Functional Procedures

Septoplasty

The nasal septum is the partition that divides one side of the nose from the other. It is rarely perfectly straight–it is slightly crooked in over 80% of people. When the septum is so crooked or deviated that it blocks the nasal passage, then a surgical operation called a septoplasty may restore clear breathing.

If your nose is congested on one side during part of the day and later congested on the other side, then it is not just the septum that is causing the nasal obstruction. In this instance, an abnormal turbinate–a structure that projects from the lateral wall of the nose into the nasal cavity–may be the cause. Usually medical treatment (such as a nasal steroid spray) is recommended before considering surgery. If the medical treatments fail to bring relief, then Dr. Beltran may also recommend a procedure known as a turbinate reduction. Turbinate reductions can be done in the office or in the operating room.

A septoplasty may be combined with a turbinate reduction so a normal nasal airway can be restored.

It is important that the turbinate not be removed completely because its removal will result in a very dry, crusty nose that is unable to adequately humidify and warm the air. This condition is called "Empty Nose Syndrome". Occasionally, turbinate tissue will re-grow after turbinate surgery and the procedure may need to be repeated. This is preferable to the situation of totally removing the turbinate.

If your doctor recommends a septoplasty, then this must be done in an operating room. It may be done under general or local anesthesia with sedation. Whether you choose general or local anesthesia, the recuperative period is similar, and patients go home within 1 – 2 hours after the operation is completed. A variety of nasal dressings are applied in the nose along the septum. Dr. Beltran prefers to pack the nose with gauze or special sponge-like material.

Because the septal cartilage has 'memory'–it has an intrinsic tendency to assume its initial shape–the septal cartilage can sometimes bend after the surgery and cause nasal obstruction. In most cases there is no bruising or black eyes associated with just a septoplasty. If the outside of your nose is crooked, then occasionally this must be fixed along with the septum in order to re-establish a patient’s airway. This procedure is called a septorhinoplasty. In these situations you are much more likely to have bruising and swelling of the nose and possibly black eyes. This bruising usually resolves within two weeks.

Endoscopic Sinus Surgery

Endoscopic sinus surgery - also called endoscopy or sinoscopy - is a procedure used to remove blockages in the sinuses (the spaces filled with air in some of the bones of the skull). These blockages cause sinusitis; a condition in which the sinuses swell, accumulate fluid, become clogged, causing pain and impaired breathing.

A thin, lighted instrument called an endoscope is inserted into the nose, and the doctor looks inside through an eyepiece. Much like a telescope with a wide-angle camera lens, the endoscope beams light into different parts of the nose and sinuses, allowing the doctor to see what is causing blockages. Surgical instruments can then be used along with the endoscope to remove the blockages and infected fluids to improve breathing.

This surgery does not involve cutting through the skin, as it is performed entirely through the nostrils, intra-nasally. Therefore, most people can go home the same day.

Endoscopic sinus surgery is a relatively new procedure designed to increase the amount of air flowing through the sinuses and allow mucus to drain properly out of the nose. The procedure can relieve nasal blockages, relieve facial pain, improve breathing and improve the sense of smell and taste.

Endoscopic sinus surgery is an effective procedure to correct Sinusitis, deviated septum, Polyps, a noncancerous water-filled swelling, tumors, a swelling caused by an uncontrolled growth of cells.

However, it seems to be less effective for those with post-nasal drip or allergies that are caused by airborne particles which cannot be avoided, such as dust and ragweed.