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Medical Forum / Diseases and Disorders / Sinusitis / July 2005

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Septoplasty/Rhinoplasty

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Sydney Ann - 25 Jul 2005 20:01 GMT
I am about to have a combined septoplasty/Rhinoplasty surgery in about
4 weeks.  I've read through some of the post, but am primarily
concerned now with all that I should do to prepare.  I've put the
surgery off for years because I'm chicken.  But I've had so many sinus
infections and breathing problems.  My doc said I'm over 90% blocked on
my right side as well as about 40% blocked on my left.  At this point
I'm scared to take anything.  I have been taking melatonin and valerian
each night for sleep.  I also have major sleep problems...mostly due to
the breathing issue.  So any help or pointers anyone can provide would
be appreciated.
Steven L. - 25 Jul 2005 22:20 GMT
> I am about to have a combined septoplasty/Rhinoplasty surgery in about
> 4 weeks.  I've read through some of the post, but am primarily
> concerned now with all that I should do to prepare.  

Hasn't your surgeon discussed post-operative care with you?  My ENT gave
me written instructions as to what I should do, which included the need
to make some follow-up appointments with him.  These instructions
included an oral antibiotic I was to take starting the day after the
surgery.  My ENT also gave me a prescription for a painkiller I could
take, in case the post-operative discomfort was too great.

These instructions said that I might have some bloody post-operative
drainage for a week or so, but not how I was to deal with that.  I
learned the hard way to wear old clothes I didn't care about staining.
Your surgeon's nurse should show you how to affix a so-called "moustache
bandage" between your upper lip and your nose, to absorb some of the
bloody secretions for the first few days.  You might want to stock up on
surgical adhesive tape and gauze, because that's how "moustache
bandages" are made.

Good luck!  Hope it all goes well for you!

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Don Brady - 25 Jul 2005 23:07 GMT
>I am about to have a combined septoplasty/Rhinoplasty surgery in about
>4 weeks.  I've read through some of the post, but am primarily
>concerned now with all that I should do to prepare.

It's nothing to worry about really.
If you have not had one recently, get a general health checkup from your Family
Doctor or Internist including EKG and clotting time and bring it with you and
give it to them on admission.  Also bring along the CT scans if they do  not
have them already.
Do not eat or drink after midnight on the day before.
Be as well rested as possible.

> I've put the
>surgery off for years because I'm chicken.  But I've had so many sinus
[quoted text clipped - 4 lines]
>the breathing issue.  So any help or pointers anyone can provide would
>be appreciated.
MS - 29 Jul 2005 16:35 GMT
Rhinoplasty is cosmetic surgery, no--a "nose job"? I don't see how that
would help your sinus infections. No sinus surgery involved?

As far as septoplasty, I would recommend against it except for people whose
septum is extremely deformed, which is thought to be the main cause of one's
nasal-sinus problems.

I make that recommendation based on my experience--when I had one of my
sinus and turbinate surgeries done, the ENT also did septoplasty from my
mildly deviated septum. In that surgery my septum developed a hole in it, a
perforation.

In another sinus surgery (with a different surgeon) the following year, the
doc tried to patch the perforation, but that didn't work, and now the hole
is larger than ever. (In one sense better large than small. When I first had
the perforation, it was smaller, and made a very annoying whistling sound
with my breathing.) I've been told the perforation contributes to my severe
rhinitis, crusting, etc.

I believe that is always a risk with a septoplasty. Therefore, unless your
septum is extremely deviated, and the docs (get more than one opinion) are
certain that straightening the septum would make a large difference in your
symptoms, I'd recommend against it. (Not just--"while we are working on your
sinuses and/or turbinates we might as well straighten your septum as well".
I wouldn't suggest going along with that.)

> I am about to have a combined septoplasty/Rhinoplasty surgery in about
> 4 weeks.  I've read through some of the post, but am primarily
[quoted text clipped - 6 lines]
> the breathing issue.  So any help or pointers anyone can provide would
> be appreciated.
Murray Grossan - 29 Jul 2005 19:50 GMT
On 7/29/05 8:35 AM, in article 1122651394.448087@news-1.nethere.net, "MS"
<ms@nospam.com> wrote:

> Rhinoplasty is cosmetic surgery, no--a "nose job"? I don't see how that
> would help your sinus infections. No sinus surgery involved?
[quoted text clipped - 32 lines]
>> the breathing issue.  So any help or pointers anyone can provide would
>> be appreciated.

There is simply no easy answer re whether a deviated septum needs corrective
surgery.
I have done septal surgery where other docs said not needed with good
results
I have done surgery where in my judgement I thought it would help and have
been wrong.
You will definitely get a varying opinion. Not that one doctor is poor and
the other is good. Its simply that one uses the best tools available
especially experience to make the decision. More important is understanding
the patient's needs.
If the patient would benefit by septal surgery and you don't perform the
surgery you do save the expense of the surgery but you allow that patient to
have symptoms that could have been avoided.

If I had recommended surgery to Mr X five years ago, I might have saved him
several bad infections. I made the wrong decision - not to operate.
How to get the RIGHT decision? Make sure the doctor understands your needs
and history. Two persons with the same deviation, one gets sinus with every
cold , the other is sick about every 4 years.
 
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