Gentle, modern surgical procedures for nose problems

Are you living with chronic nasal congestion? Do you want to get rid of nasal drops? Do you have a deviated septum but are afraid of surgery? We asked our otolaryngologist Dr. Eszter Tóth about new, gentle and minimally painful surgical solutions.
Gentle, modern surgical procedures for nose problems

Dr. Eszter Tóth : Many people live with nasal drops because of their chronic nasal congestion. The good news for them is that this problem can be solved permanently with a very simple intervention. By treating the swollen nasal mucosa of the lower concha with the radiofrequency or coblation method, the swelling disappears and the patient gets rid of nasal drops in the long term.

DMC: Why is this method better than using nasal drops?

DrTE : Long-term use of the nasal drops may damage the nasal mucosa. This situation affects many people with allergies, but it can also apply to those who cannot stop using the drug due to a cold or persistent nasal congestion. However, the over-the-counter drops can be used for a maximum of 1 week or 10 days - unfortunately, many people do not even know this.

DMC: How "serious" is such an operation?

DrTE : This is a 15-20 minute procedure that can be performed under local anesthesia. It takes place in the operating room, since it is a surgical procedure, but the nose does not even need to be tamponed afterwards and the patient can go home the same day. I think this kind of surgical solution is one of the greatest achievements of the last 10 years, because before these nasal conchas were "burned", the mucous membrane was cut, and they were subjected to much more drastic procedures. The new method is really a minimally invasive intervention.

DMC: What happens to the nasal mucosa during surgery?

DrTE: After anesthesia, a needle is inserted into the connective tissue of the lower concha, which emits high-frequency energy - but its effect is only effective in the vicinity of the needle. Therefore, there is no large-scale "burning" in the tissue environment, and as a result, the procedure is gentler compared to the old high-energy devices.

In 4-6 weeks, scarring and shrinkage will develop at the site of the burn, but it is important that all this takes place under the mucous membrane, so the surface is not damaged, the mucous membrane and the cilia hair coating remain intact. However, the swelling will shrink, there will be space in the nose again, and we will no longer need to use nasal drops.

DMC: Then you obviously don't have to worry about someone's sense of smell being damaged.

DrTE: No, olfactory disorders are primarily the background of more serious illnesses, and it is not typical for them to develop after nasal concha surgery, in fact, such an operation can even improve the sense of smell.

DMC: Let's move on to the other big area, nasal septum tilt!

DrTE: Many people have a deviated septum behind the persistent nasal congestion, but they are afraid of a surgical solution. They are afraid of it because the old, classical surgical interventions were mostly performed under local anesthesia, and the patients experienced the events associated with the surgery as a very bad experience: the unpleasant numbness, fracture-crushing, sounds and the subsequent multilayered gauze tamponade, which 2 it still has to be pulled out after a day... Today, it works differently with us, we do septum (nasal septum) plastic surgery from the start. This is a much gentler surgical procedure, it takes place under anesthesia, painlessly, so the patient does not feel anything.

DMC: What is the essence of the procedure?

This is a so-called cartilage-preserving procedure, so we do not remove a large area of cartilage and bone during the operation. We tilt the cartilage out of place, carve it a little, then put it back in place and sew it back up. Since we sew both the cartilage and the mucous membrane, there is no need for tight gauze tamponade either. There is less browning, the skeleton of the nasal septum is preserved, and its function is less damaged. Actually, we can talk about a plastic reconstructive surgery.

It is also important that, while traditional nasal septum surgeries did not provide a solution for the nasal inlet-anterior curvature, this new type of intervention mobilizes the entire nasal septum, and thus inlet curvatures can also be corrected.

Of course, there are cases when the bone is crooked to such an extent that a more extended procedure becomes necessary, but fortunately this is much rarer.

DMC: What to expect after surgery?

DrTE: After waking up, the patient can leave with a biodegradable tampon in the nose even on the day of the operation. This tampon does not need to be pulled out, but can be gently blown out after 2 days. There is no pain even after the operation, at most the stuffy nose is a little unpleasant. So we can talk about a gentle procedure from all points of view.

DMC: What other innovations can you mention regarding surgeries?

DrTE: During coblation technology, so-called plasma knife operations, approx. We work at a temperature of 50 degrees, using the plasma layer created at the end of the wand. The device cuts and stops bleeding at the same time, and thanks to the low temperature, damage to the depth of the tissue is minimal. Compared to traditional cutting, it is gentler, the wound heals easier and faster, there is less bleeding, and less pain in the surgical area. Of course, this is not painless either.

It is excellent for tonsil surgery, pharyngeal plastic surgery, sleep apnea surgery, snoring surgery, but it also has a role in nasal concha treatments and soft palate tightening.

DMC: And if you mentioned the tonsillectomy - what about that in adulthood?

DrTE : Many people do not know that the tonsils wither in adulthood, by which time they are no longer an actively functioning organ. If follicular inflammation appears in an adult, or if it is constantly inflamed, it can cause fatigue, hair loss, joint complaints, heart and kidney complaints. Then its removal becomes justified, as it can cause a much bigger problem than its benefit. There are quite a lot of other lymphatic tissues in the throat, which perform the filtering function.