Nasal Surgery
If you have nasal congestion for any reason and you either snore or have obstructive sleep apnea, then optimizing your nasal breathing surgically is an option once you fail medical therapy. There are many reasons for nasal congestion, including but not limited to: deviated nasal septum, enlarged turbinates, allergic rhinitis, nasal polyps, chronic sinusitis, and nasal valve collapse. One must remember that obstructive sleep apnea or upper airway resistance syndrome can also aggravate nasal congestion (see article on UARS).
Studies have shown that for people with obstructive sleep apnea and nasal congestion due to a structural nasal problem, by correcting the obstruction surgically only “cured” obstructive sleep apnea in about 10-15% of patients.
The most common procedure for nasal congestion is septoplasty. Another common condition that is frequently overlooked is nasal valve collapse.
Septoplasty is a procedure of the nasal septum to alleviate nasal congestion, if medical therapy does not help. Many people have deviated nasal septums, even with no history of trauma in the past. The septum is the midline plate of mostly cartilage and some bone that separates your right and left nasal cavities. What actually aggravates subjective congestion are swollen turbinates, which are wong-like structures that normally smooth, warm, and humidify air as one breathes. However, with colds, allergies or obstructive sleep apnea (and upper airway resistance syndrome), any degree of swelling on top of a crooked nasal septum will block your nose.
This is an ambulatory procedure which takes less than one hour, and you can go home the same day. You will not have black or blue marks on your face. I do not use nasal packing, so you will be able to breathe just after the operation (with gradual congestion due to crusting which is taken care of in the office 2-3 days later). Many of my patients do not need to take any pain medications, and if they do, they’ll start with Tylenol, and rarely will need Tylenol with codeine.
In addition to the septoplasty, a minor procedure is typically performed on the turbinates as well to shrink the tissues.
Although some patients improve from their sleep apnea or snoring standpoint (only 10-15%), patients are counseled that the main purpose of any kind of nasal surgery is to breathe better in general. For some obstructive sleep apnea patients, breathing better through the nose allows them to use a CPAP machine more effectively.
Steven Y. Park, M.D.
Otolaryngology – Head & Neck Surgery
(212) 315-9058
