Our Summary

This research paper discusses an unusual case where a 20-year-old woman developed a hole (fistula) in the soft part of her palate (roof of the mouth) after undergoing a nose surgery (septoplasty). This is rare, especially in patients with normal palates, and it led to the woman experiencing leakage of liquid from her mouth. Before the surgery, a CT scan had shown a slight depression at the junction of the hard and soft palate. A surgery was carried out to repair the fistula using a flap of tissue from the palate itself. After the surgery, the hole was completely closed and the woman no longer had any symptoms. The paper also reviews other reported cases of this rare occurrence after nose surgery.

FAQs

  1. What is the unusual complication discussed in the research paper following a septoplasty?
  2. How was the fistula in the woman’s palate repaired after it developed post-septoplasty?
  3. What symptoms did the woman experience due to the fistula in her palate after her nose surgery?

Doctor’s Tip

One helpful tip a doctor may tell a patient about septoplasty is to follow all post-operative care instructions carefully to reduce the risk of complications such as fistula formation. This may include avoiding certain activities that could put pressure on the surgical site, keeping the area clean and dry, and attending all follow-up appointments to monitor healing progress. It is also important to report any unusual symptoms or changes in the surgical site to your doctor promptly.

Suitable For

Patients who are typically recommended for septoplasty are those who have a deviated septum, which is a condition where the thin wall (nasal septum) between the nasal passages is displaced to one side. This can lead to difficulty breathing, snoring, frequent sinus infections, and nosebleeds. Septoplasty is often recommended for patients who have tried other treatments such as nasal decongestants, nasal steroids, or allergy medications without success.

Other patients who may benefit from septoplasty include those who have nasal valve collapse, which occurs when the nasal passages are narrow and obstruct airflow, causing difficulty breathing through the nose. Patients with nasal polyps, which are growths in the nasal passages that can block airflow, may also benefit from septoplasty.

Overall, septoplasty is recommended for patients who have persistent nasal obstruction and difficulty breathing through the nose, and who have not responded to other treatments. It is important for patients to consult with an otolaryngologist (ear, nose, and throat specialist) to determine if septoplasty is the right treatment option for their specific condition.

Timeline

Before septoplasty:

  1. Patient experiences symptoms such as nasal congestion, difficulty breathing through the nose, frequent nosebleeds, and facial pain or pressure.
  2. Patient consults with an otolaryngologist (ENT specialist) who recommends septoplasty to correct a deviated septum.
  3. Patient undergoes pre-operative evaluations, including physical examination, nasal endoscopy, and possibly imaging studies like CT scans or MRI.
  4. Surgical date is scheduled and patient receives pre-operative instructions, including fasting guidelines and medication adjustments.
  5. On the day of surgery, patient is admitted to the hospital or surgical center and undergoes general anesthesia for the procedure.

After septoplasty:

  1. Patient wakes up from anesthesia in the recovery room and is monitored for any immediate complications.
  2. Patient may experience pain, congestion, and swelling in the nose and face in the immediate post-operative period.
  3. Patient is discharged from the hospital or surgical center on the same day or the following day, with instructions for post-operative care and follow-up appointments.
  4. Patient is advised to rest and avoid strenuous activities for a few days, as well as to follow a prescribed medication regimen for pain management and to prevent infection.
  5. Over the following weeks, patient undergoes follow-up visits with the surgeon to monitor healing, remove any nasal packing or splints, and address any concerns or complications.
  6. Patient gradually experiences improvement in nasal breathing, with reduced congestion and better airflow through the nose.
  7. Patient may also undergo nasal saline irrigation or other nasal care techniques to promote healing and prevent complications like infection or bleeding.
  8. In the case of the woman with a palatal fistula, surgical repair may be performed to close the hole and restore normal function of the palate.
  9. Ultimately, the patient should experience improved nasal function and quality of life after septoplasty, with resolution of symptoms related to the deviated septum.

What to Ask Your Doctor

  1. What is septoplasty and why do I need it?

  2. What are the potential risks and complications associated with septoplasty?

  3. How long is the recovery period after septoplasty?

  4. Will I experience any pain or discomfort after the surgery?

  5. What is the success rate of septoplasty in improving nasal breathing?

  6. Are there any alternative treatments to septoplasty that I should consider?

  7. How many septoplasty procedures have you performed in the past?

  8. Will I need to follow any specific post-operative care instructions?

  9. Are there any lifestyle changes I should make before or after the surgery?

  10. What should I do if I experience any unusual symptoms or complications after the surgery?

Reference

Authors: Jeon JB, Jeon MC, Shin JH. Journal: J Craniofac Surg. 2021 Jul-Aug 01;32(5):1775-1776. doi: 10.1097/SCS.0000000000007415. PMID: 33427775