Introduction
Nasal septum deviation is a common condition that can cause a variety of problems, such as difficulty breathing, chronic sinus infections, and nosebleeds. In New York City, both public and private hospitals are recognized for their excellence in nasal septum deviation correction surgery, also known as septoplasty. This article will provide a comprehensive overview of septoplasty, including what it is, the causes and symptoms of a deviated septum, the surgical procedures, the best doctors and hospitals in New York City, and the recovery process.
What is a Deviated Septum?
The nasal septum is the wall that divides the two nasal cavities. Ideally, it should be straight and centered, evenly separating the right and left nostrils and optimizing airflow. However, a deviated septum occurs when this wall is significantly off - center. This can cause an asymmetry of the cartilage that supports the nasal cavity, resulting in one nostril becoming more blocked than the other, which can lead to a moderate to severe disruption in airflow.
Causes of a Deviated Septum
- Congenital Development: Some people are born with a deviated septum due to genetic factors or developmental variations. This misalignment may become more noticeable during adolescence as facial features continue to develop, often leading to progressive breathing difficulties. For example, certain genetic traits may cause the cartilage or bone in the septum to grow unevenly.
- Facial Trauma: Physical impacts from sports injuries, accidents, or falls can cause immediate septal deviation. These injuries often require specialized correction to restore both alignment and proper airflow. A direct blow to the nose during a contact sport like football or a car accident can cause the septum to shift out of place.
- Medical Conditions: Certain conditions can affect septal alignment. Nasal polyps can cause structural changes, inflammatory processes can affect nasal tissues, chronic sinus infections can lead to gradual deviation, and rarely, tumors can cause septal displacement.
Symptoms of a Deviated Septum
- Difficulty Breathing: This is the most common and apparent symptom. Restricted breathing can manifest as extra effort for inhalation of air and loud snoring at night. Patients who suffer from a deviated septum typically feel permanently congested.
- Frequent Sinus Infections: A deviated septum can obstruct the sinus drainage pathways, leading to mucus buildup and a higher risk of bacterial growth, resulting in more frequent sinus infections.
- Nosebleeds: The irritated nasal tissues due to the deviation can be more prone to bleeding.
- Headaches: Pain concentrated around the nose can be a result of the pressure caused by the deviated septum.
- Postnasal Drip: Mucus may accumulate and drip down the back of the throat.
- Sleep Apnea: Difficulty breathing through the nose can contribute to sleep - related breathing disorders.
- Congestion in a Single Nostril: One nostril may be more blocked than the other.
What is Septoplasty?
Septoplasty is a surgical procedure to correct a deviated nasal septum. It is also referred to as septal reconstruction or submucous septal resection. This corrective surgery straightens the partition between the two nasal cavities so that it runs down the center of the nose in the ideal anatomical formation. When the nasal septum deviates from the center line and into one of the nasal cavities, it can impede airflow due to narrowing that occurs in the affected cavity. Septoplasty aims to repair and/or correct the passageways in the nose, making it easier to breathe.
How is Septoplasty Performed?
Most septoplasty procedures are performed under general anesthesia. The surgeon usually makes an incision on the lower portion of the septum, known as the caudal septum, and then works through the nostrils to access the bone and cartilage targeted in the procedure. The typical steps of a septoplasty include:
- Exposing the Septum: The surgeon will expose the bony and cartilaginous portions of the septum by elevating the mucosal lining that covers them.
- Freeing the Cartilage: The cartilage portion of the septum is freed from its attachments to the bone.
- Removing or Repositioning Obstructive Tissue: Any cartilage or bone that is causing obstruction or narrowing of the airway is removed and/or repositioned.
- Realigning the Septum: The remaining portion of the bone and cartilage that has been preserved for structural support within the nasal cavity is realigned.
- Stabilizing the Septum: Once the septum has been straightened, it is temporarily stabilized with a splint, small plastic tubes, or internal sutures. The incision is then closed.
Septoplasty can be performed using a closed or open technique or via an endoscope. The method used for each patient depends on their unique anatomy and needs.
Candidates for Septoplasty
This surgery is typically indicated for individuals with the following conditions:
- Recurrent rhinitis
- A deviated septum causing significant breathing difficulties
- Other chronic sinusitis
- Recurrent epistaxis (nosebleeds) due to septal impaction or septal spur
- For cosmetic purposes to straighten a crooked or deviated nose
However, septoplasty should not be performed on patients presenting with acute sinus or nasal infection. Individuals with untreated diabetes, bleeding diathesis, or severe hypertension are not candidates for septoplasty.
Other Surgical Procedures Related to Deviated Septum
Septorhinoplasty
If an injury such as a fracture is the cause of a nasal obstruction, or if surgery to reposition the septum changes the appearance of the nose, septorhinoplasty may be performed. During this procedure, surgeons eliminate the nasal obstruction and use cosmetic techniques that ensure that the nose looks natural. They correct the position of the septum and address any other structural problems. For example, if the small area inside the nose between the septum and the bridge of the nose is too narrow, it may restrict airflow, and a reconstructive surgeon may widen this area to help the patient breathe more easily. Frequently, surgeons remove cartilage from the septum and place it in other areas to improve breathing and, if desired, to alter the shape of the nose.
Submucosal Resection
In submucosal resection, a surgeon removes small sections of the septum, the turbinates, or both to open the nasal passages. The surgeon accesses the septum or turbinates through the nostrils and makes a small incision in the layer of soft tissue lining the nasal passage. This incision allows surgeons to remove portions of the underlying bone structure without disturbing the outer layer of tissue, which plays an important role in keeping the nasal passages hydrated. Surgeons may use a laser or a small device called a microdebrider, a powered instrument that removes bone and soft tissue, to reduce the size of turbinates.
Turbinate Outfracture
In addition to a submucosal resection or laser procedure, surgeons may also permanently reposition the turbinates to provide more space in the nasal passages. This permanent repositioning, called out fracture, involves breaking the thin bones of the turbinates in order to reposition them.
Best Doctors and Hospitals in New York City for Septoplasty
Top Doctors
There are many highly - qualified doctors in New York City who perform septoplasty. Some of the top - rated doctors include:
| Doctor's Name | Rating | Location |
|---|---|---|
| Dr. Ashutosh Kacker, MD | 4.90 out of 5 stars | 1305 York Avenue 5th floor, New York, NY 10021 |
| Dr. Calvin Wei, MD | 4.70 out of 5 stars | 425 W 59th st fl 10, New York, NY 10019 |
| Dr. Mukesh Prasad, MD | 4.90 out of 5 stars | 1305 York Avenue 5th floor, New York, NY 10021 |
| Dr. Abtin Tabaee, MD | 4.90 out of 5 stars | 156 William Street 12th floor, New York, NY 10038 |
| Dr. David Gudis, MD | 4.90 out of 5 stars | 180 Fort Washington Avenue, New York, NY 10032 |
Top Hospitals
Both public and private hospitals in New York City are known for their excellent septoplasty services. Some of the top hospitals include:
- Hospital for Special Surgery - 535 E 70th st, New York, NY
- Maimonides Medical Center - 4802 10th ave, Brooklyn, NY
- Mount Sinai Hospital - 1 Gustave L Levy pl, New York, NY
- NYU Langone Health - Renowned for its team of otolaryngologists and plastic and reconstructive surgeons who can perform various procedures for deviated septum correction using minimally invasive techniques in an outpatient setting.
The Cost and Insurance Coverage of Septoplasty in New York City
Cost
The cost of septoplasty in New York City ranges from $5,000 to $15,000. The wide range in price depends on factors like the surgeon's fees, hospital or facility charges, and anesthesia expenses. On average, most people can expect to pay nearly $10,000 for septoplasty when performed by an experienced ear, nose, and throat (ENT) surgeon.
Insurance Coverage
The cost of a deviated septum surgery (septoplasty) can often be covered by insurance, depending on the patient's insurance plan and whether it can be proven that the deviated septum is impairing the patient's quality of life. In order to qualify for full or partial coverage for a septoplasty by insurance, it must be proven that the procedure is a medical necessity. If the patient is looking for cosmetic improvements, additional out - of - pocket costs will apply.
The Recovery Process after Septoplasty
Immediate Post - Surgery (First 24 Hours)
After septoplasty surgery, gauze packing is placed in each nasal passage to absorb drainage and prevent bleeding. Pain medication is prescribed to manage discomfort. Rest is crucial to restore energy and facilitate proper healing. Patients should keep their heads elevated on several pillows when sleeping to reduce swelling. It is recommended to rest in a reclining chair during the first few days if possible. Cool compresses may also provide some relief.
Week 1
The nose packing is usually removed within several days after surgery. Discomfort and nasal congestion are still common during the first week, but pain medication can help manage unpleasant symptoms. To allow proper healing, no heavy lifting, bending over, straining, or strenuous activity should be done. Patients should clean and care for the nasal and sinus areas as directed by their surgeon. A follow - up appointment is usually scheduled to monitor recovery by the end of the first week.
Weeks 2 - 4
Most of the discomfort should subside within 14 days after surgery. Drainage, congestion, and minor bleeding may still occur as the nasal passages heal. Saline spray can help cleanse the nose. Splints are usually removed at the beginning of the second week. Regular activity may gradually resume, but strenuous exercise should still be avoided for at least a month. Healing and adjustment to new nasal airflow continue during this time.
Long - Term Recovery
It can take up to a year for the nose to stabilize and adjust completely after septoplasty procedures. Even if the skin looks healed, the tissues, membranes, blood vessels, and nerves inside the nasal passages continue to recuperate for several months.
Risks and Complications of Septoplasty
Septoplasty is a common surgical procedure that has a very low risk of complications, and when performed by a board - certified plastic surgeon, it is both safe and effective. However, rare complications such as the following have been reported:
- Bleeding: Excessive bleeding can occur during or after the surgery, although this is rare.
- Septal Hematoma: A collection of blood within the septum, which can cause pain and may require drainage.
- Septal Perforation: A hole in the septum that can cause a whistling sound when breathing, crusting, and nosebleeds.
- Hyposmia (Decreased Sense of Smell): Some patients may experience a temporary or permanent decrease in their sense of smell.
- Return of the Nasal Blockage: In some cases, the nasal blockage may return, which could require another surgery.
- Scarring: Scarring inside the nose may occur, although it is usually not visible externally.
- Changes in Skin Sensation: There may be temporary or permanent changes in the sensation of the skin around the nose.
- Unevenness in the Appearance of the Nose: Although rare, there is a possibility of the nose appearing uneven after surgery.
- Skin Discoloration: Temporary or permanent skin discoloration around the nose may occur.
Conclusion
In conclusion, nasal septum deviation can significantly impact a person's quality of life, causing breathing difficulties, sinus infections, and other related problems. Septoplasty, along with other related surgical procedures, offers an effective solution to correct the deviated septum and improve nasal function. In New York City, both public and private hospitals have a reputation for providing high - quality septoplasty services, with many experienced doctors available to perform these surgeries. The recovery process requires patience and following the doctor's instructions carefully. While there are risks associated with the surgery, the benefits of improved breathing, reduced sinus infections, and better sleep quality often outweigh these risks. If you are suffering from symptoms related to a deviated septum, it is advisable to consult with a qualified doctor in New York City to discuss your options.
Call - to - Action: If you think you may have a deviated septum and are interested in learning more about septoplasty, don't hesitate to reach out to one of the top doctors or hospitals in New York City mentioned in this article. Schedule a consultation to get a personalized evaluation and treatment plan. Share this article with others who may be suffering from similar issues to help them make informed decisions about their health.
