Difference Between SMR and Septoplasty: ENT Expert Guide for Patients

ENT Specialist, Nashik, Maharashtra, India
🌐 www.entspecialistinnashik.com

🔹 Introduction

Septoplasty and Submucous Resection (SMR) are two commonly discussed surgical procedures for nasal blockage, breathing difficulty, recurrent sinus infections, and snoring. Both surgeries aim to correct a deviated nasal septum, yet they differ significantly in surgical technique, amount of tissue removal, recovery, and long-term outcomes.

Many patients and even caregivers often ask:

• Which surgery is better – SMR or Septoplasty?

• Are they the same or different?

Understanding the difference between SMR and septoplasty helps patients make informed decisions, set realistic expectations, and plan recovery better. This article explains SMR vs Septoplasty, their indications, risks, recovery, and which procedure is suitable for whom.

📌 Table of Contents

1. What is Submucous Resection (SMR)?

2. How Does SMR Surgery Involve?

3. What is Septoplasty?

4. What Does Septoplasty Involve?

5. SMR vs Septoplasty: Key Differences (Table)

6. Risks of SMR and Septoplasty

7. Recovery After SMR or Septoplasty

8. Septoplasty vs SMR: Key Clinical Differences

9. Difference Between Sinus Surgery and Septoplasty

10. Which Incision Is Used in SMR?

11. What Is the Nasal Septum?

12. Seven Major Differences Between SMR and Septoplasty

13. When Is Submucous Resection Recommended?

14. Cost of Septoplasty and SMR in India

15. Disclaimer

16. Summary

1️⃣ What Is Submucous Resection (SMR)?

Submucous Resection (SMR) is a surgical procedure in which large portions of deviated septal cartilage and bone are removed, while preserving the overlying mucosal lining.

SMR is usually recommended when:

• Septal deviation is severe

• Persistent sinus infections occur

• Nasal blockage does not improve with medicines

• Septal deviation significantly affects quality of life

SMR is a more radical surgery compared to septoplasty and is generally avoided in children.

2️⃣ How Does SMR Surgery Involve?

• Day-care procedure (same-day discharge)

• Performed under local or general anesthesia

• Duration: ~ 1 to 1.5 hours

• Surgery is done entirely through the nostrils

• External appearance of the nose remains unchanged

• Usually recommended for patients above 17 years

A microdebrider or surgical instruments are used to remove excess cartilage and bone while preserving the mucosal lining.

3️⃣ What Is Septoplasty?

Septoplasty is a conservative surgical procedure aimed at straightening the deviated nasal septum while preserving maximum cartilage and bone.

The goal is to:

• Improve nasal airflow

• Reduce nasal blockage

• Prevent sinus infections

• Maintain nasal structure

4️⃣ What Does Septoplasty Involve?

Steps include:

1. Local or general anesthesia

2. Incision inside the nasal cavity

3. Elevation of mucosal lining carefully

4. Correction or repositioning of deviated cartilage/bone

5. Preservation of structural support

6. Placement of splints or nasal packing (removed later)

Internal stitches dissolve naturally.

5️⃣ SMR vs Septoplasty: Key Differences

6️⃣ Risks of SMR and Septoplasty

Common risks include:

• Nasal bleeding

• Infection

• Temporary nasal blockage

• Crusting

• Anesthesia-related complications

⚠️ Serious complications are rare when surgery is done by an experienced ENT surgeon.

7️⃣ Recovery After SMR or Septoplasty

• Mild pain, swelling, nasal stuffiness for a few days

• Nasal packing removed after 24–72 hours

• Avoid:

  • Heavy exercise

  • Weight lifting

  • Nose blowing

• Use saline sprays & humidifier

• Full recovery in 2–3 weeks

8️⃣ Septoplasty vs SMR: Key Clinical Differences

• Septoplasty preserves cartilage

• SMR removes significant cartilage

• Septoplasty allows future nasal surgeries

• SMR makes revision surgeries difficult

9️⃣ Difference Between Sinus Surgery and Septoplasty

• Septoplasty corrects nasal septum deviation

• Sinus surgery opens blocked sinus pathways

• Both procedures may be done together if required

🔟 Which Incision Is Used in SMR?

Conventional SMR

• Killian incision

• Located ~5 mm above lower septal margin

• Mucoperichondrial flap raised carefully

1️⃣1️⃣ What Is the Nasal Septum?

The nasal septum divides the nose into two chambers. Deviation can cause:

• Nasal obstruction

• Snoring

• Sinusitis

• Nosebleeds

• Facial pain

• Sleep apnea

1️⃣2️⃣ Seven Major Differences Between SMR and Septoplasty

• Surgical technique

• Amount of tissue removed

• Suitability for children

• Cartilage preservation

• Future surgical options

• External nasal shape

• Risk profile

1️⃣3️⃣ When Is Submucous Resection Recommended?

SMR is advised when:

• Severe septal deviation

• Recurrent sinus infections

• Persistent nasal obstruction

• Failed medical management

• Combined sinus or cleft palate surgery

1️⃣4️⃣ Cost of Septoplasty and SMR in India

Cost depends on:

• Surgeon’s experience

• Hospital location

• Anesthesia charges

• Additional procedures

💡 Most insurance policies cover surgery done for medical reasons.

⚠️ Disclaimer

This article is for educational purposes only. Self-treatment based on online information can be dangerous. Always consult a qualified ENT specialist for diagnosis and treatment.

🔹 Summary

Septoplasty and Submucous Resection (SMR) are effective surgical options for treating a deviated nasal septum. Septoplasty is conservative, cartilage-preserving, and suitable for children, while SMR is more radical and reserved for severe cases.

Choosing the right procedure depends on:

• Age

• Severity of deviation

• Symptoms

• Future surgical needs

Consultation with an experienced ENT surgeon ensures the best functional and long-term outcome.

📞 ENT Consultation & Surgery

Dr. Sagar Rajkuwar (MS-ENT)
Prabha ENT Clinic, Ambad, Nashik
📱 7387590194 | 9892596635
🌐 www.entspecialistinnashik.com

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Deviated septum surgery options

Septoplasty is the primary surgical procedure for a deviated septum, which involves straightening the septum using endonasal (internal) or endoscopic methods, even if this may be done through either approach. An extracorporeal technique may be used in severe cases.

A septoplasty is occasionally performed in conjunction with additional treatments such as rhinoplasty (for nasal reshaping) or functional endoscopic sinus surgery if there are also sinus problems. Although less invasive methods, such as balloon septoplasty, may be taken into account, their efficacy might vary.

The diagnosis

A healthcare provider performs a physical examination to diagnose a deviated septum. A test requires using a bright light to peer into the nose, and occasionally a device to widen the nostrils. If necessary, a lengthy tube-shaped scope with a strong light at the end may display farther back in the nose.

Surgery is used to address a deviated septum that is producing symptoms. A deviated septum can only be corrected via surgery. If a deviated septum doesn’t cause any symptoms, no therapy is necessary.

A healthcare expert may advise using decongestants, antihistamines, or nasal steroid sprays to treat symptoms if allergies or sinus issues are exacerbating them.

Reconstruction surgery
Surgery to fix the deviated septum may be an option for individuals who continue to experience symptoms even after taking medication. Septoplasty is the term for this operation.

The nasal septum is straightened and positioned in the middle of the nose during a standard septoplasty. In some cases, the surgeon may need to chop and remove portions of the septum prior to repositioning them.

Changing the shape of the nose

Rhinoplasty, the surgical reshaping of the nose, is occasionally performed simultaneously with the treatment of a deviated septum. Modifying the nose’s cartilage and bone to alter its size, shape, or both is the process of rhinoplasty.

Outcomes of rhinoplasty
On the left, the nose of a woman prior to rhinoplasty. The same woman is pictured on the right one year following the procedure.

Different Septoplasty Methods

Septoplasty via the Endonasal (Closed) Approach:
This is a popular, minimally invasive procedure in which the surgeon inserts incisions into the nostrils in order to reach and reshape the septum without making external incisions.

Septoplasty via Endoscopy:
Similar to endonasal, but with a small camera (endoscope) that magnifies the nasal structures for more accurate correction of the deviation.

Septoplasty Outside the Body:
Reserved for severe or complex deformities, where the septum is removed, corrected, and then reinserted.

Alternative Surgical Choices

Submucosal Resection:
Frequently employs a motorized instrument called a microdebrider to remove little portions of the septum or to shrink the turbinates, which are tissue in the nasal passage.

Turbinate Surgery (Turbinoplasty):
If enlarged turbinates are the cause of blockage, surgery, frequently performed in conjunction with septoplasty, can be used to shrink them.

Septoplasty Using Balloons:
Some patients may benefit from a non-invasive operation in which a balloon catheter is used to gently widen the nasal passage by repositioning the septum.

Nose Surgery (Rhinoplasty):
Although the primary goal of rhinoplasty is to alter the nose’s outer form, it can be performed in conjunction with a septoplasty to address both cosmetic and structural issues.

What Affects Your Choices

Severity of Deviation: Complex deformities might necessitate alternative surgical techniques.

Other Conditions Present: Sinus problems may require further sinus surgery.

Patient Preferences: The choice between methods may depend on the desired result, such as maintaining the current form of the nose.
Methods can be carried out under general anesthesia or local anesthesia with sedation.

What Happens Following Surgery

The majority of septoplasty procedures are carried out on an outpatient basis, which means that you can go home the same day.
To stop bleeding and edema, some patients may need nasal packing (a gauze-like substance), which is usually taken out during a follow-up appointment.
Raising your head while you sleep, blowing your nose, and refraining from engaging in hard activities are all part of recovery.