What Happens During a Septoplasty?
During this procedure, your nasal septum will be trimmed if it is too wide. Then, your cartilage and bone will be repositioned. Depending on whether you were born with a deviated septum or developed one recently, we may also replace some of the cartilage and bone. If the structural damage to your septum is along your nose's bridge, we will graft extra cartilage from another part of your body and reinforce the cartilage currently supporting your septum.

Is This Procedure Painful? 
Not really, patients often comment how little pain or discomfort they experience after this procedure. The procedure is usually performed under general anesthesia. It may be administered intravenously or it may be inhaled. Depending on the scope of your procedure, your health, and your personal preference, you may only require local anesthesia. 

General anesthesia is ideal for many procedures because it numbs the entire body and puts you to sleep so you will not feel anxious during your procedure. Local anesthesia is administered into your nasal tissues via injection and numbs only the nose. If you would like to be sedated during your procedure, this will be done intravenously, but you will still be conscious. The intravenous sedation will only make you feel groggy.

How Should I Prepare for My Procedure?
There are several very important things you must do in preparation for your procedure. One of the most important things you can do pre-op is to stop smoking and drinking alcohol. It is so important to refrain from consuming alcohol and tobacco products because these products contain chemicals that elevate your blood pressure. Elevated blood pressure may affect your procedure and will slow down your recovery significantly.

Another very important thing you must do to prepare for your procedure is to ensure you are hydrated. The more hydrated you are, the smoother your procedure and recovery will go. Other important preparation steps include not taking NSAIDs, not taking fish oil supplements, and not taking garlic supplements. These drugs and supplements will thin your blood and may affect your procedure.

Will I Have to Fast Before My Procedure? 
We will advise you on whether you need to fast before your procedure during your initial consultation. If you are only receiving local anesthesia, there will be no need to fast.

However, if you have general anesthesia, you must refrain from eating or drinking during the eight hours leading up to the time you are scheduled to arrive at our office. Note, you may drink clear liquids, like water up to two hours before your scheduled arrival time.

What Happens After This Procedure? 
Once your septum is repaired, we will use absorbable sutures to close the incisions. If your septum needs a little extra support during your recovery, we will insert a soft silicone splint into each nostril. Also, a bandage may be packed into your nose temporarily. Once all of that is done, we will move you to a recovery room and observe you for a few hours to ensure that your general anesthesia wears off enough.

What Should I Expect During My Recovery Period? 
During the first 24 to 72 hours following your procedure, you should expect to feel pretty groggy. This is a natural response to sedatives regardless of whether you receive intravenous sedation or general anesthesia. Also, you will feel tired because it takes energy for your body to heal, which is what it will be concentrating on for a few days.

How Should I Care for Myself During My Recovery Period? 
There are several things you must do to care for yourself during your recovery period. For instance, you must keep your head elevated above your head while you sleep. To accomplish this, you may want to sleep with a travel pillow under your neck, sleep with an extra pillow under your head, or sleep in a recliner. It is also highly advisable to wear dresses or button-up shirts so you don't have to pull anything over your head.

Furthermore, it is very important that you avoid strenuous activities for up to two weeks post-op. If you have a strenuous job, we will meet with you when you start to feel like your old self to determine whether it is safe for you to go back to work.

Is There Anything Else I Should Avoid Post-Op? 
Yes, there are other post-operate restrictions. For instance, it is very important that you don't blow your nose for several weeks. If your nostrils feel itchy, you can spray a saline solution into your nostrils to relieve the itching. You can make your own sterile saline solution by boiling tap water and mixing salt and baking soda into it, or you can use distilled water that doesn't need to be boiled. You can also purchase nasal spray at your favorite pharmacy.

Other things you should avoid during your recovery period include steaming hot water and foods, alcohol, spicy foods, and tobacco products. It is very important to keep your blood pressure normal while you recover.

How Long Will My Recovery Period Take? 
You will only need to take a few days off from school, or you will only need to take a few days off from work if you have a sedentary job. If you have a strenuous job, you may need to take over a week off. We will bring you in for a follow-up appointment after your procedure to assess your recovery and advise you on how much of your routine you can get back to. As for complete recovery, you will only need to wait four to eight weeks.

Am I a Good Candidate for This Procedure? 
To determine whether septoplasty is right for you, it is important that you come in for an initial consultation. During this initial consultation, we will discuss your medical history, including any other procedures or treatments you have had in the area. We will also discuss your current health to ensure you are currently healthy enough to undergo this procedure.

Septoplasty is a procedure that will improve your breathing by trimming off any excess cartilage and bone, reposition your nasal septum as necessary, and replace any damaged cartilage. To find out if this procedure is right for you, visit the office of Dr. Thomas S Higgins, MD, MSPH in Louisville, KY for an initial consultation. We look forward to meeting you and helping you improve your breathing.

Some ear conditions are ultimately related to the nose.  Once you think about the intertwined anatomy and physiology of these two body parts, it makes complete sense. The nose is connected to the ear via a functional tube called the Eustachian tube. This tube helps ventilate, drain, and maintain an equilibrium of air pressure in the middle ear. It opens in the back of the nose called the nasopharynx. If something were to block that opening, the system gets backed up, causing increased ear pressure and ear fluid.

We have known that one of the causes of ear infections or persistent middle ear fluid in kids is obstruction of the Eustachian tube from the adenoids, which are in the nasopharynx. Thus, performing an adenoidectomy is one of the treatments for chronic ear fluid in kids.

Our research group set out to see if chronic rhinosinusitis affected ear symptoms in adults and our findings were significant. We found that, in patients with chronic rhinosinusitis, ear symptoms and nose/sinus symptoms were strongly correlated.  So, those with worse sinus symptoms seemed to have worse ear symptoms.

We also looked at how sinus surgery affected ear symptoms. In this study, 80% of the patients had improvement in ear symptoms with sinus surgery alone and 60% had complete resolution (or normalization) of their ear symptoms!

So, we have found it important to ask questions about both nose and ear symptoms because treating the nose is often the answer to solving certain ear problems.    

Nasal surgery provides many benefits in the treatment of obstructive sleep apnea (OSA), says the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS). Nasal surgery is considered any surgery of the nasal passages to improve nasal breathing, such as septoplasty and inferior turbinate reduction. According to the AAOHNS Position Statement from September 8, 2017, here are four evidence-based benefits of nasal surgery in OSA.

1. Nasal surgery improves the use of Continuous Positive Airway Pressure (CPAP), the mainstay treatment for OSA. Many people do not tolerate CPAP, often throwing the mask off in the middle of the night.  A CPAP mask on the nightstand doesn't help at all! 

2. Nasal surgery may improve the use of oral appliances. Oral appliances are used to pull the jaw and/or tongue forward at night to open the airway. A couple of studies have shown that many of the people who are unable to tolerate such appliances are those with higher nasal resistance, so reducing nasal resistance could improve compliance.  

3. Nasal surgery improves quality of life in people with OSA. Two quality-of-life scales, the Epworth Sleepiness Scale and the SF-36, improve significantly after nasal surgery, with decreases in excessive sleepiness along with improved general health and mental health scores.

4. Nasal surgery can reduce the severity of OSA in some people. A few studies, including a randomized control trial, showed improvement in OSA severity, after nasal surgery alone. These results certainly do not indicate that nasal surgery is the cure for OSA, but they do show direct beneficial effects of nasal surgery on OSA. 

The evidence currently shows that nasal surgery provides benefit to OSA sufferers.  Can it take away OSA? Usually not, but it can help make the treatment easier. Thanks for reading this article. Don't forget to check out other related topics, including septoplasty, inferior turbinate reduction, and functional endoscopic sinus surgery. 
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Ref: http://www.entnet.org/content/nasal-surgery-and-osas# (accessed 5/20/2018)