What is septoplasty?

Septoplasty is a reconstructive plastic surgery performed to correct an improperly formed nasal septum (commonly called a deviated septum) that may be caused by:

• Birth defect
• Injury
• Damage from previous medical treatments

The nasal septum is a wall that divides the two nasal passages. The septum is made of cartilage and bone. A deviated septum is one that is twisted or deformed so that it does not evenly divide the two chambers of the nose. This may cause problems with proper breathing or nasal discharge.

About the surgery

In most cases, septoplasty is performed with traditional surgical techniques from inside the nose. If your child has internal surgery performed, scarring will not be visible.

In rare situations, an open — or external — septoplasty is required. When open surgery is performed, your child will likely have small scars the base of the nose, but they usually are not noticeable.

Potential surgical complications

Children vary greatly in their anatomy and healing ability, and the outcome of any surgery is never completely predictable. Complications that may occur with septoplasty include:

• Infection
• Nosebleed
• Reaction to the anesthesia
• Change in the shape of the nose (rare)

What to expect after surgery

• Your child will have intravenous (IV) fluids until the time of discharge. Clear liquids for your child to drink are available in the Post Anesthesia Care Unit (PACU), also called the recovery room.
• Your child may complain of a sore nose, not being able to breathe through the nose, and difficulty swallowing.
• A pain reliever may be given for pain. An antibiotic is prescribed to prevent infection.
• The head of the bed will be raised to help with swelling, breathing and drainage. At home, you should have pillows or a recliner chair available to help your child stay comfortable with the head elevated above the level of the chest.
• There may be packing in your child's nose to prevent bleeding. This packing is either dissolvable or may need to be removed.
• If packing is used, your child may be able to feel it in the nose. Your child should be told before surgery that she or he may feel like there is something in the nose when waking up. If packing is not used, swelling may cause this feeling. Your child should not forcefully blow the nose for a week or two.
• At first, there may be some drainage from the nose. You may see a small piece of gauze taped under your child's nose. This is called a "drip pad" or "moustache dressing." This is usually only needed for the first day, if at all. The drainage from the nose will probably be tinged with blood. Your child may cough or spit up some pink or brown mucus.
• Most children are fussy the first few hours after this procedure.
• Your child may begin normal play after several days, but may need to stay home from school until the discomfort improves. Consult your child's physician for more specific recommendations.
• Your child's physician may recommend the use of nasal ointment, salt water spray, or nasal steroid spray after surgery. Follow instructions carefully.

Short-term side effects of surgery 

The following short-term side effects may occur after your child's surgery:

• Nose will feel puffy
• Nose may ache
• Dull headache
• Small amount of bleeding in first few days

If symptoms do not subside, consult your child's physician.

When to call your child's physician

The following are some of the symptoms that may indicate a need for you to promptly contact your child's physician:

• Vomiting bright red blood or a coffee ground-like material
• Bright red bleeding from the nose or mouth
• Vomiting (or if the vomiting becomes severe)
• Signs of dehydration (a child can become dehydrated when he or she has prolonged or severe vomiting and is not able to drink enough fluid)
• A temperature greater than 101.3° F or 38.5° C taken under the arm; greater than 102.2° F or 39° C by mouth or rectum.

Signs of dehydration

• Dry mouth
• Sunken look around eyes
• Decreased amount of urine (i.e., fewer wet diapers than usual in an infant)
• No tears when crying
• Skin that, when pinched, forms and holds the shape of a tent

Follow-up care

A visit with your child's physician is usually scheduled a few weeks after surgery to make sure your child's nose is healing properly. If non-dissolvable packing was used, an earlier visit will be required to remove it.

Consult your child's physician if you have any questions.