Submucosal Resection of the Nose for Treatment of Deviated Septum

Submucosal resection (SMR) of the nose is a surgical procedure used to treat a deviated septum. This procedure is also called a septoplasty.

According to some sources, septoplasty differs from submucosal resection in that during an SMR large portions of tissue are removed while a septoplasty is a "tissue sparing" procedure. However, both surgeries are used to correct a deviated septum and are quite similar.

Issues Associated With a Deviated Septum

The septum is the wall made of mostly of cartilage and some bone that divides the nose in half. Approximately 80 percent of people have a septum that is not exactly centered but this isn't usually a problem. A deviated septum can cause problems with breathing through the nose or cause problems with the way the sinuses drain.

A deviated septum can also lead to other problems such as frequent nosebleeds, frequent sinus infections, facial pain, or postnasal drip. Symptoms may get worse if you have a cold. Many individuals are born with a deviated septum but this condition can also be caused by trauma to the face. Septal deviation actually may start out as a mild condition that gets worse with time.

Indications for Submucosal Resection

Submucosal resection is not always used to treat a deviated septum but may be used if you are having chronic sinus infections that have not responded to other treatments. It is sometimes used if you have a septal deviation that is causing chronic nosebleeds, or if the deviation is causing difficulty breathing.

A submucosal resection of the nose may also be done if you are having nasal sinus surgery and your deviated septum is making it difficult for your doctor to access other parts of your nose or sinuses. Sometimes a submucosal resection is done as part of a cleft palate repair.

The Procedure

A submucosal resection of the nose can usually be performed on a same-day surgery basis. It can be done using a local or general anesthetic. The surgery itself is on average an hour to an hour and a half long. During the surgery, some portions of the septum may be either entirely removed or just readjusted.

This procedure is not usually performed on individuals under the age of 18 since the septum is still growing. The procedure is performed entirely through the nostrils and does not change the external appearance of the nose (you look the same after surgery as you did before with no visible incision or bruising).

Risks

Risks of a submucosal resection of the nose may include, bleeding, infection, and complications from anesthesia. You may have some bleeding from the nose for about 24 hours after surgery. You may also have a stuffy nose for a few days after this surgery due to swelling. A cool-mist humidifier may be helpful for this and prevent crusting around the nostrils. Some doctors use packing to control bleeding and to hold the septum in place but this has not been proven effective.