Health Information

Diagnosis of A Deviated Septum

Patients with chronic sinusitis often have nasal congestion, and many have nasal septal deviations. However, for those with this debilitating condition, there may be additional reasons for the nasal airway obstruction. The problem may result from a septal deviation, reactive edema (swelling) from the infected areas, allergic problems, mucosal hypertrophy (increase in size), other anatomic abnormalities, or combinations thereof. A trained specialist in diagnosing and treating ear, nose, and throat disorders can determine the cause of your chronic sinusitis and nasal obstruction.

Your First Visit

.After discussing your symptoms, the primary care physician or specialist will inquire if you have ever incurred severe trauma to your nose and if you have had previous nasal surgery. Next, an examination of the general appearance of your nose will occur, including the position of your nasal septum. This will entail the use of a bright light and a nasal speculum (an instrument that gently spreads open your nostril) to inspect the inside surface of each nostril. Surgery may be the recommended treatment if the deviated septum is causing troublesome nosebleeds or recurrent sinus infections. Additional testing may be required in some circumstances.

Septoplasty

.Septoplasty is a surgical procedure performed entirely through the nostrils, accordingly, no bruising or external signs occur. The surgery might be combined with a rhinoplasty, in which case the external appearance of the nose is altered and swelling/bruising of the face is evident. Septoplasty may also be combined with sinus surgery.

The time required for the operation averages about one to one and a half hours, depending on the deviation. It can be done with a local or a general anesthetic, and is usually done on an outpatient basis. After the surgery, nasal packing is inserted to prevent excessive postoperative bleeding. During the surgery, badly deviated portions of the septum may be removed entirely, or they may be readjusted and reinserted into the nose. If a deviated nasal septum is the sole cause for your chronic sinusitis, relief from this severe disorder will be achieved.

Laser Assisted Uvula Palatoplasty (LAUP)

Some 45 percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight persons and it usually grows worse with age. Snoring sounds are caused by an obstruction to the free flow of air through the passages at the back of the mouth and nose. Only recently have the adverse medical effects of snoring and its association with Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS) been recognized. Various methods are used to alleviate snoring and/or OSA. They include behavior modification, sleep positioning, Continuous Positive Airway Pressure (CPAP), jaw adjustment techniques, Uvulopalatopharyngoplasty (UPPP), and Laser Assisted Uvula Palatoplasty (LAUP).

What Is Laser Assisted Uvula Palatoplasty (LAUP)?

LAUP allows treatment of snoring and mild OSA by removing the obstruction in your airway in an outpatient setting under local anesthesiA. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures. LAUP is performed while you are positioned in an upright sitting position in an examination chair.

Before administration of anesthesia, you are informed that the back of your throat will become numb and that you will lose the sensation of swallowing and breathing. A local anesthesia is sprayed over the back oral cavity, soft palate, tonsils, and uvula followed by an injection of additional anesthesia in the muscle layer of the uvulA. After several minutes, a CO2 laser is used to make both, vertical incisions in the palate on both sides of the uvulA. The uvula is shortened, eliminating the obstruction that has contributed to the snoring. LAUP requires up to five treatments spaced four to eight weeks apart (although one to three are usual).

How Long Will It Take To Recover From LAUP?

If you undergo the LAUP procedure you can expect to return to a normal routine almost immediately. For the majority of those undergoing this procedure there will be swallowing pain similar to a severe sore throat. This discomfort lasts for approximately ten days and can be relieved by oral analgesic and antiinflammatory medicines. Improvement is noted by the reduction in or disappearance of your snoring.

Should You Consider LAUP?

If your snoring is habitual and disruptive to others, you may be a prime candidate for LAUP. Your otolaryngologist will evaluate you and ask the following questions"

Do you snore loudly and disturb your family and friends?
Do you have daytime sleepiness?
Do you wake up frequently in the middle of the night?
Do you have frequent episodes of obstructed breathing during sleep?
Do you have morning headaches or tiredness?
Suitability for LAUP is determined after a review your health history, lifestyle factors (alcohol and tobacco intake as well as exercise), cardiovascular condition, and current medications in use. You will also receive a physical and otolaryngological (ear, nose, and throat) examination to evaluate the cause of the snoring.

Before the laser procedure is conducted, you will participate in a "sleep study," which will grade the level of actual snoring and sleep apnea. This will complete the evaluation necessary for prescribing the appropriate treatment for your needs.