Causes of Nasal block?
- Deviated nasal septum with inferior turbinate bone hypertrophy (most common cause)
- Adenoid hypertrophy ,etc
What is nasal septum?
The septum is a structure that separates the nasal cavity into two halves. The nasal septum is composed of bone, cartilage, and membranes
What is deviated nasal septum?
It is displacement of nasal septum to one side presenting with nose block. It has to be corrected by surgery
Surgeries to correct deviated septum include
- Submucous resection(SMR)
We tailor make every nasal surgery is to correct most deviated part of nasal septum ie cartilaginous or bony deviation, leaving behind sufficient structures to support nose. Every patient will have a unique septal framework and distortion, we take utmost care to correct this to near normal framework.
What are inferior turbinates?
The turbinates are structures on the side wall of the inside of the nose. They project into the nasal passages as ridges of tissue. The turbinates help warm and moisturize air as it flows through the nose. Patients come with nasal block when they have enlarged inferior turbinates.
Surgeries for enlarged inferior turbinates
- Inferior turbinectomy- removal of inferior turbinates
- Partial inferior turbinectomy – removal of inferior turbinates partially
- Microdebrider assisted submucous resection
- Coblation assisted reduction
We remove part of inferior turbinate using a special instrument called microdebrider. This is done under endoscopic visualization so that inferior turbinate bone is evenly cut and taking pains not to remove excessively. Post reduction of turbinate its posterior end which has bleeders will be cauterized with valley lab spray cautery device. This technique is used in adults as results are mostly permanent.
Above: before surgery image with deviated nasal septum to left and turbinate hypertrophy
Above : post operative images with adequate bilateral nasal airway
Second technique we use is coblation assisted turbinate shrinkage. This is mostly opted for paediatric age group. As the shrinked turbinate can increase its size after months or years. As it’s a non aggressive surgery its opted in children.
Pain after surgery?
Pain will be present but very much bearable as analgesic tablets will be give in post operative period
Post surgery there will be sponge (merocel) packs kept in nose. They will be removed in 24-48 hours. During this period patient may feel-dryness of throat, excessive watering of eyes, ear blocked sensation or some headache. All symptoms will subside ones packs are removed.
- You may have medicated gauze or sponge (merocel) packs in your nose for 24-48 hours following surgery; this will make breathing through your nose difficult
- Do not pull at the packing material or the thin suture holding them in place.
- Some oozing of blood and mucus is expected for 2-3 days after surgery.
- Do not excessively blow your nose until cleared to do so.
- Avoid straining with bowel movements.
- Take all of your routine medications as prescribed, unless told otherwise by your surgeon; any medications which thin the blood should be avoided. These include aspirin and aspirin-like products (Advil, Motrin, Excedrin, Alleve, Celebrex, Naproxyn).
- There are no diet restrictions, but alcohol consumption is not recommended and tobacco use is prohibited as Nicotine decreases blood flow to the healing nasal tissues and can actually compromise wound healing. Please make sure that you have eaten something the morning of pack removal; low blood sugar may make you feel faint when the packs are removed.
- No heavy lifting , no bending or stooping to lift, and no vigorous exercise until cleared by surgeon
- You can expect to have a stuffy nose for about 3-5 days after surgery, with some intermittent congestion for up to 2 weeks depending on a personal history of allergies or other factors. Sense of smell will be diminished during this time,. There may be some tenderness or numbness in your upper teeth. You may express old clot and discolored mucus from your nose for up to 3-4 weeks after surgery, depending on how frequently and how effectively you irrigate your nose with the saltwater spray.
- Patients can go to office approximately 7 days of rest after surgery. Nasal crest cleaning is performed at post-op weekly visits
- Post op review visits will be scheduled by your surgeon.
- Patients should follow post op nasal douching, nasal sprays for duration suggested by your surgeon for quicker clearance of symptoms.