This document describes the submucous resection of the nasal septum procedure. It outlines the indications, contraindications, anesthesia used, positioning of the patient, steps of the operation including infiltration, incision, elevation of flaps, incision and removal of cartilage and bone, stitching, packing, and post-operative care. Potential complications are also listed. The submucous resection of the nasal septum is a procedure used to correct a deviated nasal septum causing nasal obstruction by elevating mucoperichondrial flaps and removing excess cartilage and bone.
13. 5.ELEVATION OF OPPOSITE
MUCOPERICHONDRIUM AND
PERIOSTEUM
With the elevator passed through cartilage incision
Mucoperichondrium and periosteal flap is raised from opposite side of the
septum
14. 6.REMOVAL OF CARTILAGE AND
BONE
Now cartilage and bone are removed between two flaps
Cartilage can be removed with Ballenger swivel knife
Bone with Luc’s foreceps
Bony spur or rigde can be removed with gouge and hammer
15. 7.STITCHING
One or two catgut or silk stitches are applied in the initial
mucoperichondrial inscision
16. 8.PACKING
Ribbon gauze, smeared with furacin ointment or liquid paraffin is packed in
each nasal cavity to prevent collection of blood between two flaps
17. POST-OPERATIVE CARE
Patient is placed in semi sitting position to prevent oozing blood
A soft diet should be taken to minimize active mastication that cause
bleeding
18. Analgesic should be taken to treat pain
Antibiotics should be taken for 5-6 days
19. Nasal packs should remove gently
Decongestant nasal drops and steam inhalations are given daily for 5-6
days
20. Silk stitch should remove on 5 or 6th day
Patient should avoid trauma to the nose for several days
21. COMPLICATIONS
Bleeding
Septal heamatoma
Septal abcess
Perforation
Depression of bridge (due to too much removal of cartilage)
Persistence of deviation
Flapping of nasal septum
Toxic shock syndrome