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Deviated Septum
May 2001

Q. I had surgery for a deviated septum on December 6, 2000. I was told I had bone spurs and other blockages, and I believe there was also work done on the turbinates. Before surgery I had almost 3 years of chronic congestion on the left side of my nose, sinus infections, and allergies. However, at this point, 5 weeks post-op, I have some concerns that my ENT does not seem to be addressing...

First, I don't feel any better. To my shock, the septum appears to be deviated the other way! The turbinates on the right side are also still quite inflamed. There is barely any air getting through on the right side, and even the left side, although better, is certainly not clear. About 3 weeks after surgery I came down with a horrible sinus infection and took antibiotics. But over the past few days I have begun to have a yellow discharge from my nose again, which in my history has signified the potential beginning of a sinus infection. I'm concerned that the septum will stay bent over enough to cause congestion. And I'm afraid if it doesn't move, then I will go right back to getting chronic infections.

Secondly, I looked in my nose with a small flashlight in the dark to see what it looked like. I realize this isn't the most efficient method, but I could actually see the septum and the turbinate, and they were almost touching on the right side. There was a tiny slit, barely wide enough to let any air through. This doesn't make sense to me. I thought the idea of this surgery was to make the septum straight up and down. I had the packing removed the day after surgery and had the splints removed 10 days after.

In your experience, is this normal? Will the septum now stay deviated to the right, or is there a chance that it will move back? What is the average healing time? (I was told it was 4-6 weeks.) My ENT doesn't seem to be able to give me a straight answer. He's already talking about a turbinate reduction procedure and medications, and that makes me believe that I've had this surgery for nothing. I've taken tons of medication before surgery, including allergy shots for 18 months, none of which worked. Any answers you could give me would be helpful and appreciated. Thank you.

A. Some of the problems you describe could still be due to inflamed tissue following the surgery itself, so it is probably too early to know the effectiveness of the procedure you had done. Several conditions can contribute to the chronic nasal congestion you have had. Causes include anatomic blockage (deviated septum, bone abnormalities, soft tissue swelling in the adenoids, nasal polyps) and situations in which the anatomy is fine but there is physiologic swelling of the tissues (allergies, sinus infection, side effects from medication, overuse of nasal sprays). Several factors may pertain to an individual with a chronic problem as you describe. All relevant factors need treatment for the problem to clear up, so often more than one doctor is involved in the evaluation including your family physician, an ear, nose, and throat specialist (otolaryngologist), and an allergist. Definitely let the doctors know if matters are not clearing, and even consider getting another specialty consultation.

WEBSITE REFERENCES:
http://www.entnet.org/patient.html
http://www.aaaai.org/public/default.stm
BOOK: The Sinus Sourcebook

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