Septoplasty Risks and Complications: Informed Consent Guide

Septoplasty (deviated septum correction) is generally safe but carries specific risks patients must understand.

Common Risks (1–5% each)

• Bleeding: Intraoperative or postoperative (first 24–48 hrs). May require packing, cautery, or rarely transfusion.
• Infection: Cellulitis, abscess, toxic shock syndrome (rare with packing).
• Pain: Moderate; managed with acetaminophen/NSAIDs; opioids rarely needed >3 days.
• Nasal obstruction (persistent): Edema, synechiae (adhesions), inadequate correction, valve collapse.

Less Common but Significant Risks

• Septal perforation (1–2%): Through-and-through hole → crusting, whistling, epistaxis, obstruction. May need repair (graft, flap).
• CSF leak (rare): Cribriform plate injury → rhinorrhea, meningitis risk.
• Change in nasal shape: Dorsal saddle deformity, tip ptosis (if caudal septum over-resected).
• Olfactory disturbance: Temporary (edema) or permanent (nerve injury).
• Dental/nasal numbness: Nasopalatine nerve injury (transient usually).
• Scarring/synechiae: Lateral wall to septum adhesions; may require lysis.

Risk Reduction Strategies

• Surgeon experience (fellowship-trained rhinologist/facial plastic surgeon).
• Mucosal preservation; bilateral flaps for perforation repair.
• Splints/stents (7–14 days) to prevent synechiae.
• Post-op: Saline irrigation, antibiotic ointment, avoid trauma/nose blowing.
• Manage expectations: 85–90% symptomatic improvement; not "perfect" breathing.

When to Contact Surgeon

• Brisk bleeding unresponsive to 10 min compression + Afrin.
• Fever >101°F, worsening pain, purulent drainage.
• Clear unilateral nasal drip (CSF concern).
• Visual changes, severe headache, neck stiffness.

Shared decision-making with a qualified surgeon ensures realistic expectations and optimal outcomes.