Endoscopic septoplasty is a newer technique where an endoscope is used to visualize the nasal cavity to straighten the nasal septum. Most people’s septum will be deviated to one side or the other, which is not a cause for concern. However in some people the deviation is significant enough that it results in nasal obstruction. If this is the case, then they would be a candidate for septoplasty. The incision is made on the side of the deviation, 1-2cm back from the most forward part of the septum. The mucosa is lifted up on this side, then the cartilage is incised and the flap is lifted on the other side. Deviated bone and cartilage is removed, and the deviation is reduced. The flaps are stitched together with an absorbable mattress suture. The vast majority of the time, stents and packing are not required. This results in minimal post op pain, and Tylenol is adequate for postoperative pain control. Neilmed rinses are begun the next day. Not all people are candidates for endoscopic septoplasty, namely those with significant forward deviations, where a traditional approach is indicated. Please see the link below for an intraoperative video. Frequently endoscopic septoplasty is performed concurrently with endoscopic sinus surger.y In fact, inadequate septoplasty can be a reason for failure of surgery due to limited visualization of the sinuses while performing endoscopic sinus surgery.
Josh Meier, M.D. F.A.R.S.