Submucosal Resection of the Nasal Septum 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 SMR in that during an SMR, large portions of tissue are removed while a septoplasty is a "tissue sparing" procedure. Most ENT surgeons use these 2 names interchangeably. however, as the surgery is used to correct a deviated septum.

A surgeon at work in hospital
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Issues Associated With a Deviated Septum

The septum is the wall that divides the nose in half. It is composed primarily of cartilage and some bone. 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 may cause problems with the way the sinuses drain.

A deviated septum can also lead to other problems, such as frequent nosebleeds, frequent sinus infections, or facial pain. 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 facial trauma. Septal deviation actually may start out mild and can progress with time.

Indications for Submucosal Resection

SMR is not always necessary for treating a deviated septum. But you and your healthcare provider may consider this option if you are having chronic sinus infections that have not responded to other treatments.

It may also be considered if you have a septal deviation that is causing chronic nosebleeds, or if the deviation is causing difficulty breathing.

This procedure may also be done if you are having nasal sinus surgery and your deviated septum is making it difficult for your healthcare provider to access other parts of your nose or sinuses. Sometimes SMR is done as part of a cleft palate repair.

The Procedure

SMR of the nose is usually performed as same-day surgery. It can be done using a local or general anesthetic. The procedure lasts for an average of an hour to an hour and a half.

During the surgery, some portions of the septum may be either entirely removed or readjusted.

SMR is performed entirely through the nostrils and does not change the external appearance of the nose—you will look the same after surgery as you did before, with no visible incision or scar.

This procedure is not usually performed on individuals under the age of 18 since the septum is still growing.


Risks of SMR of the nose may include bleeding, infection, septal perforation (hole), saddle nose deformity (if too much septum is removed), 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 can be helpful and may prevent crusting around the nostrils.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Deviated septum. Harvard Health Publishing.

  2. Teixeira J, Certal V, Chang ET, Camacho M. Nasal Septal Deviations: A Systematic Review of Classification SystemsPlast Surg Int. 2016;2016:7089123. doi:10.1155/2016/7089123

  3. Deviated septum. [internet].

  4. Fettman N, Sanford T, Sindwani R. Surgical management of the deviated septum: techniques in septoplasty. Otolaryngol Clin North Am. 2009;42(2):241-52, viii. doi:10.1016/j.otc.2009.01.005

  5. Chand G, Shafiq M, Khan A. The comparative study of submucosal resection of nasal septum under local and general anaesthesia. J Pak Med Assoc; 62(10):1020-2.

  6. Deviated nasal septum. Texas Sinus Institute [internet].

  7. Low WK, Willatt DJ. Submucous resection for deviated nasal septum: a critical appraisal. Singapore Med J; 33(6):617-9.

Additional Reading

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.