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Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft
CPT4 code
Name of the Procedure:
Septoplasty or Submucous Resection, with or without Cartilage Scoring, Contouring, or Replacement with Graft
Summary
Septoplasty is a surgical procedure to correct a deviated nasal septum, the wall between the two nostrils. Depending on the case, it might involve reshaping, repositioning, or replacing parts of the septal cartilage.
Purpose
- Addresses deviated septum, which can cause nasal congestion, difficulty breathing, and recurrent sinus infections.
- Aims to improve airflow, ease breathing, and enhance quality of life.
Indications
- Chronic nasal obstruction
- Recurrent nasal or sinus infections
- Nosebleeds (epistaxis)
- Breathing difficulties that affect sleep (e.g., snoring or sleep apnea)
- Headaches due to nasal obstruction
Preparation
- Fasting for several hours before the procedure (as per doctor's instructions)
- Avoiding certain medications (e.g., blood thinners) prior to surgery
- Preoperative assessments including nasal exams, imaging studies (like CT scans), and lab tests
Procedure Description
- Anesthesia: Typically general anesthesia or local anesthesia with sedation.
- Incision: A small incision is made inside one side of the nose.
- Resection/Reshaping: The mucous membrane is lifted, and the deviated septal cartilage/bone is corrected by trimming, repositioning, or removing obstructions.
- Grafting (if needed): Graft material may be used to replace or bolster cartilage.
- Closure: Mucous membrane is repositioned, and the incision is closed with sutures.
Duration
Approximately 30 to 90 minutes.
Setting
Hospital or outpatient surgical center.
Personnel
- Otolaryngologist (ENT surgeon)
- Anesthesiologist
- Surgical nurses and support staff
Risks and Complications
- Bleeding
- Infection
- Persistent septal deviation or obstruction
- Perforation of the septum
- Altered sense of smell
- Adverse reactions to anesthesia
Benefits
- Improved nasal airflow and breathing
- Reduced nasal congestion and sinus infections
- Enhancement in overall quality of life
- Benefits can often be realized within a few weeks post-surgery
Recovery
- Nasal splints or packing may be used to support the septum as it heals.
- Instructions to avoid blowing the nose, heavy lifting, or strenuous activities for several weeks.
- Use of saline sprays and prescribed medications to aid healing.
- Follow-up appointments for monitoring and suture removal (if applicable).
- Typical recovery time: 1-2 weeks for initial healing, with full recovery in 3-6 months.
Alternatives
- Non-surgical treatments such as nasal corticosteroids or decongestants.
- Continuous Positive Airway Pressure (CPAP) for sleep apnea.
- Pros: Non-invasive, avoids surgical risks.
- Cons: Often temporary relief, does not correct structural issues.
Patient Experience
- During: No sensation due to anesthesia.
- After: Mild to moderate discomfort, congestion, possible swelling, and nasal drainage.
- Pain management through prescribed medications and comfort measures.