Our Summary

This study examines the rates of repeat nose surgery in children compared to adults. This surgery, known as septoplasty, is performed to correct a deviated septum - a condition where the thin wall between your nostrils isn’t straight. The data used in the study came from the IBM MarketScan Commercial Database, which contains information on patients covered by employer-sponsored health insurance from 2007 to 2016.

The study found that children are more likely to need a second surgery than adults. Among the 24,322 children who had a septoplasty, 2.9% needed a second operation. This compares to just 1.1% of adults. The study also found that children are more likely to have a rhinoplasty (a cosmetic surgery on the nose) as their second surgery.

Children aged 9 to 13 had the highest rates of second surgery. Also, those living in the West and Northeast, and those with certain types of health insurance plans, were more likely to need a second operation.

The study concludes that more research is needed to understand why children are more likely to need a second surgery. These findings could help doctors make better decisions about when and how to perform this type of surgery in children.

FAQs

  1. What is a septoplasty and why is it performed?
  2. According to the study, who are more likely to need a second septoplasty - children or adults?
  3. What did the study find about the age group and regions where second surgeries were more likely?

Doctor’s Tip

One helpful tip a doctor might tell a patient about septoplasty is to follow post-operative care instructions carefully to reduce the risk of needing a second surgery. This may include avoiding strenuous activities, avoiding blowing your nose forcefully, and keeping the nasal passages moist with saline spray. Additionally, attending follow-up appointments with your doctor is crucial to monitor healing and address any concerns promptly.

Suitable For

Patients who are typically recommended septoplasty include those with a deviated septum that is causing symptoms such as difficulty breathing through the nose, chronic nasal congestion, frequent nosebleeds, recurrent sinus infections, or snoring/sleep apnea. Septoplasty may also be recommended for patients who have experienced trauma to the nose or have a nasal deformity that is affecting their quality of life. Additionally, patients who have tried conservative treatments such as nasal sprays or allergy medications without success may be candidates for septoplasty.

Timeline

Timeline of patient experiences before and after septoplasty:

Before septoplasty:

  1. Patient experiences symptoms such as difficulty breathing through the nose, frequent nosebleeds, nasal congestion, and sinus infections.
  2. Patient consults with an ENT specialist who evaluates their symptoms and recommends septoplasty as a treatment option.
  3. Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for surgery.
  4. Patient schedules the septoplasty procedure and prepares for the surgery by following pre-operative instructions provided by the surgeon.

After septoplasty:

  1. Patient undergoes the septoplasty surgery, which typically takes 1-2 hours and is performed under general anesthesia.
  2. Patient wakes up in the recovery room and may experience some pain, swelling, and congestion in the nose.
  3. Patient is discharged home the same day or the following day with post-operative instructions on pain management, wound care, and activity restrictions.
  4. Patient follows up with the surgeon for post-operative appointments to monitor healing progress and address any concerns.
  5. Patient gradually resumes normal activities and may experience improvements in breathing and nasal function over the following weeks to months.
  6. In some cases, patient may require a second surgery, especially in children, due to persistent symptoms or complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about septoplasty include:

  1. What are the potential risks and complications associated with septoplasty?
  2. What is the success rate of septoplasty in correcting a deviated septum?
  3. How long is the recovery period after septoplasty?
  4. Will I need to take time off work or school after the surgery?
  5. What type of anesthesia will be used during the procedure?
  6. How soon after the surgery will I be able to resume normal activities?
  7. Are there any restrictions on physical activities or nose blowing after the surgery?
  8. What can I expect in terms of pain and discomfort after the surgery?
  9. What follow-up care will be needed after the surgery?
  10. What are the chances of needing a second surgery in the future, and what factors could increase this likelihood?

It’s important for patients to have a thorough understanding of the procedure and its potential outcomes before undergoing septoplasty.

Reference

Authors: Shah JP, Youn GM, Wei EX, Kandathil C, Most SP. Journal: JAMA Otolaryngol Head Neck Surg. 2022 Nov 1;148(11):1044-1050. doi: 10.1001/jamaoto.2022.3041. PMID: 36201221