Contraindication of septoplasty
Although septoplasty is a common surgical procedure, there is a few conditions where the septoplasty procedure may be contraindicated such as in cases of acute sinusitis or active nasal infection.
Some conditions that coexist with the deviated septum and worsens its symptoms as vasculitis, or rhinosinusitis may benefit from some medications like the decongestants to decrease the breathing difficulties without undergoing the surgical procedures as first line treatment.
Some drug use may compromise the septoplasty surgery like intranasal cocaine. Cocaine inhalation must be stopped one year before undergoing the surgery, as the intranasal cocaine has a severe vasoconstriction effect, and causes mucosal atrophy. These effects on the nose may increase the possibility of serious complications as:
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- Perforation of the nasal septum
- Delaying the healing process
- May results in some nasal deformity like saddle nose deformity
Vasoconstrictor sprays that can be used as OTC treatment of rhinitis or rhinosinusitis, and should be avoided for extended period before the septoplasty surgery.
Large septal perforation is one of the septoplasty contraindications as the complete closure, and the healing of the defect could not be achieved.
Patients diagnosed of lymphomas, because the local healing following the procedure would be delayed, and even impaired due to the effect of the tumor itself or from the effect of radiotherapy.
In some systemic diseases as Wegener granulomatosis, the aim of the treatment is to treat the nasal septal perforation, but the disease activity should be kept in total remission, because the disease activity may interfere with the healing of the wound. The size of the perforation is also a key as the perforation tends to be large in patients with Wegener granulomatosis, and the septoplasty surgery may fail in treating large septal perforations.
Other contraindications include uncontrolled systemic diseases as hypertension and diabetes mellitus.
