Septoplasty (Submucous Resection, SMR)
What is the nasal septum?
The nasal septum is the vertical wall that divides the nose into two nasal cavities.  It is made up of cartilage (quadrilateral septal cartilage) in the front and thin bone (perpendicular plate of the ethmoid and vomer) in the back.  The nasal cavities and nasal septum are lined with a thin membrane of tissue called mucosa.
What is septal deviation?
At birth, the nasal septum is usually straight and remains straight in childhood, however, as age progresses, there is a tendency for the septum to bend to one side or the other, or for an irregular shelf of cartilage or bone to develop (septal spur).  Often, there is no history of injury to account for the irregular septum.  In some individuals, the septum loses its midline position during the growth process rather than as the result of injury.  Few adults have a septum that is completely straight.  Sometimes the septum is bent as a result of birth trauma.  During childhood or adult life, trauma plays a major factor in producing septal deviation.

In order to simplify the anatomy, the nose will be depicted as an isoceles triangle with the septum as the height dropped from the apex.
What is septoplasty?
Septoplasty is an operation to correct a deformity of the nasal septum.  It is sometimes referred to as submucous resection of the septum (SMR) or septal reconstruction.  The usual purpose is to improve nasal breathing, but it may also be performed to allow adequate examination of the inside of the nose for treatment of polyps, inflammation, tumors, or bleeding. When the nasal septum is deformed, there is no medicine that will cause it to be straightened, so surgery is the only solution to this problem.
How is septoplasty done?
Septoplasty is performed under general or local anesthesia.  It takes about one hour and is usually carried out on a day surgery basis. A small incision is made inside the nose.  (THERE ARE NO EXTERNAL INCISIONS - see photos below).  The mucosal lining of the septum is detached from the cartilage and bones of the septum. The deviated portions of the septum are removed or straightened.  The nasal lining mucous membrane is replaced.  Splints or packs are placed in the nose for a few days.  These splints / packs have a straw that allows the patient to breathe from the nose and makes swallowing much easier.  There are no external bruises or swelling of the eyes because the outer nasal bones are not broken or interfered with as in cosmetic nasal surgery (nasoplasty / rhinoplasty).
What are the complications of  septoplasty?
The undesirable results that may occur include: a hole in the septum, failure to completely improve breathing, postoperative bleeding (usually easy to control), wound infection, nasal crusting, and very rarely, a change in appearance. Because of the proximity of dissection to the incisors, these teeth and a small area of the hard palate behind them, may feel numb for 2 to 3 months.

This page was last updated on: March 30, 2017
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Bechara Y. Ghorayeb, MD. 1140 Business Center Drive, Suite 560.  Houston, TX 77043.
Phone: (713) 464 2614

What is the post-operative care of septoplasty?  Click Here
Doyle Nasal Splints
What is turbinate reduction? (Turbinectomy)
Picture of turbinate reduction

Turbinate reduction / turbinectomy/ turbinoplasty is a procedure that is frequently performed with septoplasty. It consists of removing a piece of the inferior turbinate to widen the nasal airway.  Several surgical methods have been described.  The above diagram depicts the removal of a wedge of tissue from the left inferior turbinate and then collapsing the turbinate on itself.

Surgical photograph of septoplasty showing a metallic speculum spreading the left nostril as the incision is made with a scalpel.  There are no external incisions.