How to Approach Nasal Septal Deviations

Gordon H. Sun, MD, MS

December 21, 2015

General Considerations

Nasal obstruction is a very common symptom, and a deviated nasal septum is considered the most common cause of nasal obstruction.[1] The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) reported that approximately 80% of all nasal septa are deviated.[2]

In general, patients who do not have symptoms related to an identified septal deviation do not need septoplasty; candidacy for septoplasty is based on both symptoms and physical examination.[3] An estimated one fourth of patients with nasal obstruction ultimately pursue surgical treatment.[4] In the United States, more than 340,000 septoplasties and turbinate surgeries are performed in ambulatory surgical centers, based on data from the 2006 National Survey of Ambulatory Surgery.[5] In this particular study, no cases of cardiac arrest, malignant hyperthermia, or blood transfusion were reported, and only 0.1% of all patients with septoplasties made postoperative visits to the emergency department.

For patients who decide to undergo septoplasty, historically the procedure has been done under general anesthesia. However, several reports indicate that septoplasty can be done safely under local anesthesia with sedation, contributing to decreased operative and recovery times, decreased postoperative pain and epistaxis, and lower cost in many instances.[1,3,6,7,8,9]

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