New ranking of membranous septum resection in New York City launched!

Introduction

In New York City, the medical field is constantly evolving, and one area that has seen significant attention is membranous septum resection, particularly in relation to septoplasty surgeries. A deviated septum can cause a multitude of issues for patients, including breathing difficulties, chronic congestion, and sinus problems. The launch of a new ranking in membranous septum resection is a significant event as it can help patients make more informed decisions when choosing a surgeon for their procedure.

Understanding the Nasal Septum and Septoplasty

Anatomy of the Nasal Septum

The nasal septum is the wall that divides the two nasal cavities. It is made up of cartilage in the front two - thirds and thin bone in the back portion. The septum is lined with a smooth, shiny skin called mucosa that covers the cartilage and bone. It sits on a small groove of bone called the maxillary crest, which is the top of the bone that forms the palate (roof of the mouth). The septum extends from the floor of the nose to the bridge above and down to the nasal tip below. If you put your finger in your nose and feel a wall in the middle, that's your nasal septum (Pearlman Aesthetic Surgery).

What is Septoplasty?

Septoplasty is a surgical procedure used to correct a deviated nasal septum. Also referred to as septal reconstruction or submucous septal resection, this corrective surgery aims to straighten 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 in the affected cavity. Deviations of the septum can often lead to nasal obstruction and sinus issues. A deviated septum can be the result of an injury or can occur during childbirth. If the septum shifts towards one side at a degree greater than 50%, it can cause difficulty breathing. In some cases, this shift causes the inferior turbinate on the opposite side to enlarge, a condition known as compensatory hypertrophy (Cangello Plastic Surgery).

Indications for Septoplasty

This surgery is typically indicated for individuals with recurrent rhinitis, a deviated septum, or other chronic sinusitis. Septoplasty can also be performed to alleviate recurrent epistaxis (nosebleeds) due to septal impaction or septal spur. Additionally, it can be done 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 this procedure (Cangello Plastic Surgery).

The Septoplasty Procedure

Pre - operative Evaluation

Before recommending septoplasty, a surgeon will perform a thorough physical examination of the nose, which may include nasal endoscopy. In certain cases, a CT scan of the nose and sinuses may also be recommended. This helps in accurately diagnosing the deviation and any associated structural problems. For example, if there are signs of chronic sinus conditions, the surgeon can plan to combine sinus drainage procedures with septoplasty (Facedoctornyc). Surgeons may also take into account the patient's medical history, any allergies, and previous surgeries.

Anesthesia

Most septoplasty surgeries are performed under general anesthesia, ensuring that the patient is completely comfortable and pain - free during the procedure. However, in some cases where the patient has no other health concerns, a local anesthetic with sedation can be used. General anesthesia is the preferred mode for many surgeons as it allows for better control during the operation and reduces the patient's anxiety (Facedoctornyc; Doctoralizadeh).

Surgical Techniques

• Closed Technique: Many septoplasty procedures are performed using a closed or endonasal approach. This means that the surgeon makes an incision inside the nose, usually on the lower portion of the septum (the caudal septum). They then work through the nostrils to access the bone and cartilage targeted in the procedure. This approach is scarless and can often lead to less downtime and a quicker recovery (Pearlman Aesthetic Surgery).
• Open Technique: In some cases, especially for more complex deviations or when combined with other procedures like rhinoplasty, an open technique may be used. This involves making an external incision, usually across the columella (the tissue between the nostrils). This allows for better visualization of the nasal structures but may result in a longer recovery period and a small scar (although efforts are made to minimize its visibility) (NYCFaceDoc).
• Endoscopic Technique: Endoscopic septoplasty is a minimally invasive approach where the surgeon uses an endoscope (a thin, flexible tube with a light and camera) to guide the surgery. This technique provides a clear view of the nasal cavity and can be used to perform precise corrections. It may result in less tissue damage and a shorter recovery time compared to traditional methods (NYULangone Health).

Regardless of the technique used, the general steps in a septoplasty procedure include exposing the bony and cartilaginous portions of the septum by elevating the mucosal lining that covers them. The surgeon then frees the cartilage portion of the septum from its attachments to the bone. Next, they remove and/or reposition any cartilage or bone that is causing obstruction or narrowing of the airway. Finally, the remaining portion of the bone and cartilage is realigned to provide structural support within the nasal cavity. Once the septum has been straightened, the surgeon may temporarily stabilize it with a splint, small plastic tubes, or internal sutures (Cangello Plastic Surgery).

Types of Surgeries Related to Septum and Nasal Function

Septorhinoplasty

Septorhinoplasty is a comprehensive surgical procedure that combines the goals of both rhinoplasty and septoplasty. It is designed to address both the aesthetic appearance and functional issues of the nose. Rhinoplasty focuses on altering the shape, size, and proportions of the nose to achieve a more harmonious and balanced facial appearance. It can involve refining the nasal tip, reducing a dorsal hump, narrowing the nasal bridge, or correcting asymmetries. Septoplasty, on the other hand, corrects a deviated septum to improve nasal airflow. During a septorhinoplasty, the surgeon first corrects the deviated septum by making an incision inside the nose to access the septum, then removing or repositioning the deviated parts of cartilage and bone. After that, they proceed with the rhinoplasty portion, which may involve reshaping the nasal bones, refining the tip, or altering the size and shape of the nostrils. Cartilage grafts may be used to support and shape the nose. This dual - purpose surgery is ideal for patients who want to improve both the look and function of their nose (NYCFaceDoc).

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 allows them to remove portions of the underlying bone structure without disturbing the outer layer of tissue, which is important for keeping the nasal passages hydrated. Surgeons may use a laser or a small device called a microdebrider to reduce the size of turbinates (NYULangone Health).

Turbinate Outfracture

Turbinates are curly bones in the nose that help channel the air we breathe and also play a role in warming and humidifying the air. In addition to a submucosal resection or laser procedure, surgeons may perform a turbinate outfracture. This involves permanently repositioning the turbinates to provide more space in the nasal passages. It typically involves breaking the thin bones of the turbinates in order to reposition them (NYULangone Health).

Recovery from Septoplasty

Immediate Post - operative Period

After septoplasty, patients can expect some swelling, bruising, and discomfort in the first few days. Cold compresses and prescribed medications can help manage these symptoms. It is important to keep the head elevated and avoid strenuous activities to minimize swelling and promote healing. Nasal drainage of blood and mucous is also common. Some surgeons may place nasal packing to support the newly shaped septum, which is usually removed within a few days. Patients may feel groggy from the anesthesia, and they should arrange for someone to accompany them home (NYCFaceDoc; Doctoralizadeh).

Short - term Recovery

Swelling and congestion inside the nose usually last between two and three days, and drainage may continue for up to five days. While over - the - counter (OTC) medications usually suffice, the surgeon may prescribe a pain reliever for the first day following surgery, as well as a saline spray or irrigation treatment several times a day for the week following surgery to clear any nasal congestion. Most patients can return to work within a week, but the exact recovery time depends on the extent of the correction performed during the operation. For example, if the deviation was severe and more extensive surgery was required, the recovery may take longer (Cangello Plastic Surgery; Doctoralizadeh).

Long - term Recovery

The final results of septoplasty will gradually become apparent over several months as swelling continues to subside. Most patients experience a significant improvement in their ability to breathe once the initial swelling goes down. In some cases, the sense of smell may also be restored or improved. Full recovery generally takes one to two months, during which time patients should avoid strenuous exercise and contact sports. The incision usually heals so that it is barely visible, if at all, especially when viewed from below the nose (Cangello Plastic Surgery; Pearlman Aesthetic Surgery).

Benefits of Septoplasty

• Improved Breathing: Correcting a deviated septum can significantly improve airflow through the nasal passages, allowing patients to breathe more easily. This can have a positive impact on overall health, as better oxygen intake can improve sleep quality, energy levels, and reduce the risk of snoring and sleep apnea (Cangello Plastic Surgery; Doctoralizadeh).
• Reduced Sinus Problems: A deviated septum can contribute to chronic sinusitis by blocking the normal drainage of the sinuses. By straightening the septum, septoplasty can help alleviate sinus issues and reduce the frequency of sinus infections (Doctoralizadeh).
• Improved Quality of Life: With better breathing and fewer sinus problems, patients often experience an improved quality of life. They may sleep better, have more energy during the day, and be able to participate in physical activities without the hindrance of nasal congestion (Pearlman Aesthetic Surgery).
• Cosmetic Benefits: In some cases, septoplasty can also improve the appearance of the nose, especially if the deviation has caused an external nasal deformity. When combined with rhinoplasty, it can achieve a more balanced and attractive facial profile (NYCFaceDoc).

Risks and Complications of Septoplasty

Although septoplasty is a common and generally safe surgical procedure, there are some risks and potential complications:

• Bleeding: Bleeding is one of the most common risks associated with nasal surgeries. While mild bleeding is expected in the first few days post - surgery, excessive bleeding can occur during or after the procedure. Surgeons may use nasal packing or cauterization to control bleeding. Patients are advised to avoid blood - thinning medications and supplements before surgery to reduce this risk (NYCFaceDoc).
• Infection: Although infections are rare due to the use of sterile techniques and prophylactic antibiotics, they can still occur. Signs of infection include increased redness, swelling, warmth, pain, and discharge from the surgical site. Infections are typically treated with antibiotics, but severe cases may require drainage or additional surgical intervention (NYCFaceDoc).
• Septal Perforation: A septal perforation is a hole in the nasal septum that can develop if the septum is damaged during surgery. This can cause symptoms such as whistling sounds during breathing, crusting, nosebleeds, and difficulty breathing. Small perforations may be managed with ointments or saline sprays, but larger perforations may require surgical repair (NYCFaceDoc).
• Breathing Difficulties: While septoplasty aims to improve breathing, complications such as swelling, scarring, or insufficient correction can occasionally lead to persistent or worsened breathing issues. These issues may resolve as swelling decreases, but in some cases, additional surgeries or procedures may be needed to correct the problem (NYCFaceDoc).
• Changes in Nasal Sensation: Temporary or permanent changes in nasal sensation, such as numbness, tingling, or altered sensitivity, can occur due to nerve damage during surgery. This is usually temporary but can persist in some cases. Most changes in sensation resolve over time as nerves regenerate, but persistent issues may require further evaluation (NYCFaceDoc).
• Cosmetic Dissatisfaction: Despite careful planning and execution, some patients may be unhappy with the cosmetic results of their surgery. This could be due to unmet expectations, asymmetry, or changes in nasal shape or size that do not align with the patient's aesthetic goals. Communication with the surgeon before surgery is essential to set realistic expectations. In cases of dissatisfaction, revision surgery may be considered after the initial healing period (NYCFaceDoc).

The Significance of the New Ranking in Membranous Septum Resection in New York City

Helping Patients Make Informed Decisions

The new ranking can provide patients with valuable information when choosing a surgeon for their membranous septum resection or related septoplasty procedures. With the large number of doctors performing nasal septum surgeries in New York City (as many as 970 according to Healthgrades), it can be overwhelming for patients to select the right one. The ranking can highlight surgeons with high patient ratings, extensive experience, and a good track record of successful surgeries. For example, some surgeons like Dr. Ashutosh Kacker and Dr. Mukesh Prasad have a rating of 4.90 out of 5 stars, which can give patients more confidence in their abilities (Healthgrades).

Promoting High - Quality Care

Surgeons are likely to strive for better performance and patient outcomes when there is a ranking system in place. This can lead to an overall improvement in the quality of membranous septum resection and related nasal surgeries in New York City. Surgeons may invest in advanced technologies, continuous training, and better patient care protocols to enhance their ranking and reputation. For instance, they may adopt the latest endoscopic techniques or improve their post - operative follow - up procedures to ensure better patient recovery (Personal analysis based on industry trends).

Choosing the Right Surgeon

Qualifications and Experience

When considering a surgeon for membranous septum resection or septoplasty, it is crucial to look at their qualifications. They should be board - certified in relevant fields such as otolaryngology (ear, nose, and throat) or facial plastic and reconstructive surgery. Experience is also key; surgeons with many years of performing these types of surgeries are more likely to have encountered a wide range of cases and be able to handle complex situations. For example, a surgeon who has performed hundreds of septoplasties is more likely to be familiar with different types of septal deviations and the best techniques to correct them (NYCFaceDoc; Pearlman Aesthetic Surgery).

Patient Reviews and Testimonials

Reading patient reviews and testimonials can provide valuable insights into a surgeon's bedside manner, communication skills, and the quality of their surgical outcomes. Patients often share their experiences, including their pre - operative consultations, the surgery itself, and their post - operative recovery. This can help potential patients get a sense of what to expect when working with a particular surgeon. Additionally, high patient satisfaction ratings, such as those found on health review websites, can be an indication of a surgeon's competence and ability to provide good care (Healthgrades).

Communication and Compatibility

Good communication between the patient and the surgeon is essential. The surgeon should take the time to understand the patient's concerns, goals, and medical history. They should be able to explain the surgical procedure, the expected outcomes, and the potential risks in a clear and understandable way. Patients should feel comfortable asking questions and discussing any doubts they may have. Compatibility between the patient and the surgeon can also contribute to a more positive surgical experience and better results (Pearlman Aesthetic Surgery).

Cost and Insurance Considerations

Cost of Septoplasty

The cost of septoplasty can vary depending on several factors. These include the extent of the correction required, the surgeon's fees, the location of the surgery (such as an operating room or an accredited ambulatory surgery center), and any additional procedures that may be performed simultaneously. On average, the cost of a septoplasty surgery is about $5,000, but it can be higher or lower depending on these variables. For example, if a patient requires a more complex septorhinoplasty that combines septoplasty with rhinoplasty,