When is a septoplasty required?

Question

Hello doctor,

I was advised for septoplasty. I have a very minor breathing issue, and my nose is never blocked due to working out. However, the doctor recommends surgery based on the CT scan. I want to get a second opinion before going forward with it. Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

Most people have some degree of septal deviation and only those who have symptoms like nasal blockage, recurrent headache, or sinusitis. The deviation may need surgical correction. If you do not have symptoms then no septoplasty is needed. The CT scan shows (attachment removed to protect the patient's identity) you do not have much septal deviation but there is bilateral hypertrophy of the inferior turbinate and prominent septal tubercle. There is concha bullosa but it is not obstructing the sinus ostium so no intervention is needed. I suggest that your condition is manageable with medications. Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Yes, hypertrophied turbinate and prominent septal tubercles can be reduced with nasal and systemic decongestants, but sometimes medical therapy may not give optimum results. That time the inferior turbinate can be reduced with interventions like cryotherapy, laser, diathermy, or co-ablation. But I do not think you require septoplasty. The concha bullosa cannot be reduced by any medical means, it needs surgery to correct it but only if it's causing symptoms like a blockage in the sinus drainage pathway. As I can see in the CT scans (attachment removed to protect the patient's identity) your sinuses are pretty clear, so it is evident that the concha bullosa is not causing any problem. Tinnitus can happen due to nasal blockage if it is causing a compromise in eustachian tube function with consequent tympanic membrane retraction. For that, you need to get impedance audiometry done. Thank you.