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Nasal Airway Surgery

By

Sarah Lewis, PharmD

What is nasal airway surgery?

Nasal airway surgery is the surgical repair of abnormal structures in the nasal cavity. Your nasal cavity is a tunnel that extends from your nostrils to the top of your throat. It is made up of various bones, soft tissue, and cartilage. Nasal airway surgery can help restore airflow and full function of a damaged or diseased nasal cavity.

Nasal airway surgery is a common but major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your treatment choices before having nasal airway surgery. 

Types of nasal airway surgery

The types of nasal airway surgery procedures include:

  • Ethmoidectomy removes part of the ethmoid bone. Your ethmoid bone is located at the top of your nasal cavity and makes up the ethmoid sinus. Ethmoidectomy can improve nasal drainage into your throat.

  • Polypectomy removes polyps in the nasal cavity. Polyps are noncancerous swellings in the nose that can block airflow.

  • Septoplasty corrects a deviated nasal septum or other septal deformity that can obstruct airflow through the nose and cause difficulty breathing. Your nasal septum divides your nasal cavity into left and right sides and ends at your nostrils. 

  • Tumor removal is the surgical excision of a tumor from your nasal cavity.

  • Turbinate surgery reduces the size of your nasal turbinates, which can cause obstruction and difficulty breathing through the nose. Your nasal turbinates are located on the outer side walls of your nasal cavity. They project out into your nasal cavity and are responsible for conditioning and filtering the air that moves through your nasal cavity.

Other procedures that may be performed

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Your doctor may perform other procedures in addition nasal airway surgery. These include:

  • Rhinoplasty is the repair or reshaping of the nose. It is often called a “nose job.”

  • Sinus surgery is the widening of the sinus passages to allow for proper drainage to the nose.

Why is nasal airway surgery performed? 

Your doctor may recommend nasal airway surgery to treat a damaged or diseased nasal cavity. Damaged or diseased structures in the nasal cavity can block the flow of air through your nose. Nasal airway obstruction can lead to chronic mouth breathing, sleep apnea, chronic headaches, and recurrent nasal infections.

Your doctor may only consider nasal airway surgery for you if other treatment options with less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on nasal airway surgery.

Your doctor may recommend nasal airway surgery for: 

  • Enlarged nasal turbinates that extend too far into your nasal cavity, blocking efficient airflow

  • Nasal airway obstruction from polyps or an abnormal ethmoid bone

  • Nasal polyps or tumors that block efficient airflow

  • Deviated septum or nasal septal deformity that is making it difficult to breathe through your nose

  • Septal spur headaches caused by a sharp projection of the septum from a nose injury

  • Uncontrollable nosebleeds, often from septal deformities

Who performs nasal airway surgery?

The following specialists perform nasal airway surgery:

  • Otolaryngologists (ENTs) specialize in the treatment of diseases and conditions of the ears, nose and throat. 

  • Head and neck plastic surgeons specialize in correcting physical defects within the head and neck that can affect a person's appearance and ability to function.

  • Plastic surgeons specialize in correcting physical defects that affect a person's appearance or ability to function. 

  • Pediatric otolaryngologists (pediatric ENTs) specialize in the treatment of diseases and conditions of the ears, nose and throat in infants, children and adolescents.

How is nasal airway surgery performed?

Your nasal airway surgery will be performed in a hospital or outpatient surgery setting. 

Surgical approaches to nasal airway surgery

Your doctor will perform nasal airway surgery using one of the following approaches:

  • Minimally invasive endoscopic surgery involves inserting special instruments and an endoscope through your nose. An endoscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your nose to a video screen viewed by your doctor while performing surgery. Endoscopic surgery generally involves a faster recovery and less pain and risk of complications than other types of surgery. This is because it requires no incision and causes less trauma to tissues and organs.

  • Open surgery involves making an incision inside or around the nose. An open surgery incision allows your doctor to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference.  Learn about the different procedures and ask why your doctor will use a particular type for you.
Types of anesthesia that may be used

Your surgeon will perform nasal airway surgery using either general anesthesia or regional anesthesia. 

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. 

  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.

What to expect the day of your nasal airway surgery

The day of your surgery, you can generally expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.

  • A surgical team member will start an IV.

  • The anesthesiologist or nurse anesthetist will start your anesthesia.

  • A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.

  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of nasal airway surgery? 

As with all surgeries, nasal airway surgery involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

Potential complications of nasal airway surgery

Complications of nasal airway surgery include:

  • Continued headaches

  • Damage to your eye, eye socket, or related structures

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