“Why Did I Wait So Long?”
We always hear that from patients who delayed having surgery to improve their breathing.
Those patients with blocked noses or a nose that is not attractive typically started out early in life with that problem. It is not a matter of aging.
Patients with deviated septums, uncorrected nasal fractures and enlarged turbinates due to allergies, typically are plagued with these conditions for many, many years before they start to do something. For some, the nasal blockage pre-disposes them to sinus infections.
Frankly, some of our brethren in other medical specialties do not recognize the architectural problem soon enough. A good family practitioner or internist should be able to evaluate the inside of the nose to see if, in fact, there is a deviated septum and/or enlarged turbinates or crookedness of the entire nose which could be contributing to the blockage causing the misery that follows a cold or allergy attack.
It is not normal to not be able to breathe. Period.
Our happiest patients are patients where we correct the deviated septum, trim the turbinates and also do rhinoplasty to improve their appearance because in one two-hour session, they have not bettered their quality of life for the rest of their life. It is so great to do teenagers with these problems because they will not be plagued being self-conscious about their appearance or suffer from blocked noses for another 60, 70 or 80 years.
Recently one of our patients came and uttered that often-heard remark, “Why did I wait so long?” Well one reason was he really was afraid to have it done because he was concerned about what he heard from other people who have had the operation. There is a little bit of “bad press” going on out there, not because of the operation itself nor the results. It is because the pos-toperative period has been uniformly unpopular since the surgeons have had to put packing of some form inside the nose. Unless some provision is made for providing an airway through the nose, packing equals total nasal blockage. Not fun for the patient.
Packing is placed by surgeons performing rhinoplasty, correction of deviated septum, turbinate surgery and sinus surgery because it is important to help control bleeding following the operation. Also, today’s packings which may be cotton-like, gauze-like or even a thick liquid gel, have antibiotics and even other ingredients such as bioengineered healing factors which hasten the healing and reduce the chance of infection.
So the packing, of whatever substance or material, is important. But the patient’s misery of having a blocked nose for up to five days has long been underestimated by head and neck surgeons, ear, nose and throat surgeons, facial plastic surgeons and plastic surgeons.
One patient likened it to having “to walk around with a clothespin on my nose for five days.” Another claimed, “I felt I was drowning.” Patients get anxious, somewhat depressed and complain about the dry mouth and soreness of the throat.
I have been involved personally in trying to better that situation for over three years. Working at my “work bench,” I developed a soft plastic airway tube that the surgeon seats onto the floor of the nose and allows the patient to breathe very well after surgery despite the remaining nasal cavity being packed with the usual packing devices or materials.
We have had over 93 patients in our clinical research study undergo the routine surgeries and yet have the benefit of the nasal airway in place. It wins high grades with 95% of the patients endorsing it.
We always try to do better. Science never sleeps. Progress goes on and our aim is to have patients more satisfied, more comfortable under the safest of surgical circumstances.