Septoplasty: Surgery for Nasal Obstruction and Related Concerns

Nasal septum deviation surgery

Hello Doctor: I have been suffering from nasal congestion for a long time, and it is not fixed to one side.
Recently, I visited an ENT department at a teaching hospital for an examination, and the doctor diagnosed me with allergic rhinitis, nasal polyps, and a deviated septum.
The doctor mentioned that the nasal polyps can be removed using laser treatment, while the deviated septum would require endoscopic surgery, which can be done under local anesthesia and takes about 30 minutes.
I have a few questions:
1.
I found two different names for the septal surgery online: Septomeatal plasty and Septal reconstruction/septoplasty.
What are the main differences between them? For example, what about the length of hospital stay, postoperative care, pain levels, and potential complications? I apologize for forgetting to ask my attending physician about the types of surgery.
The doctor also mentioned that I would need to stay in the hospital for two nights and that I could return to light physical work shortly after discharge.
Is it safe to resume work so soon?
2.
My nasal congestion sometimes affects one side, sometimes both, and it does not consistently affect the same side.
This variability makes me wonder if, in addition to the nasal polyps and deviated septum, there is a significant amount of mucus in my nasal cavity causing the congestion to shift.
I feel that since the nasal polyps and deviated septum are fixed conditions, the congestion should also be consistently on one side or both sides.
I am concerned that the primary cause of my nasal congestion may not be the deviated septum, and that the surgery may not significantly improve my symptoms.
3.
Recently, I tested positive for the Epstein-Barr virus (EBV) during a health check-up.
I also asked the doctor to examine my nasal cavity, and he found no abnormalities, advising me not to worry too much.
I would like to ask if EBV, like hepatitis B virus, can remain in the body for life? Or can it disappear when the immune system is strong and potentially re-emerge when the immune system is weak? Do I need to return to the ENT department regularly to check for any issues in my nasal cavity? Additionally, does a positive EBV result increase the risk of developing nasopharyngeal carcinoma? Thank you for your answers, Doctor.

xiao, 20~29 year old female. Ask Date: 2006/09/22

Dr. Ye Dawei reply Otolaryngology

1.
The main difference between Septomeatal plasty and Septoplasty is that Septomeatal plasty involves correction of the nasal septum along with resection of the inferior turbinate, while Septoplasty is solely focused on correcting the nasal septum.

2.
The length of hospital stay, postoperative care, pain levels, and potential complications are quite similar for both procedures.
3.
Is it okay to return to work immediately? Yes, it is generally acceptable.
4.
Is it possible to be a lifelong carrier? A positive reaction indicates elevated levels of EBV VCA IgG and IgA antibodies, which is unrelated to being a carrier.
5.
When the immune system is weak, could the virus invade? Yes, if IgA levels are above 1.0, then the possibility of nasopharyngeal carcinoma should be considered, regardless of immune strength.
6.
Should I regularly return to the ENT specialist to check for nasal issues? Yes, regular check-ups are necessary.
7.
Is the risk of developing nasopharyngeal carcinoma higher? Yes, if IgA levels are above 1.0, caution is advised.

Reply Date: 2006/09/22

More Info

Understanding Septoplasty: Surgery for Nasal Obstruction and Related Concerns
Septoplasty is a surgical procedure aimed at correcting a deviated septum, which can lead to nasal obstruction and various symptoms such as difficulty breathing, chronic sinusitis, and nasal congestion. In your case, it seems that you have been diagnosed with allergic rhinitis, nasal polyps, and a deviated septum, all of which can contribute to your nasal obstruction. Let's address your questions regarding the surgery and related concerns.

1. Difference Between Septomeatal Plasty and Septoplasty:
Septoplasty is a general term for the surgical correction of a deviated septum. It can involve various techniques, including septomeatal plasty, which specifically addresses the area where the septum meets the nasal passage (meatus). The choice of procedure often depends on the specific anatomical issues present. In terms of hospitalization, most septoplasty procedures are performed on an outpatient basis, meaning you may not need to stay overnight. However, if your surgeon anticipates complications or if you have other health concerns, they may recommend a short hospital stay. Post-operative care typically involves managing pain and preventing infection, and the pain level can vary from person to person. Some patients report mild discomfort, while others may experience more significant pain. The risk of complications, such as bleeding or infection, is generally low but should be discussed with your surgeon.

2. Understanding Your Nasal Congestion:
The fluctuating nature of your nasal congestion could indeed be influenced by the presence of mucus, in addition to the structural issues like nasal polyps and a deviated septum. Allergic rhinitis can cause inflammation and increased mucus production, leading to congestion that can switch sides. It's not uncommon for patients with these conditions to experience variable symptoms. After surgery, if the primary issues are addressed, you should see an improvement in your symptoms. However, if you continue to have nasal congestion, it may be worth investigating other potential causes, such as allergies or chronic sinusitis.

3. EB Virus Concerns:
The Epstein-Barr virus (EBV) is a common virus that can remain dormant in the body after initial infection. While it is not directly related to nasal issues, it can affect your immune system. Most people who contract EBV do not develop serious complications, but it can lead to conditions like infectious mononucleosis. EBV does not behave like hepatitis B, which can lead to chronic infection in some individuals. Instead, EBV typically remains latent in the body and can reactivate under certain conditions, particularly when the immune system is weakened. Regular check-ups with your ENT specialist can help monitor any changes in your nasal health, especially if you have concerns about nasal cancer. However, the presence of EBV alone does not significantly increase your risk of developing nasal cancer.

In conclusion, septoplasty can be an effective solution for your nasal obstruction, and understanding the nuances of the procedure can help alleviate your concerns. It is essential to maintain open communication with your healthcare provider, especially regarding post-operative symptoms and any new concerns that arise. If you have further questions or if your symptoms persist, do not hesitate to reach out to your ENT specialist for guidance and support. Your health and comfort are paramount, and addressing these issues proactively will contribute to your overall well-being.

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