Vincent Cumberworth BSc FRCS Consultant Ear, Nose and Throat Surgeon

Clementine Churchill Hospital Sudbury Hill Harrow Middlesex HA1 3RX
Private Secretary: Tel: 020 8872 3866 Fax: 0208872 3861

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Septoplasty and turbinate surgery

Deviation of the cartilage and bone in the septum, which divides the nasal airway into two channels, can cause obstruction and may occur after previous injury. The very thin bony plates may have been fractured at the time of the injury and also it is possible for the cartilage to eventually grow sideways due to damage to the covering layer of mucoperichondrium, which provides nutrition to the cartilage.

The turbinates are a series of structures on the lateral, sidewall, of the nose which normally warm, moisten and anti-humidify the air but may become larger than usual. They consist of fleshy erectile tissue on small scroll bones (conchae) which can swell with either allergic or “vasomotor rhinitis” and block the nose. Sometimes they are large (hypertrophic) anyway, producing obstruction.

A septoplasty is an operation to straighten the nasal septum and this is done by an incision on the inside of the nose under general anaesthesia. The dissection enables the cartilage to be straightened, just removing small portions of the most deviated parts of cartilage and bone. It is closed with dissolving sutures and packs need to remain in the nose for a short time post-operatively, sometimes overnight.

The turbinates may be reduced in size by various procedures including fracturing them outwards, reducing them submucosally and also trimming them. Cautery and diathermy procedures can also be used to reduce their size to attempt to improve nasal airflow. Occasionally this may also be done for excessive rhinorrhoea (watery running of the nose). Similarly dressings may be required as above either for a few hours or overnight. These will completely block your nose (which will be apparent as soon as you wake up) and may cause a little watering of your eyes whilst they are in place.

The dressings are a little uncomfortable at removal; after this immediately the nasal airway should be better but very soon afterwards it may become blocked again due to some swelling of the interior of the nose. Generally it can take up to 6 weeks to gain the full benefit of the operation in terms of airway improvement. The tenderness and discomfort of the nose after the surgery varies considerably, depending on the extent of dissection required, but is usually controllable by simple analgesics.


It is possible to get bleeding, even with the dressings in the nose, which can sometimes mean repacking or a return to theatre prior to discharge home. It is also possible to get bleeding 7 – 10 days after the operation which can mean reattending the hospital or the Casualty department. The nose is also quite wet and oozy anyway after such procedures, but this usually improves after a few days.

With a septoplasty procedure there is a very small risk of a slight change in shape of the nose, although this is unlikely unless very extensive surgery is required.

It is occasionally possible to get anosmia, a loss of sense of smell, after the operation but this usually settles.

Also occasionally, when the bony deviation is most pronounced and the small dissection along the floor of the nose, it is possible to get a slight numbness affecting the upper two incisor teeth but this also generally settles.

Occasionally the improvement in airway may not be as great as expected and, in the case of turbinate surgery may not be a permanent cure if the underlying allergy is persisting. It may also be necessary to use further drops and sprays post-operatively to augment the benefit from the operation.

Very rarely it is possible that the septum will healed leaving a small perforation or hole in the middle of the nose internally. This is not visible externally and often produces no problems but sometimes can produce a little crusting. Also very rarely an infection or abscess can form which can cause further loss of the septal cartilage: this can result in a depression in the shape of the nose which may require future corrections by a small graft of cartilage.

After discharge take at least one week off work and attempt to rest indoors for at least the first 3 to 5 days. Avoid touching the nose, smoky atmospheres and exposure to people with colds. Try to sneeze with your mouth open!


© Vincent Cumberworth 2005