Introduction

The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Don't forget to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting).  

What function does the nose have?

The nose is certainly not only there for the smell, although this is of course an important part of the function. The nose is primarily a part of the respiratory organs. In the nose, the inhaled air is heated, moistened and cleaned. For example, more than 95% of the particles that pollute our air are filtered out through the nose and made harmless. The nose ensures the best possible breathing. In addition, the nose has an important function in voice formation and the drainage of tear fluid also runs through the nose. Finally, the external shape of the nose is also an important aspect; this determines a person's appearance to a large extent. Nasal function can be affected in many ways. For example, due to a cold as it sometimes occurs in everyone, or due to an allergy (hypersensitivity). Disorders in the function of the nose can often be made worse by an abnormal shape of the interior of the nose. The most common is a misalignment of the nasal septum (the septum), which separates the nasal halves. This abnormal shape of the nasal septum is very common and can lead to a wide range of complaints, such as a feeling of constipation, disturbed breathing or headache. This is an explanation for the fact that straightening the nasal septum (the so-called septal correction) is an operation that is common. The aim of this procedure is to improve nasal function.

 

Septoplasty (septum correction)

The purpose of the operation

The aim of the operation is to correct deviations/crookedness of the nasal septum, so that it is straightened and there is therefore sufficient breathing space in the nose on both sides.

The technical aspects of the operation

Surgery is performed exclusively in the interior of the nose, so no visible scars are to be expected. During the operation, the cartilage and bone of the nasal septum is exposed through a small incision inside the nose, usually on the right side, a few millimeters past the entrance to the nose. After this, the partition is then straightened, ie protruding parts are removed, curved parts are straightened, etc.

Immediate Effects

The thus repaired nasal septum is then temporarily held in place by so-called splints inserted into the nose (silicone plates that are placed in the nose on both sides and that allow some breathing through the nose). In this way the septum is supported in the correct position on both sides, so that the mucous membrane, cartilage and bone can grow back together. The splints are removed after about 1 week. The sutures at the incision are removed after 1-2 weeks, if applicable.

Late Effects

The healing of the nasal mucosa takes several weeks. During this period, treatment with nasal rinses and/or vapors and/or nasal ointments may be applied. In rare cases, problems during healing can cause a misalignment of the septum or cause deformities that could negatively affect nasal breathing.

Serious and/or exceptional complications

Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Bleeding is always more or less to be expected, there are of course cases where the doctor will have to intervene extra. Cerebrospinal fluid leakage can occur after both nasal and sinus surgery (although it is extremely rare with septoplasty). If a leak does occur, it is not very noticeable and only becomes apparent late. Confusing in this regard, of course, is that any patient undergoing surgery on the nose or sinuses will always have some watery nasal discharge. If the nasal discharge is profuse or noticeably one-sided, it is best to inform the doctor.

​

Nasal turbinate surgeries (conchaplasty or conchacoagulation)

The purpose of the operation

Especially the inferior concha (the lower turbinate) is mentioned in this context as it plays the most important role in nasal breathing. The concha media can also be surgically corrected, usually in conjunction with sinus or septal surgery, so that we only focus on the inferior concha here. Most procedures on the inferior concha are intended to reduce this structure and thus improve nasal breathing.

The technical aspects of the operation

In order of invasiveness we distinguish the RF conchaplasty, the conchacoagulation and the conchaplasty. In the RF conchaplasty, a needle is inserted into the concha (usually under local anaesthetic), which causes a controlled heating of the concha, after which the concha scars and shrinks. In the concha coagulation, this effect is achieved by burning the concha from the surface using electric current. This can be done under local or general anaesthetic. In conchaplasty, part of the conchamucosa is cut away, almost always under general anaesthetic. Many turbinate surgeries are done in conjunction with a septal correction or sinus surgery.

Immediate Effects

Bleeding is to be expected to a greater or lesser extent if a conchaplasty is performed. this is why a nasal tamponade is sometimes temporarily applied, which can then be removed after 1 or a few days.

Late Effects

Crust formation at the inferior concha occurs in the first weeks, as long as the mucosa is still in the healing phase. Nasal rinses and/or nasal ointment are usually used for this  or nasal drops.

Serious and/or exceptional complications

There are, apart from the already mentioned bleeding with conchaplasty, no serious or exceptional

complications from these operations.

​