Deviated septum and "Gogol's nose"

An elegant and slim lady with a Gogolian nose just entered in the medical cabinet. In her eyes we can read she would do anythind to change this profile.

"It is not a problem anymore because people look at my nose ( she laughs) but the major problem is that I cannot find a more stylish job - all hopes dissapear when my nose appears."

This case is not an unique case. Doesn't matter if the owner of a Gogol's nose is a woman or a man, her/his life is influenced by the hunched appearance of the nose. This situation cannot be hidden under a coat, cosmetic, or by practicing sport. It is interesting to know that in muslim countries, rhinoplasty is the most used aesthetic surgery for women. It is absolutely obvious that the nose is one of the central parts of the physiognomy. If it is changed, this thing can change the social life of an individual. Most of the times, the "hooked"nose is associated with deviated septum.

The best result is reached if the plastic surgeon will work with a otorhinolaryngology surgeon or if she/he has the abilities and the necessary equipment for the surgery of the nasal septum. A good looking and functional nose can be obtained only if a complex surgery of septorhinoplasty

What is a nasal deviated septum ?

It is a condition characterized by difficulty in nasal breathing. It is due to position modification of the nasal septum, congenital or posttraumatic with obstructive effect in the way of airflow inspiring / expiratory inside the nose. Often obstructive factor may be compounded by the presence of associated diseases (chronic rhinitis, sinusitis, otitis, allergy, polyposis) that turns the principle operative indication in an imperious one.

When should nasal septum deviation be operated ?

In case of a permanent nasal obstruction, irreducible. In case of complications neighborhood: otitis, sinusitis. When nasal obstruction is involved in the mechanism of snoring (with suffocation while sleeping)

What should I know about this surgery ?

Operation consists in removing or reshaping portions of diverted osteocartilaginous skeleton until the calibration of a sufficient respiratory aisle and a good evacuation for the nasal secretions.

It is totally made inside the nose, no scars remain and the external shape of nose is not changed post surgery.

Laser is useless, and sometimes even dangerous because of the risk of synechia with obstructive effect. In endonasal surgery,laser is usually used only for treatment of hypertrophic rhinitis, a completely different disease.

What steps are followed ?

Before surgery - you should consult your doctor if you:

Are allergic to algocalmin, antibiotics or any other drug;
Perform various treatments (pills, antidiabetic, antihypertensive, etc.)
Current physiological status (for women) menstrual-cycle, pregnancy.

Blood analysis you need before surgery: hemolucogram, ESR, coagulogram, blood glucose, liver transaminases, bilirubin, creatinine, urea, uric acid. Before blood tests( in that morning) you should not eat and not drink.

If you will be operated with general anesthesia: heart-lung X-ray, EKG, Anesthesiologycal consultation.

Surgery:

before surgery you should not eat, not drink anything, you should not smoke
it lasts approx. 60-90 minutes
it surgically removes portions of the septum with obstructive effect, then in the two nasal passages are placed special haemostatic swabs;
anesthesia:
involves a preanesthesia having the role of sedation (a intramuscular injection in buttock);
It may be:
<lilocal-you are aware during surgery, but there are no pains !>
total (general) - by oro-tracheal intubation - you will be asleep for the whole operation and you will be woke up at the end.

Dupa operatie:(veti sta in pat, cu capul usor ridicat deasupra nivelului patului);

After surgery: (you will stay in bed, with head slightly elevated above the bed level);

for 24-48 hours you will have two hemostatic nose pads, and you will breathe through your mouth and please don't talk too much;
you can go to the toilet;
diet-only if you have no restrictions on Dexamethasone treatment ( salt)
minimum duration of hospitalization is 24-48 hours (how long you use nose swabs)
rarely it can happen to spill blood swallowed during surgery (dark blood), particularly in total anesthesia;
swabs will be removed after 24-48 hours, after a light anesthesia and the process is painless
you may not blow your nose 3-4 days, you put drops in the nose (Bixtonim) -3-4 bit. 3-4 times / day, oily vitamin A and saline to soften the scabs that normally form in the nose postsurgery;
after 2 days when you may blow your nose, after local cleaning, you will use a cream with healing effect (Bepanthene)
antibiotics treatment, orally or by injection, lasts 5 days

At discharge:

you can leave the hospital after minimum 24 hours;
avoid physical effort, hot baths, respiratory infections,
diet should not contain hot, spicy, irritating food, carbonated beverages, acid juices (citrus), etc.
rest in the house 7 days;
for detaching the intranasal crusts that form in the wound it is necessary to clean the nose as often as possible, and soak them with the cream and serum
respect the postoperative controls;
healing occurs on average after 10-14 days
if bleeding appears it is advisable to attend hospital!