Our Summary

This research paper discusses a rare but dangerous condition called negative-pressure pulmonary edema. This condition, which can cause breathing problems and even death, can happen after a type of nose surgery called a septoplasty. The main cause is a condition called laryngospasm, which can lead to low oxygen levels and coughing up blood. The case they studied involved a 36-year-old patient who had this nose surgery. Three hours after the breathing tube was removed, the patient had low blood pressure, a fast heart rate, and low oxygen levels. The doctors diagnosed the patient with negative-pressure pulmonary edema. They treated it with a special type of ventilation and water pills. The authors note that this condition can present differently in different people and it may not always be accompanied by laryngospasm.

FAQs

  1. What is negative-pressure pulmonary edema?
  2. What are the symptoms of negative-pressure pulmonary edema after septoplasty?
  3. How is negative-pressure pulmonary edema treated after septoplasty?

Doctor’s Tip

A doctor might advise a patient undergoing septoplasty to closely monitor their breathing and oxygen levels in the days following the procedure. If they experience sudden difficulty breathing, coughing up blood, or a rapid heart rate, they should seek immediate medical attention as these could be signs of negative-pressure pulmonary edema. It is important for patients to follow post-operative care instructions carefully and contact their healthcare provider if they have any concerns or unusual symptoms.

Suitable For

Patients who are typically recommended septoplasty include those with a deviated septum causing nasal obstruction, difficulty breathing through the nose, chronic sinus infections, frequent nosebleeds, and snoring or sleep apnea. Septoplasty is also recommended for patients who have experienced trauma to the nose resulting in a deviated septum.

Timeline

Before septoplasty:

  • Patient may have symptoms such as difficulty breathing, nasal congestion, frequent nosebleeds, and snoring.
  • Patient consults with an otolaryngologist for evaluation and diagnosis of a deviated septum.
  • Preoperative appointments and tests are scheduled, including a physical exam, imaging studies, and blood work.
  • Patient is advised to stop taking certain medications, avoid smoking, and follow preoperative instructions provided by the surgeon.

After septoplasty:

  • Surgery is performed under general anesthesia, typically lasting 1-2 hours.
  • Patient wakes up in the recovery room with nasal packing and splints in place to support the septum during healing.
  • Patient may experience pain, swelling, bruising, and nasal congestion in the days following surgery.
  • Follow-up appointments are scheduled to monitor healing progress, remove packing and splints, and assess any complications.
  • Patient undergoes postoperative care, including pain management, nasal irrigation, and avoiding strenuous activities.
  • Full recovery can take several weeks, with gradual improvement in breathing and reduction of symptoms such as snoring and nasal congestion.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with septoplasty, including negative-pressure pulmonary edema?

  2. How common is negative-pressure pulmonary edema as a complication of septoplasty?

  3. What are the symptoms of negative-pressure pulmonary edema that I should watch out for after my septoplasty surgery?

  4. How is negative-pressure pulmonary edema diagnosed and treated?

  5. Are there any specific precautions or steps I can take to reduce my risk of developing negative-pressure pulmonary edema after septoplasty?

  6. How soon after surgery should I contact you if I experience symptoms that could be related to negative-pressure pulmonary edema?

  7. Are there any specific post-operative care instructions or medications that can help prevent negative-pressure pulmonary edema?

  8. What is the typical recovery process after septoplasty, and how might negative-pressure pulmonary edema affect this?

  9. Are there any red flags or warning signs that I should be aware of during my recovery that may indicate a potential complication like negative-pressure pulmonary edema?

  10. How will you monitor my recovery and address any concerns related to negative-pressure pulmonary edema after my septoplasty surgery?

Reference

Authors: Erden B, Ak S, Çiftçi F. Journal: J Craniofac Surg. 2020 May/Jun;31(3):e270-e272. doi: 10.1097/SCS.0000000000006265. PMID: 32097382