What Is a Submucous Resection?

J.M. Willhite

A submucous resection is a common procedure performed to straighten a nasal septum that has been displaced from its anatomical position. Originating from a congenital malformation or trauma, a deviated septum can cause several secondary issues to develop, including infection. Generally performed as an outpatient procedure, a submucous resection does carry some risk for complication, including infection, scarring, and septum perforation.

After submucous resection, it is important to keep packing material, such as gauze, in the nose until told to remove it.
After submucous resection, it is important to keep packing material, such as gauze, in the nose until told to remove it.

The septum is the wall of cartilage inside the nose that separates the nostrils. As a rule, the positioning of the septum dictates the size and depth of the nostrils. In the event of septum deviation, or displacement, an individual can become vulnerable to chronic infections, nasal sensitivity and bleeding, or impaired nasal breathing.

Nasal discharge, occasional bleeding, and discomfort are to be expected following submucous resection surgery.
Nasal discharge, occasional bleeding, and discomfort are to be expected following submucous resection surgery.

When septum displacement causes significant complications, such as difficulty breathing, a resection may be performed. Preparing for a submucous resection involves adhering to preoperative instructions to reduce one’s risk for complications, such as disclosing a full medical history. Preoperative endoscopic testing may also be performed to further assess the condition of the septum and determine the surgical approach.

Nasal discharge, such as bleeding, is expected following submucous resection surgery.
Nasal discharge, such as bleeding, is expected following submucous resection surgery.

Once the patient is sedated with an intravenous (IV) anesthetic, the surgeon makes incisions in the mucosal tissues to gain access to the septal cartilage. To reposition the septum, the surgeon may need to remove cartilage or bone to restructure the septal shape. After the cartilage is straightened, the mucosal tissues are repositioned and sutures are created. All incisions made during the resection are within the nasal cavity, so there are no visible stitches.

A patient will be sedated for a submucous resection.
A patient will be sedated for a submucous resection.

After a submucous resection, precautions must be taken to protect the repositioned septum and keep it stable while it heals. Flexible splints made of synthetic material are usually positioned inside the nasal cavity to provide septal support. In cases where there is excessive discharge or bleeding, gauze packing may be temporarily placed in the nostrils. A postoperative list of restrictions and suggested tips for a full recovery are usually given to the patient and reviewed with a nurse.

While recovering from a submucous resection, patients are encouraged to avoid activities that would result in elevated blood pressure.
While recovering from a submucous resection, patients are encouraged to avoid activities that would result in elevated blood pressure.

Nasal discharge, occasional bleeding, and discomfort are to be expected following this resection surgery. Regular use of a prescribed saline nasal rinse and analgesics usually promotes healing and alleviates discomfort. During recovery, individuals are encouraged to avoid activities, such as bending, which may elevate blood pressure, contribute to nasal swelling, or otherwise place the nose at risk for inadvertent injury. In order to properly monitor recovery, individuals should keep all scheduled, postoperative doctor visits. Individuals who undergo submucous resection surgery usually make a full recovery and are able to resume everyday activities without restriction within three months.

Following a submucous resection, people are advised to avoid activities that would contribute to nasal swelling.
Following a submucous resection, people are advised to avoid activities that would contribute to nasal swelling.
The septum separates a person's two nostrils.
The septum separates a person's two nostrils.

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