septotomy

Septotomy is a surgical procedure that involves incising or dividing a septum, a partition separating two anatomical spaces, to relieve obstruction or gain access to underlying structures. The term derives from Latin septum and tomy, meaning cutting. In medical practice, septotomy is most commonly performed in otolaryngology to address nasal septal problems but may be described in other specialties when a septum is involved.

Indications include nasal obstruction due to a deviated or obstructed nasal septum, a septal spur causing airway limitation, or the need to allow drainage and ventilation of the nasal cavities or paranasal sinuses. In some cases, septotomy is used as part of endoscopic sinus surgery to create a workable corridor to sinus outlets, or to access a lesion beneath the septum. It may also be employed in rare congenital anomalies where a septal barrier impedes ventilation.

The procedure is typically performed under general anesthesia and involves a mucosal incision along the septum, followed by division or removal of a portion of cartilage or bone while preserving mucosa when possible. Endoscopic visualization is common and helps minimize tissue damage. Postoperative care includes nasal hygiene, crust management, and avoidance of trauma to the operated septum. Healing occurs over weeks with the aim of improved airway patency.

Complications can include bleeding, infection, septal perforation, synechiae, crusting, and, rarely, restenosis. Long-term outcomes depend on the indication and technique.