30620 Septal or other intranasal dermatoplasty (does not include obtaining graft)

Name of the Procedure:

Septal or other intranasal dermatoplasty

Common Name:

Intranasal reconstruction, Nasal mucosal repair

Summary:

Septal or other intranasal dermatoplasty is a surgical procedure aimed at repairing or reconstructing the mucosal lining within the nose. This does not include the act of obtaining grafts but rather focuses on reshaping or restoring the intranasal tissues.

Purpose:

This procedure addresses nasal dysfunctions or deformities that affect breathing or nasal structure. Goals include restoring proper nasal function, alleviating symptoms like nasal obstruction, and enhancing structural integrity.

Indications:

• Chronic nasal obstruction not responding to medical treatment
• Nasal deformities or irregularities due to trauma, previous surgery, or congenital issues
• Recurrent nasal infections or mucosal lesions
• Septal perforations

Preparation:

• Pre-procedure fasting for at least 6-8 hours if sedation is used
• Adjustments to medications as per doctor's advice (e.g., anticoagulants)
• Diagnostic tests: nasal endoscopy, CT scan of sinuses, blood tests

Procedure Description:

1. The patient is administered local or general anesthesia based on the complexity of the procedure.
2. An intranasal incision is made to access the nasal structures.
3. Mucosal tissues are carefully reshaped, repaired, or repositioned to restore proper nasal function.
4. Sutures may be used to secure the tissues in place.
5. Nasal packing or splints may be applied to support the newly repaired areas.

Duration:

Typically, 1 to 3 hours depending on the extent of the repair required.

Setting:

The procedure is usually performed in a hospital's operating room or an outpatient surgical center.

Personnel:

• ENT surgeon (Ear, Nose, and Throat specialist)
• Surgical nurses
• Anesthesiologist

Risks and Complications:

• Bleeding
• Infection
• Nasal obstruction or persistent symptoms
• Septal perforation
• Adverse reactions to anesthesia
• Scarring or adhesions within the nasal cavity

Benefits:

• Improved nasal breathing
• Reduction in nasal obstruction symptoms
• Enhanced nasal structure and function
• Relief from recurrent nasal infections

Recovery:

• Post-procedure care includes nasal saline irrigation and possible antibiotic or pain medication.
• Avoiding strenuous activities and nose blowing for a specific period.
• Follow-up appointments for suture removal and assessment.
• Expected recovery time varies but is typically 1-2 weeks for initial recovery, with full recovery over a few months.

Alternatives:

• Medical management with nasal sprays or medication
• Balloon sinuplasty for specific conditions
• Conservative watchful waiting
• Each alternative carries different benefits and limitations based on individual patient conditions.

Patient Experience:

During the procedure, the patient may experience minor discomfort if under local anesthesia. Postoperatively, there may be some pain or a sensation of nasal congestion, which can be managed with prescribed medications. Proper care and follow-up ensure a comfortable recovery process.