting the individual, or unreasonable, that is, the nasal septum is centered and the nasal passages are well ventilated, but that means the symptoms do not improve. It is important to emphasize that medication before and after surgery is still a very important part, and a systematic and complete treatment plan should be given according to the recovery situation, which, if not handled properly, can lead to prolonged illness and no or unsatisfactory improvement of symptoms. More often than not, it is because of the lack of systematic and comprehensive drug treatment, surgery is done and the nasal inflammation does not subside.
5.What should be done for deviated nasal septum? At present, what is the best method?
At present, the main surgical methods for deviated septum are: the traditional surgical method which is performed in sitting position with frontal mirror illumination and under anterior nasal mirror and the modern minimally invasive surgical method which is performed in supine position and under nasal endoscope. There are three main surgical procedures: submucoperiosteal resection, orthoplasty, and kyphoplasty.
The best way is to choose endoscopic septoplasty to preserve more cartilage and bony structures in the nasal septum and avoid submucoperiosteal resection and orthopedic surgery as much as possible. In conclusion, the most advanced way and the best procedure should be chosen for the surgery, and it should be done well.
In addition, regardless of the way, the surgery is done through the anterior nostril approach, confined to the nasal cavity, without damaging the facial skin, therefore, there is no incision on the face.
6.What kind of anesthesia is used for septal surgery? Is the surgery painful?
Nasal septum surgery can be performed under local or general anesthesia. If the economic condition allows, or if you are nervous and especially afraid of surgery, it is best to use general anesthesia. Currently, general anesthesia is an international trend and is also very safe, but relatively expensive.
The pain present in local anesthesia surgery is generally tolerable. General anesthesia is painless during surgery. In fact, regardless of general anesthesia and local anesthesia, intraoperative pain is not the key to the problem; it is the pain caused by filling 24-48 hours after surgery that is the main problem. Currently, postoperative analgesic pumps are used to effectively reduce pain. Individual patients can still have different degrees of dry mouth, sore throat, headache and other manifestations because of the difference in tolerance.
Second, post-operative problems of the nasal septum
1.Can I use glucocorticoids (Reynocort, Berkner, etc.) after nasal septal surgery?
Question added.
Dr. Wang, please advise you.
1. I happened to read a professional article that glucocorticoids may cause perforation of the septum after surgery, is that true?
A: Glucocorticoids (Renolcort, Percocet, etc.) may cause septal perforation after surgery, but not all of them. So to prevent it: spray the right nostril with the bottle in your left hand and the left nostril with the bottle in your right hand, taking care not to spray on the septum.
2.How to use medicine and conditioning after nose surgery
A: It is recommended to clean up the nasal cavity with seawater salt, order cod liver oil (role: to prevent the mucous membrane from drying), spray the nose with Renolcort (role: to stop the inflammatory reaction in the nasal cavity and reduce the edema of the nasal mucosa), and come to the clinic regularly to change the medication.
3.Recovery time after nasal septum surgery?
A: It takes 3 months after the septum surgery to be completely free of traumatic sensation, but progress is made every day from 2 weeks after surgery.
One month after surgery, the two nostril channels are completely open. It will not be crooked anymore. Only 3 weeks after surgery can swim.
4.What should I do if I have false sweating after surgery?
A: Normal reaction. Pay attention to strengthen nutrition.
5.Why do we need to review regularly after the septum surgery, do we have to find the surgeon?
A: Nasal septum is a sterile surgery, it is especially important to prevent infection after septum surgery, and the mucous membrane recovery after surgery is also very important, so regular review is needed.
It is better to find the surgeon who operated to review the situation, others do not know the situation very well.
6.Why does my nose itch and want to run after septum surgery?
A: It is normal. After surgery, the mucous membrane of the nose becomes more sensitive, and it will get better slowly.