Septoplasty: How did it impact you?

Posted by John, Volunteer Mentor @johnbishop, Sep 23, 2019

I have a deviated septum and was trying to find others that have had a septoplasty to see what it was like and what impact it had on them after having the surgery. I'm really trying to find out if it's worth pursuing at my age (76) since I've lived with it so long. I'm also wondering whether it may help with some of the obstructive sleep apnea issues I have with mouth breathing. My sleep medicine doctor didn't seem to think it would make a big difference but I've struggled somewhat with using my CPAP and consistently getting good results over the past year. Sometimes I am able to clear my nose and breathe normal but the times are few and far between.

If you have had a septoplasty, are you happy with the results? Also, would be interested in talking with anyone who has had a septoplasty and also has obstructive sleep apnea.

Thanks! John

@johnbishop

Hi @grant2021, Welcome to Connect. It's been one of those years and I've not been able to discuss the possibility of having a septoplasty with my primary care but it's still one of the things I want to discuss with the doctor. I am hoping the COVID-19 situation eases up so I can get a regular appointment setup. I will definitely provide an update.

Are you considering a septoplasty?

Jump to this post

I am definitely considering it. I would like to be able to breathe in a mostly normal fashion.

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@grant2021

I am definitely considering it. I would like to be able to breathe in a mostly normal fashion.

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I hear you on that. I have a few hours a day that it feels good/normal breathing.

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I recently found out i had a deviated septum and im debating on surgery since ive read good and bad things about it. I have 90% blockage in my left nostril and allergies on top of that so breathing is a major issue. It’s affecting my sleep at night since i have to sleep on my left side and if i sleep any other way i become completely stuffed up and it takes awhile to get my nose clear again. Can anyone share their story about surgery or any alternatives? Thanks.

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@mastro99 Welcome to Mayo Clinic Connect, a place to give and get support.

You recently found out that you have a deviated septum and you are considering surgery.

You will notice that I moved your question to a previous discussion related to deviated septum surgery. I did this so you can connect with members like @judyhodgern @grant2021 that have experience with this topic and may be able to offer suggestions and/or support.

Below I have linked another related discussion that you might find helpful. You may wish to scroll through the previous posts.
– Septoplasty question https://connect.mayoclinic.org/discussion/septoplasty-question/

@johnbishop Was kind enough to direct us towards the discussions above. He also found the link below produced by Mayo Clinic related to repairing a deviated septum.

Repaired Deviated Septum is a Breath of Fresh Air
https://sharing.mayoclinic.org/2019/02/22/repaired-deviated-septum-is-a-breath-of-fresh-air/

May I ask your major concerns related to the surgery?

REPLY

@mastro99– I will speak to my experience and what I have learned. 80% of the population has a deviated septum. It is very very common. These surgeries are presented as “normal and routine”. Routine, because it is one of the most common findings that an ENT will point out to any patient that they see with one and tell them they can “fix” it. But what exactly are they “fixing”. Something that doesn’t look “normal”. Do not fall into the trap of abnormalities. ENTs are surgeons, first and foremost. They will spend more time focusing on things they can present to you that need to be cut or removed. They spend very little time discussing how the nose actually works. The nose is a complete organ system. I works entirely in a finite pattern. This organ is not like the liver or kidney that can still function with less than.
Swelling in the nasal passages is caused my many many different things that need to be addressed first. Many people will get septal surgery thinking it will solve breathing issues. But if the underlying issue has not been addressed, you will still have the same issues. Allergies, in door/outdoor can cause swelling. Hormonal changes, Diet, Stress as well. When we sleep, the nasal mucosa lining and turbinate structure naturally enlarge due to increased blood flow to that area while laying on our backs. This is why a lot of people have to prop head on pillow to breathe better and they are fine. There are many REAL risks that occur with Septum surgery that are not “rare”. Septal perforations are very common. This is one of the most difficult revisions to perform. If this occurs you are often referred to one of the very few ENTs who can perform this correctly. Some ENTs will remove too much cartilage, causing a weakening in the entire septum structure. There is a saying in ENT world “As goes the septum, so goes the nose”. The risk of dryness is common. When the structure is altered if it is done conservatively it can leaves a too open pathway on one or both sides then you will have a sensation of too much air which causes extreme uncomfortability. The lining of the septum is richly innervated with nerve endings. It is very common for these nerves to get damaged, stretched and altered causing constant pain. Neurologists see many patients after all kinds of nasal type surgeries.
Airflow is a very subjective feeling that only you can explain or feel. Only you know what feels normal to you. When an ENT sees you in your original state, he is looking for something objective to match your subjective feeling. ENTs can not “see” airflow. So most of the time it is a guess as to your cause of complaint. If something structurally is altered and you return with a subjective feeling. There is not much they can do at this point as they have already offered their objective findings which they have removed/altered and can not be replaced or put back in. You can bring up everything I just mentioned to your ENT and if he/she denies it or seems caught off guard then then I would move on to a different ENT. I would explore every alternative first. Address the allergies. Use humidifier, nasal irritation moisture before sleep. Assess your diet, exercise and over all lifestyle. Any type of nasal surgery is difficult to ask others, because these surgeries are all performed so different and for different reasons and half the time ENTs don’t even know why they really work.
There are risks with every surgery regardless of how it’s presented. “Simple routine outpatient procedure. You are in and out and probably only need a week off work”. Nasal surgeries also have some of the highest failure rates. This is because this is one of the most delicate, open areas on your body that you still need immediately after surgery. It’s not a knee or shoulder that can be put in a boot or sling.
I know I have provided a lot here. Only because of the way the procedures are presented to patients. Ask yourself if what you are dealing with now, is a minor annoyance that you can control with other modalities rather than running the risk of completely altering your breathing pattern.
Sit with yourself without other opinions or surgical opinions and let your intuition guide you on this. Hope my honesty was helpful.

REPLY
@mastro99

I recently found out i had a deviated septum and im debating on surgery since ive read good and bad things about it. I have 90% blockage in my left nostril and allergies on top of that so breathing is a major issue. It’s affecting my sleep at night since i have to sleep on my left side and if i sleep any other way i become completely stuffed up and it takes awhile to get my nose clear again. Can anyone share their story about surgery or any alternatives? Thanks.

Jump to this post

@mastro99 I had the deviated septum surgery 40 years ago when I was in my early 20's. I used to get a lot of sinus infections so it was supposed to help. After the surgery, I still got sinus infections but I could tell I was breathing better. From what I remember, the surgery was done at the ENT's office under local anesthetic. The procedure was not bad in the sense that there was no pain, only the discomfort of receiving the anesthetic. It's probably equivalent to the test for covid. Your eyes will water. The doctor removes cartilage but I didn't feel anything other than pressure from cartilage removal. I think I was back to work the next day.
Tony in Michigan

REPLY
@erikas

@mastro99 Welcome to Mayo Clinic Connect, a place to give and get support.

You recently found out that you have a deviated septum and you are considering surgery.

You will notice that I moved your question to a previous discussion related to deviated septum surgery. I did this so you can connect with members like @judyhodgern @grant2021 that have experience with this topic and may be able to offer suggestions and/or support.

Below I have linked another related discussion that you might find helpful. You may wish to scroll through the previous posts.
– Septoplasty question https://connect.mayoclinic.org/discussion/septoplasty-question/

@johnbishop Was kind enough to direct us towards the discussions above. He also found the link below produced by Mayo Clinic related to repairing a deviated septum.

Repaired Deviated Septum is a Breath of Fresh Air
https://sharing.mayoclinic.org/2019/02/22/repaired-deviated-septum-is-a-breath-of-fresh-air/

May I ask your major concerns related to the surgery?

Jump to this post

My concerns are coming out of it worse as far as breathing , a bigger nose, perforated septum, no change in breathing, and pretty much everything nrd1 mentioned below.

REPLY
@tonyinmi

@mastro99 I had the deviated septum surgery 40 years ago when I was in my early 20's. I used to get a lot of sinus infections so it was supposed to help. After the surgery, I still got sinus infections but I could tell I was breathing better. From what I remember, the surgery was done at the ENT's office under local anesthetic. The procedure was not bad in the sense that there was no pain, only the discomfort of receiving the anesthetic. It's probably equivalent to the test for covid. Your eyes will water. The doctor removes cartilage but I didn't feel anything other than pressure from cartilage removal. I think I was back to work the next day.
Tony in Michigan

Jump to this post

Thanks for your reply.

REPLY
@nrd1

@mastro99– I will speak to my experience and what I have learned. 80% of the population has a deviated septum. It is very very common. These surgeries are presented as “normal and routine”. Routine, because it is one of the most common findings that an ENT will point out to any patient that they see with one and tell them they can “fix” it. But what exactly are they “fixing”. Something that doesn’t look “normal”. Do not fall into the trap of abnormalities. ENTs are surgeons, first and foremost. They will spend more time focusing on things they can present to you that need to be cut or removed. They spend very little time discussing how the nose actually works. The nose is a complete organ system. I works entirely in a finite pattern. This organ is not like the liver or kidney that can still function with less than.
Swelling in the nasal passages is caused my many many different things that need to be addressed first. Many people will get septal surgery thinking it will solve breathing issues. But if the underlying issue has not been addressed, you will still have the same issues. Allergies, in door/outdoor can cause swelling. Hormonal changes, Diet, Stress as well. When we sleep, the nasal mucosa lining and turbinate structure naturally enlarge due to increased blood flow to that area while laying on our backs. This is why a lot of people have to prop head on pillow to breathe better and they are fine. There are many REAL risks that occur with Septum surgery that are not “rare”. Septal perforations are very common. This is one of the most difficult revisions to perform. If this occurs you are often referred to one of the very few ENTs who can perform this correctly. Some ENTs will remove too much cartilage, causing a weakening in the entire septum structure. There is a saying in ENT world “As goes the septum, so goes the nose”. The risk of dryness is common. When the structure is altered if it is done conservatively it can leaves a too open pathway on one or both sides then you will have a sensation of too much air which causes extreme uncomfortability. The lining of the septum is richly innervated with nerve endings. It is very common for these nerves to get damaged, stretched and altered causing constant pain. Neurologists see many patients after all kinds of nasal type surgeries.
Airflow is a very subjective feeling that only you can explain or feel. Only you know what feels normal to you. When an ENT sees you in your original state, he is looking for something objective to match your subjective feeling. ENTs can not “see” airflow. So most of the time it is a guess as to your cause of complaint. If something structurally is altered and you return with a subjective feeling. There is not much they can do at this point as they have already offered their objective findings which they have removed/altered and can not be replaced or put back in. You can bring up everything I just mentioned to your ENT and if he/she denies it or seems caught off guard then then I would move on to a different ENT. I would explore every alternative first. Address the allergies. Use humidifier, nasal irritation moisture before sleep. Assess your diet, exercise and over all lifestyle. Any type of nasal surgery is difficult to ask others, because these surgeries are all performed so different and for different reasons and half the time ENTs don’t even know why they really work.
There are risks with every surgery regardless of how it’s presented. “Simple routine outpatient procedure. You are in and out and probably only need a week off work”. Nasal surgeries also have some of the highest failure rates. This is because this is one of the most delicate, open areas on your body that you still need immediately after surgery. It’s not a knee or shoulder that can be put in a boot or sling.
I know I have provided a lot here. Only because of the way the procedures are presented to patients. Ask yourself if what you are dealing with now, is a minor annoyance that you can control with other modalities rather than running the risk of completely altering your breathing pattern.
Sit with yourself without other opinions or surgical opinions and let your intuition guide you on this. Hope my honesty was helpful.

Jump to this post

I appreciate your honesty and information. You definitely reinforce a lot of my concerns.

A little bit of background, im 45 and very healthy and the only reason im considering surgery is because of the poor quality of sleep i get most nights. My left side of my nostril is 90% blocked so i can never breathe through it. I can only fall a sleep on my left side, I rarely sleep through the night because of my nose being stuffed up. I move a lot during sleep so I almost always end up on my back. For some reason, im not good at breathing through my mouth and if i try everything becomes dry and my breathing suffers as well. Afrin works really well but as you all know that cant be used very often. I haven’t found any allergy medications that work so my right side is always stuffed up unless im laying on my left side. I dont get many sinus infections so for me it comes down to the poor quality of sleep. I can live with all the other side effects but the sleep thing is a major problem. Also, i have no idea how it became deviated, ive never broke my nose nose but my ENT Doctor says I definitely did at some point. Anyways, thats my story and why im considering surgery but ive heard more bad than good so thats why im hesitating.

Thanks

REPLY
@tonyinmi

@mastro99 I had the deviated septum surgery 40 years ago when I was in my early 20's. I used to get a lot of sinus infections so it was supposed to help. After the surgery, I still got sinus infections but I could tell I was breathing better. From what I remember, the surgery was done at the ENT's office under local anesthetic. The procedure was not bad in the sense that there was no pain, only the discomfort of receiving the anesthetic. It's probably equivalent to the test for covid. Your eyes will water. The doctor removes cartilage but I didn't feel anything other than pressure from cartilage removal. I think I was back to work the next day.
Tony in Michigan

Jump to this post

I had a deviated septum and I went to an ENT doctor and he is known as being very very good and this was in Austin Texas and I had many many sinus infections and all of this was changed for the good once I had the deviated septum repaired and my sinuses cleaned out With inhaled antibiotics and sinus surgery. I’m so glad that I had it done—breathing easier and hardly any sinus infections since—-10 yes ago.

REPLY
@mastro99

I appreciate your honesty and information. You definitely reinforce a lot of my concerns.

A little bit of background, im 45 and very healthy and the only reason im considering surgery is because of the poor quality of sleep i get most nights. My left side of my nostril is 90% blocked so i can never breathe through it. I can only fall a sleep on my left side, I rarely sleep through the night because of my nose being stuffed up. I move a lot during sleep so I almost always end up on my back. For some reason, im not good at breathing through my mouth and if i try everything becomes dry and my breathing suffers as well. Afrin works really well but as you all know that cant be used very often. I haven’t found any allergy medications that work so my right side is always stuffed up unless im laying on my left side. I dont get many sinus infections so for me it comes down to the poor quality of sleep. I can live with all the other side effects but the sleep thing is a major problem. Also, i have no idea how it became deviated, ive never broke my nose nose but my ENT Doctor says I definitely did at some point. Anyways, thats my story and why im considering surgery but ive heard more bad than good so thats why im hesitating.

Thanks

Jump to this post

@mastro99-the additional information is helpful.
Is the blockage noticeable to you only when you sleep?
Have you tried breathe right strips or the silicone nasal cones?
And just and FYI, deviated septums can happen in fetal development and even at birth. As you grow and change so does your nose. It doesn’t only happen from a broken nose.
If you choose to pursue the route of septoplasty do the following;
-speak to people who only have had septoplasty due to sleep issues and see if that improved. Ask them if it was just septoplasty or did it include turbinate reduction with it.
– meet w/ several different ENTs that are double board certified in Rhinology and Facial Plastic surgery that know the form/function of the nose.
-Procedure vs. Surgery: Procedure is done in office, Surgery is done in the O.R. The in office procedure is done under local anesthesia, which is just that “local” to the site while you are awake. Local anesthesia does not require narcotics afterwards to tolerate the pain like awakening from general anesthesia. Like the other member mentioned he had hardly any pain and back to work. General anesthesia I’m sure as you know, your entire body is out. It is a longer recovery because your entire body system are getting the anesthesia out and it is a different pain processing. You now will probably wonder how can one doctor perform this same procedure in office and another one can’t or won’t. ENTs who work under local anesthesia have to be more skilled and delicate because you are awake. They also make less money in office and most likely do not have financial ties or obligations to get patients into the operating room.
-Ask the ENTs you meet with these questions
-Even if you have to drive further to find someone who performs in office, do so for less pain and better recovery.
These are things that people don’t think to ask, but they make a big difference.

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