Septoplasty for Children

Septoplasty is surgery to straighten and reposition the septum. The septum is the wall that divides the nose into two sides. It's made of soft cartilage and bone and is covered with a mucous membrane. A deviated septum is when the septum is not in the middle. This problem may be present at birth (congenital). Or it can happen from an injury.

The surgery is done entirely through the nostrils. During the surgery, the surgeon may cut, remove, or reshape part of the septum. Septoplasty may be done at the same time as other surgeries on the nose or sinuses. It's rarely done in children because the cartilage is still developing.

A deviated septum usually doesn't need treatment. When it does, the most common reason is a blockage in the nose. When one side of the nose is blocked, your child may have:

• Frequent sinus infections
• Bloody noses
• Pain in the face or headaches
• Noisy breathing while sleeping

A deviated septum may be present at birth (congenital). It can also be caused by an injury, trauma, or a broken nose.

The risks of septoplasty include:

• Infection
• Nosebleeds
• Bruising or swelling of the face
• Buildup of blood and swelling in the septum
• A hole in the septum
• Numbness of the teeth or nose
• Changes in smell, taste, or voice
• Leak of fluid that surrounds the brain and spinal cord
• Infection of the covering of the brain and spinal cord
• Reaction to the anesthesia

Your child's healthcare provider will send you to an ear, nose, and throat (ENT) specialist. The ENT will ask you about your child's health history and symptoms. The provider will check your child's ears, nose, and throat. Your child may have diagnostic tests, such as anterior rhinoscopy or fiberoptic endoscopy. Both of these tests use special instruments to check the nose and nasal septum using a narrow tube and a camera. 

Each surgery is different based on the child, the position of the septum, and other health concerns. The ENT will explain what to expect with your child's surgery. Make sure you talk with your child's ENT about:

• Any medicines that your child should not take before surgery, including over-the-counter medicines
• When your child should stop eating and drinking. For example, it is common not to eat or drink after midnight the night before surgery.
• When your child needs to arrive at the hospital or facility
• What to expect and how to care for your child after surgery
• When can your child get back to normal activities, including returning to daycare or school

If your child gets sick before surgery, call their ENT. Surgery may need to be rescheduled.

Your child will probably have the septoplasty as an outpatient. That means that they can go home the same day. The surgery usually takes about 1 to 1.5 hours and will go as follows:

• Your child will get sleep medicine (general anesthesia).
• The ENT will usually make a cut inside your child's nose. Some additional procedures need cuts outside of the nose.
• The ENT will use a tool with a light and tools on the end (endoscope).
• The ENT will cut through the mucous membrane and remove or reshape the septum.
• The ENT will make other repairs to the nose or sinuses, if needed.
• The ENT will stitch the cut closed. Gauze or cotton may be placed inside your child's nose.

After the surgery, you can expect the following:

• Your child will be watched in the PACU (postanesthesia care unit) while waking up from anesthesia. They will usually be able to go home in a few hours.
• Your child will likely have pain and be sleepy. The ENT and staff will give you directions about helping ease the pain.
• Your child will have a follow-up appointment with the ENT. Call the ENT if you have any questions or concerns before the follow-up appointment.

Make sure you follow all directions given to you by the ENT, hospital, or facility.

Before you agree to the test or procedure for your child make sure you know:

• The name of the test or procedure
• The reason your child is having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• When and where your child is to have the test or procedure
• Who will do the procedure and what that person’s qualifications are
• What would happen if your child did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how you will get the results
• Who to call after the test or procedure if you have questions or your child has problems
• How much you will have to pay for the test or procedure