septoplasty and turbinate surgery

per-turbed in san jose wrote:Sorry...my above post is for "Turb-Boston", not Rob.

Thanks for your reply, per-turbed in san jose . Just had the surgery yesterday. I arrived at the hospital at 8:00am and went under anesthesia at around 9:45am. I woke up at 11:45am (although my friends waiting outside told me the surgery only took about 45min). The doctor said I would expect much improvement of my breath since things seem clogged up in my nose. After waking up from general anesthesia, I felt mild nausea, but the breath seems better than before the surgery. The nurses gave me a shot to control the nausea and later I felt fine. I was discharged by the hospital at around 2pm. It's not very pain for me since after coming back home, I only took one extra strength Tylenol. I did have more bleeding than I expected yesterday (about 10 gauzes in total），but my surgeon didn't pack my nose. My spectrum is slightly deviated to right, I guess they cut more of my left turbinate and thatswhy I got more bleeding from left nostril. The bleeding stopped this morning. Last night, I didnt have much problem with sleeping,however, my nose was still congested.This morning, I have started using the 'Ocean spray'. I am wondering how long the swelling caused by surgery will gone and I can experience the normal breath again. Although my surgeon said I only need to stay at home for one more day before going back to school, I think I need more time to recover.

Isn't it amazing how many of us have had this surgery?

I had this surgery on 2/28/06. While the details are now somewhat hazy to me, the removal of the packing in my nose remains vivid. (I felt like the inside of my nose was on fire).

I recently started a cpap machine (on May 12th) and I'm reading everything on this board to fully educate myself. I am very thankful for everyone's contributions.

Hi,

I just had Septoplasty and turbinate reduction yesterday. With mild sedation, not general anesthesia. This is my second time having nasal surgery, my first time (1999) was septoplasty & rhinoplasty. My first time was extremely painful (your nose is broken basically).

After my first surgery, I continued having breathing problems, allergies and was diagnosed as having asthma. Aside from not being able to breathe one of my biggest complaints has always been the fact that I snore. I snore through my nose, very, very loudly, to the point where I can be heard on the first floor of my house! Many times, I wake myself up with my snoring. I am 142 pounds and 5'2", I'm not exactly overweight. I have gotten tired of waking up tired all the time, but I am also tired of not wanting to take vacations with other people to not have to explain why I don't want to share a room.

I recently moved and changed allergist, my new allergist suggested I see an ENT about my breathing issues. The ENT I am seeing now specializes in "Snoring" A quick CT scan later (my first ENT never had me take a CT SCAN!!!!) , revealed my nose was still blocked by my septum, and I have extremely enlarged turbinates he has seen. Yesterday he performed Septoplasty and Turbinate reduction. It was fairly quick and pretty much painless. It was performed in a hospital, I was sedated but not sleeping. I have gel in my nose and a gauze pad that I change as needed. Today is my day 2 and I will start rinsing with Nasal Spray (I am a coward, not sure how I will do that, lol)

I'm wondering for those on this board that had septoplasty and turbinate reduction, did your snoring stop after the surgery?

I am 9 days post surgery. I had a septoplasty and nasal polyps removed. I was completely out during the 2 hour surgery.
The first day I had lots of bleedindg. I was surprised that there was NO PAIN. The doctor used a gel so I could still breath from my nose. NO CPAP FOR 7 DAYS. After 5 days the doctor cleared some dried blood and mucus from the area. At that point I started using a sailine spray and Flonaise 2x day. Thank goodness I now have CPAP back!!!!

Hey Boston...hope you are doing well and starting to feel better. My surgeon told me that congestion after procedure with the microdebrider is about a week, which is less than with traditional submucosal reduction. I can tell you that for me, his statement was true. I didn't have much swelling and by the end of the first week, things were much better. You don't mention if you had anything else like septoplasty, which would give you more swelling, therefore, requiring more time for swelling to resolve. I only had the turbinate reduction. I will tell you that I continued to be tired for about two weeks post surgery. Don't know if that is typical or was just something that happened for me. I hope you are feeling better and breathing easier.

per-turbed in san jose wrote:Hey Boston...hope you are doing well and starting to feel better. My surgeon told me that congestion after

Hi, San jose, I am 3 days post op and back to work now. No bleeding and almost no pain right now. My procedure was just turbinate reduction (submucous resection) not including septplasty since my deviation of spectrum is not serious. Although my surgeon also used microdebrider, he did mentioned he would remove some of my bones in turbinate too (maybe I have large bones). I guess thats why I had more bleeding than you. My congestion problem is getting better. This morning is the first time in the past 3 months that I waked up with both my nostrils open. One of them always closed up in the past 3 months. My nose still feels tender and something dry and stuffy is there. But generally, The situation is improving. I will go back to see the surgeon next Tuesday and get more information about the recovery of this surgery. Hope normal breath will come back soon

The microdebrider has been the most common instrument used for submucosal inferior turbinoplasty for nearly ten years now. If your surgeon wants to use something else, I would get a second opinion from a surgeon who does all of this surgery with the microdebrider.

roster wrote:The microdebrider has been the most common instrument used for submucosal inferior turbinoplasty for nearly ten years now. If your surgeon wants to use something else, I would get a second opinion from a surgeon who does all of this surgery with the microdebrider.

Really, Rooster? I went to four surgeons, all from big name schools and only one, the person I had do my surgery, used a microdebrider. Everyone else uses a blade and the other three told me a microdebrider is not preferable because, in their opinions, too much tissue gets eaten up and with a blade, they can be more precise. I frankly didn't want the cut through my mucosa all along the bottom of my turbinate, so it is why I opted for the surgeon who used the microdebrider. I live in a place where technology is pretty state of the art (the surgeon who did my prior turbinate reduction using radiofrequency actually helped invent the procedure), as well as two of the leading medical universities in the country and submucosal turbinate reduction using a microdebrider is not the most common instrument used around here.

per-turbed in san jose wrote:

roster wrote:The microdebrider has been the most common instrument used for submucosal inferior turbinoplasty for nearly ten years now. If your surgeon wants to use something else, I would get a second opinion from a surgeon who does all of this surgery with the microdebrider.

Really, Rooster? I went to four surgeons, all from big name schools and only one, the person I had do my surgery, used a microdebrider. Everyone else uses a blade and the other three told me a microdebrider is not preferable because, in their opinions, too much tissue gets eaten up and with a blade, they can be more precise. I frankly didn't want the cut through my mucosa all along the bottom of my turbinate, so it is why I opted for the surgeon who used the microdebrider. I live in a place where technology is pretty state of the art (the surgeon who did my prior turbinate reduction using radiofrequency actually helped invent the procedure), as well as two of the leading medical universities in the country and submucosal turbinate reduction using a microdebrider is not the most common instrument used around here.

Hi
I am confused a bit on your comment. Doesn't the microdebrider cut through the mucosa to get to the bone? Are you saying that using blades will cut through more mucosa than the microdebrider?
Either way, it sounds like you had the microdebrider. How did it go for you?

per-turbed in san jose wrote:

roster wrote:The microdebrider has been the most common instrument used for submucosal inferior turbinoplasty for nearly ten years now. If your surgeon wants to use something else, I would get a second opinion from a surgeon who does all of this surgery with the microdebrider.

Really, Rooster? I went to four surgeons, all from big name schools and only one, the person I had do my surgery, used a microdebrider. Everyone else uses a blade and the other three told me a microdebrider is not preferable because, in their opinions, too much tissue gets eaten up and with a blade, they can be more precise. I frankly didn't want the cut through my mucosa all along the bottom of my turbinate, so it is why I opted for the surgeon who used the microdebrider. I live in a place where technology is pretty state of the art (the surgeon who did my prior turbinate reduction using radiofrequency actually helped invent the procedure), as well as two of the leading medical universities in the country and submucosal turbinate reduction using a microdebrider is not the most common instrument used around here.

per, I have no problem with your statement as I only had the one opinion from a doc that came highly recommended, had a wonderful bedside manner in the two initial consultations and did a great job on my surgery. He did say the microdebrider was most commonly used and he had been using it exclusive of blades for a number of years (this was in 2007) . So this was only one opinion and I may have received different opinions on instruments if I had checked around.

Now you have me curious as to what percent of these surgeries are done with blades vs. microdebrider vs. radio frequency vs. whatever else.

Here is part of my Operative/Procedure Report:

A 15 blade was used to make a stab incision in (the left anterior/inferior turbinate) and a small microdebrider was placed under endoscopic control into the submucosal area and was used to remove and submucosally resect the inferior turbinate tissue. Small amounts of bone were then removed with Takahashi forceps through the stab incision. Next, the Boies elevator was used to outfracture the remnant of the left inferior turbinate. This resulted in an excellent nasal airway on the left side. An identical procedure was performed ....

My favorite part:

Estimated blood loss was minimal. The patient tolerated the procedure well, was awakened and extubated in the operating room and sent to the recovery room in good condition without complication.

I had zero memory of awakening in the operating room. First memories were of my private angelic nurse in the recovery room.

Hi, everyone. I am one week post op now and today I saw my surgeon again for follow up. I am still mild congested and honestly far from what I expected for the final outcome. I feel even more tired than usual in the past 2 or 3 days. However, I believe the airway in my nose is wider than before the surgery (at least when I wake up in the morning, both of my nostrils were partially open rather than one completely closed up before surgery). My surgeon showed the picture of my turbinate before and after my surgery. It surprised me that how big was my turbinate before the surgery (almost hit my spectrum just as those ones in the youtube ). After checking my nose again, he told me in the following 2 or 3 weeks, I would expect 85% improvement I can get from the surgery. And there's no more follow up for me if I feel well enough after this period of time. I am wondering if this is the same situation for you guys that the first week was miserable and the significant improvement happened in the 2nd or 3rd even 4th week after the surgery?

turb, My guess is you are worrying too much. Concentrate on other things and trust that healing and major improvement will come in due time. You are past the tough part, now be patient until the good stuff kicks in.

Do you have sleep apnea?

roster wrote: Do you have sleep apnea?

Thanks Rooster. I guess I dont have sleep apnea (havent been examined for that yet) and I am 25 years old. It's true I might worrying too much. It's just because I was so congested before the surgery and looking forward to the help from this surgery.

Juan...yes, a cut is made through the mucosa to insert the microdebrider into the turbinate, but it's a small incision. When a blade is used, the turbinate is cut along the bottom, the "flap" is lifted up and the blade is used to remove submucosa. I guess like everything in life, each doctor has their preferences as to what works best. I did about 6 months of intense research on the procedure and it's why I sought out a surgeon who specifically used a microdebrider. Frankly, I think I did too much research for my own good. As far as the procedure itself, it worked great. I was about 80-90% blocked more than halfway down the turbinate. Because I was so blocked, I actually breathed better right after surgery, even with swelling, than I did prior to surgery. I was really nervous about getting the surgery, but very glad I did. Have you had turbinate reduction?

Rooster...I agree it would be interesting to know what percentage of surgeries are done with each procedure. I have a friend who had turbinate reduction about 4 years ago and it was actually done with electrocautery. Massive bleeding during the procedure and now has problems with dry nose, but it's not horrible. As I mentioned to Juan, I did about 6 months of intense research before surgery, too much for my own good mental health, really, but I know it helped me make the right decision on choosing my surgeon. Their are plenty of people who have had the surgery done with a blade and have had excellent results and no long term problems. I just didn't want to take the chance as I had already had a failed radiofrequency done and my options were running out in terms of how many more procedures I could have done.