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Tracheal tube as a nostril splint

I had revision septorhinoplasty 3.5 weeks ago. According to my surgeon, my nose was rather complex. I had collapsed nostrils and a mishaped tip that he corrected using cartilage grafts from my ear and temporal fascia. I did not have any internal or external splints. Right after surgery, my left nostril quickly swelled shut (my right one was fine). During my first follow up 10 days later, it was still swollen, but my surgeon said it was swelling and should go down. Today, I had my second follow-up (25 days post-op). My nostril is still completely swollen shut (pic attached). So, as a solution, my surgeon cut a piece of endotracheal tubing (6.5cm) and shoved it up my nostril (which was extremely painful). He told me to keep it up there as much as possible, which would help my nostril avoid "scarring together". While it did the job of opening up my nostril, I'm kind of worried about what its lasting effects might be. Is it common to use a trachea tube as a way to splint the nostril? Because it's rounded, i'm worried it being pushed up against my rather sensitive, newly worked on septum might cause a permanent dent in the cartilage. Additionally, the size of the tubing makes me worry that my nostril will be stretched way too big. Any thoughts/opinion you might be able to provide on this, I'd be grateful! I'm just really scared. As this is my third revision, I just really want it to go right.

March 16th, 2016 QLD

  • Answer
    Peter Callan

    Peter Callan

    5 answers

    Plastic Surgeon
    Victoria, Australia

    Hi there. As this is your third operation there will be swelling.  Rhinoplasty and septoplasty depends on the surgery being done so as relationships are good and the framework is solid.  However that being said it would be only so strong until all of the tissues have healed together.  Splinting on the whole will not help the surgery if the nasal relationships at the end of surgery are not correct, but if your surgeon is confident that the surgery was good, splinting can help hold things in place and reduce some swelling to help with the healing.

    The choice of splinting material doesn't really matter that much.  Endotracheal tubing would be a fairly firm material and quite uncomfortable I agree, but your surgeon will know what your requirements are.  It won't stretch up your nostril, so don't worry about that.

    I hope this helps.
  • Answer
    Dr. Raymond Goh

    Raymond Goh

    123 answers

    Plastic Surgeon
    Queensland, Australia

    Hi. Revision septo-rhinoplasty can be extremely complicated, involving multiple structural grafts and extensive dissection through scar tissue. As a result, swelling is usually greater than a primary procedure, and can be prolonged. Internal splinting is used not only to provide an airway, but also to avoid a synechiae (scarring forming between the sidewall of the nose and the septum. The use of internal nostril splints however should be weaned down as the swelling decreases so as to not put too much pressure on the nose. It should not affect the size of your nostril.
    Hope this helps.
    Kind regards,
    Dr Ray Goh