Nasal Surgery For Breathing

Functional Nasal Surgery

Nasal surgery is often performed to improve nasal breathing through procedures such as septoplasty, functional rhinoplasty, and or turbinate reduction. Functional nasal procedures are often performed concurrently while reshaping the nose with a cosmetic rhinoplasty.

Nasal breathing difficulty can be due to the narrowing of the nasal passages from a variety of factors. The nasal septum is tissue made of cartilage and bone that separates the right and left nasal passages. Deviations (crookedness) of the septum, often related to trauma, can cause obstruction of the nasal airway resulting in difficult nasal breathing and stuffiness. Correction of the septal deviation (septoplasty) is done to straighten the septum, decreasing the blockage and improving airflow within the nasal passages. Most septoplasty procedures are done through an incision on the inside of the nose, but if the deviation is severe a small external incision across the bridge of tissue at the base of the nose between the nostrils (columella) may be used (the same incision often used to perform cosmetic rhinoplasty). This external incision allows for greater exposure of the septum and portions of the nasal framework that may require grafts for additional support to improve breathing (functional rhinoplasty repairing nasal valves).

Swelling of the tissue on the inside sidewall of the nose called turbinates may also contribute to nasal obstruction. When medical therapy in the form of anti-histamines and or steroid nasal sprays do not fully alleviate swelling of the turbinates, a turbinate reduction procedure may be indicated.

Who is an ideal candidate for functional nasal surgery?

Patients who have a nasal obstruction that adversely affects their quality of life and whose obstruction has not responded effectively to medical therapy are ideal candidates for functional nasal surgery. Such therapies include topical nasal steroid sprays, anti-histamine and or decongestant medication, and Breath Right strips. Patients who have anatomical abnormalities such as a deviated nasal septum, nasal valve collapse, and turbinate enlargement typically have significant improvement after undergoing functional nasal surgery.

What is involved with functional nasal surgery?

• The Initial Consultation — The initial consultation centers around your goals of nasal surgery, an examination of your nose in the context of an overall head and neck examination, and a discussion of how best to improve your nasal breathing. During your consultation, a variety of techniques for functional nasal surgery may be discussed, such a septoplasty, inferior turbinate reduction, and or functional rhinoplasty that involves nasal valve repair. A method is chosen that results in the best functional and cosmetic outcome for you. Pre and post-operative examples of other similar rhinoplasty are often reviewed. The details of the procedure and post-operative care are explained, and any questions you may have are answered. If a plan is confirmed to move forward with surgery, you meet with our patient care coordinator to schedule a surgery date.
• Pre-operative Visit — Prior to your surgery, you may have one more pre-operative visit. This visit typically involves a pre-operative history and physical at our office. This visit is performed to assess any medical issues you may have and to ensure that your surgery is conducted in the safest manner. Pre and post-operative instructions are reviewed, and this visit is also an opportunity for you to ask additional questions that may have arisen after your initial consultation.
• Day of Surgery — Once in the pre-operative area, you will meet the nursing and anesthesiology staff who will take care of you during your procedure. Your surgeon will meet with you and your family prior to the procedure to review the procedure and discuss any last-minute questions you have. After the procedure is performed, you will be taken to the recovery room. You will have a nasal cast and likely intranasal splints in place that will be removed at your post-operative visit. All rhinoplasty procedures are performed as outpatient surgery, and you will be sent home with detailed post-operative instructions and pain medication. We will call you on the night of surgery to ensure that you are doing well and to answer any questions you may have.
• Post-operative Visits and Follow-up Care — Your first post-operative visit will be approximately one week after surgery to remove your sutures, nasal cast, and any intranasal splints. You will then follow-up at one month after surgery and usually every three months for the first year after your surgery to ensure adequate healing.