Septoplasty and Turbinate Surgery

• If the patient is on any blood-thinning medications such as aspirin, ibuprofen, omega 3 and/or vitamin E, they should stop their intake at least a week before the surgery. If prescription blood thinners are required for another medical condition, please get the surgeon to provide guidance on stopping and re-starting them.
• Till the preceding night of the surgery, duly take all medications prescribed by the ENT surgeon. Bring along any medicines, that are being taken currently, both prescribed and non-prescribed, in original packaging while checking in for surgery the next morning. 
• Get a good night’s sleep. Have a good dinner but do not eat anything at all from midnight onwards prior to the surgery day.
• Make sure to bring the hospital file at the time of the check-in for surgery duly including all required test reports such as the major surgical profile, pre- anaesthetic check-up sheet, radiological investigation films and reports (X-ray, CT scan, MRI, PET scan etc.) and any others investigations advised by the ENT surgeon. Ge the file ready a day before the surgery.
• The patient should be accompanied by an attendant. It is advised to bring along a close family member.
• Please make sure to report at the hospital at least three hours prior to the surgery’s scheduled timing.
• Report at the reception desk in time and the hospital staff will guide through the next steps.
• If there is any change in physical condition such as cough, cold, fever or throat pain, be sure to mention it to the doctor and anaesthetist. 
• If allergic to any drugs, be very sure to mention that as well.

• In the first 24 hours take complete bed rest in the post-operation ward.
• Food or drink is not allowed for 4-5 hours after surgery. After that water is allowed. Caffeinated beverages such as tea, coffee or aerated drinks are to be avoided. Semi-solid diet in moderate quantities is allowed after 12 hours and normal food from second day onwards.
• The nose will be packed after the surgery for 1-2 days and the patient will have to breathe through the mouth. Before discharge though, the hospital staff will remove this packing. Patient will be discharged either on the same day or the next day of the surgery
• On the 10th day from the date of the surgery, you will receive an endoscopic nose cleaning in the Minor Procedure Room. 
• Be sure to take all medications on schedule as prescribed by the surgeon.
• Please ensure to spray, the prescribed nasal sprays (5-6 times daily in each nostril) towards the side wall and not the centre of the nose always. Till 2 weeks after the surgery, it is normal to have a ‘stuffy’ feeling in the nose that comes from the swelling caused by the surgery. Pease do not, blow your nose, breathe back forcefully or probe the inside of your nose with finger, as that may cause bleeding.
• Till 2 weeks after the surgery, your nose will secrete blood-stained watery fluid. This is expected and simply needs to be gently wiped using a soft, clean cloth or tissue.
• Stay away from places with dust, smoke, or anything that can cause an allergic reaction to induce excessive sneezing or watering of nose and eyes.
• Abstain from cold foods such as ice creams and cold drinks or any other foods that can cause an allergic reaction to induce excessive sneezing or watering of nose and eyes.
• If a sneeze comes, please open your mouth and sneeze out to protect the nose.
• While regular body bath is allowed post the day of discharge, wait till the doctor gives clearance to have a head bath.
• Protect your nose from pressure by abstaining from heavy lifting, straining, or undertaking any vigorous work for at least 3 weeks after the surgery. Also stay away from contact sports and any activity that can injure the nose.
• Never bend the head below the heart level.
• One can resume office work a week after the surgery. However, if work requires strenuous activity, it is advised not resuming it till two weeks after the surgery.

The patient will need to come for reviews twice – 10 days after endoscopic nose cleaning for the first review and 10 days after that for the second review. If there is any problem in-between or after the reviews, please schedule a visit to the OPD of the hospital.

• As with any other surgical procedure, septal and turbinate procedures too come with a few associated risks, though its rare. One should understand the potential risks and clarify their concerns from the surgeon well in advance.

  • Bleeding: Some degree of bleeding is expected in nasal surgeries. Very rarely, significant bleeding may require termination of the procedure. Blood transfusion in a nasal surgery is rare and is strictly an emergency measure.
  • Persistent symptoms: Some patients may get limited or nominal relief after the surgery. In a rare case, the obstruction symptoms may even worsen.
  • Infection:  As the nose is not a sterile environment free of microbes, post-surgery infection can attack but only in rare cases.
  • Toxic shock syndrome: In rarest of rare cases (just 1 in every 100000 septology procedures), a very serious infection called “Toxic Shock Syndrome” can also strike. This is a life-threatening situation that needs immediate treatment. If one notes a change in  blood pressure, heart rate, fever and unusual symptoms of skin discoloration, they should contact the surgeon immediately.
  • Tooth and nose numbness: As the nerves going to upper jaw gums and front teeth pass through the nose, septal surgery can stretch/ injure these to cause numbness of the incisors of the upper jaw and/ or the nose tip. In most instances, the numbness is temporary. This is mostly a temporary phenomenon that resolves itself in anywhere from a few days to weeks to months. In rare cases, this numbness can persist.
  • Septal perforation: A septal perforation (hole in the nasal septum) can develop during or after surgery, especially in case of an infection. At times, this hole can cause crusting and obstruction. If the perforation does not cause any bleeding or crusting, no further action is needed. If perforation leads to these symptoms, a surgical closure or placement of a synthetic septal button is advised.
  • Spinal fluid leak: As the top of the nasal septum is located below the skull, a leak of cerebrospinal fluid or a brain injury can occur and create a potential pathway for infection such as meningitis requiring additional surgery and hospitalization. It is an extremely rare risk that seldom occurs after septology.
  • Other risks: Other rarely witnessed septology risks include changes in ability to smell or taste, persistent / worsening of facial pain, change in voice quality, and swelling or bruising of the area around the eye. There is also a very small risk that your nose may look slightly different after a septoplasty.