Medical content: Op. Dr. Tamer Haliloğlu · Last updated:
What is Deviation Surgery?
The operation performed to correct a curvature of the nasal septum is called “nasoplasty”. The nasal septum separates the two nasal passages; its front part is made of cartilage and its back part of bone. Because septal deviation is a very common problem in the population, deviation surgery performed to correct it is one of the most frequently performed operations. When deciding on septoplasty, the patient’s complaints, the negative effects of nasal obstruction on health and quality of life, and the results of the nasal examination are taken into account. In patients with nasal obstruction caused by a curved (deviated) nasal septum, there is no option other than surgical treatment.
How is Deviation Surgery Performed?
Successful results can be achieved with the standard closed nasoplasty technique. This operation is performed through the nostril and takes 20–30 minutes. In general, it consists of removing the curved cartilage and bone parts of the deviated section that is not close to the nasal bridge. The cartilage at the front of the nasal septum should not be bent excessively, and the upper part of the nose should not be included. Although the large number of such standard operations has misled people into believing that deviation surgery is a “simple” surgical procedure, the frequency of severe curvatures that require different surgical methods due to genetic characteristics is quite high.
When is Open Technique Deviation Surgery Preferred?
If the nasal curvature is narrow or perpendicular to the upper part of the airway, if the septal cartilage is severely deformed, or in patients who have had previous nasal surgery, “open septoplasty” should be the first choice, because the curved part itself is repaired rather than patched. In patients with this type of deviation, the standard closed operation often ends in failure. When the operation is repeated, there is not enough cartilage left in the nasal cavity to repair, and the likelihood of problems is high.
In cases where the cartilage curvature or the outer bone of the nose is also crooked, and in patients for whom aesthetic nose surgery is planned during the deviation operation, open technique deviation surgery is preferred. Although standard deviation operations are part of Ear, Nose and Throat specialty training, achieving good results in open technique surgery generally requires experience and special training in nasal surgery.
In today’s surgery, the “open technique”, which is often preferred only for aesthetic purposes, can correct the cartilage and bone curvature of the nose in the most ideal and permanent way without changing the appearance of the nose. In patients with cartilage defects or deformities due to previous operations, if there is not enough cartilage in the nasal septum to create a straight and strong structure, it may be necessary to use pieces of cartilage taken from the ear or the ribs.
Is Nasal Packing Used in Deviation Surgery?
Thanks to the surgical techniques developed today, it is possible to perform aesthetic and deviation nose operations without nasal packing. This makes an important contribution to the comfort of patients after surgery. In patients who have not had endoscopic reduction procedures of the lower turbinates requiring packing during the same operation, deviation surgery is performed without packing. Because of blood collection under the mucosa and the effects of mucosal swelling in the early period, placing thin silicone supports inside the nose after surgery is a frequently preferred practice.
Can Aesthetic Nose Surgery Be Performed Together with Deviation Surgery?
If a patient who needs surgery because of a deviation is also considering aesthetic nose surgery, the most ideal approach is to perform the two operations together. One of the most important advantages of the combined operation is that the bone tissue or excess cartilage causing the curvature inside the nose during deviation surgery can be used for different purposes in the aesthetic part.
What Should Be Considered After Deviation Surgery?
Deviation surgery is preferably performed under general anesthesia. If deviation surgery is performed with the closed technique, it takes 15–20 minutes. If the open technique is used, it can take between 1 and 2.5 hours, depending on the severity of the problem and whether cartilage tissue needs to be taken from the rib or ear. Patients generally stay in the hospital on the day of surgery. The next day, the patient’s nose is cleaned and they are discharged.
It is generally sufficient for the patient to come for 2 or 3 check-ups after the operation. Softening sprays or drops and saline cleansing sprays are used for the crusting and dryness that occur for two or three weeks until healing of the mucosa inside the nose is complete.
In patients who have not had aesthetic intervention, or in whom the open technique was not applied because the cartilage curvature was not at a level that would change the outer appearance, there is no change in the outer appearance of the nose after surgery, and there is no discoloration or swelling around the eyes and face.
After deviation surgery, patients need to protect their noses from any impact for 6 weeks. They can start sports activities without risk of impact after 2 weeks and swimming after 1 month. Patients who have had only deviation surgery can wear glasses regardless of the technique used.
Deviation Nose Surgery Prices
Nose operations can be performed in various ways using different instruments, techniques and materials. Surgery fees vary depending on previous nasal surgery, the extent of the problem in the nose, whether it is necessary to take tissue from the rib or ear, and whether there are problems such as turbinate (concha) enlargement or sinusitis that need to be treated in the same operation.
Another factor that affects the price is the hospital where the operation will be performed. In fully equipped large private hospitals, although the surgical fee is the same, the cost is higher than in other hospitals because other factors such as operating room use, room, tests, anesthesia and materials are more expensive.
Operations for nasal septum curvature are performed under private insurance under conditions that vary according to the insurance coverage. For patients who do not use private insurance and in cases where the operations are not covered by insurance, surgery prices are generally given as a package price. In other words, the total price that patients will pay is clearly known before the operation. The costs of the materials to be used are not calculated one by one and can be set as a fixed price.
The success of an operation on an organ with very important functions such as smell and breathing depends above all on the experience, surgical skills and training of the surgeon who will perform it. In addition, the quality and content of the materials and instruments used during the operation also play an important role. Many different factors, from the quality of other equipment and materials to their sterilization, can have an effect. In other words, a lower price means compromising on quality.
Surgery prices vary depending on various parameters. The most accurate approach is to have a complete functional nasal evaluation after deciding on your physician, and then to decide on the interventions. Additional procedures such as sinus surgery or turbinate surgery that need to be performed for deviation surgery to be successful in terms of nasal function may affect not only the price but also the choice of hospital.
