Septoplasty

Септопластика (from Latin septum, meaning partition, and Ancient Greek πλαστική, meaning reconstruction) is a surgical procedure aimed at correcting deformities (deviations) of the nasal septum. This procedure is considered functional surgery, as its primary goal is to restore or improve nasal breathing, rather than to alter the external appearance of the nose.

The operation involves resection, repositioning, and/or remodeling of deviated cartilage and bony segments of the septum. Septoplasty is one of the most commonly performed procedures in otorhinolaryngology.

Indications for Tonsillectomy

The main indication for septoplasty is a nasal septum deviation causing significant clinical symptoms that impair the patient’s quality of life.

Key clinical indications include:

• Persistent nasal obstruction: The most common reason. Patients complain of constant congestion in one or both nostrils, not associated with a cold or allergy.
• Chronic rhinosinusitis: Deviation can block natural sinus openings, impairing ventilation and drainage, and sustaining chronic inflammation.
• Recurrent nosebleeds: The source of bleeding is often the thinned mucous membrane on the convex part of the deviated septum.
• Snoring and obstructive sleep apnea syndrome (OSAS): Severe nasal obstruction may contribute to these conditions.
• Creating surgical approach: Septal straightening may be required as a preliminary step for other endonasal procedures (e.g., sinus or pituitary surgery).

Surgical Technique

Septoplasty is performed endonasally, meaning all incisions are made inside the nasal cavity, avoiding external facial scars. It can be done under local or general anesthesia, though modern practice favors general anesthesia.

The main principle of the operation is submucosal resection of the nasal septum. The surgeon makes an incision in the mucous membrane and elevates it (together with the perichondrium and periosteum) from the underlying cartilage and bone. Deviated fragments of cartilage and bone are removed, straightened, or repositioned. The main goal is to create a straight midline septum while preserving sufficient bone and cartilage support for the external nose.

At the end of the surgery silicone splints or nasal packing may be placed to stabilize the septum and prevent hematoma formation.

Difference from Rhinoplasty

It is important to distinguish septoplasty from rhinoplasty. Septoplasty is a functional procedure addressing internal nasal structures to improve breathing; it does not alter the external shape of the nose. Rhinoplasty, on the contrary, is an aesthetic or reconstructive operation that reshapes the external nasal framework by manipulating the bones and cartilages of the nasal pyramid. When a patient has both septal deviation affecting breathing and a desire for cosmetic nasal correction, these procedures can be performed at the same time. Such combined surgery is called a septorhinoplasty.