Nasal Adhesions (Synechiae) After Nose Surgery: Causes, Symptoms and Treatment

3 days ago

3 min read

Key takeaways

Nasal synechiae (adhesions) are bands of scar tissue connecting two raw surfaces inside the nose, most often the septum and a turbinate.
They typically form after nasal or sinus surgery, nasal packing, trauma, cauterisation or infection, when opposing surfaces heal in contact.
Symptoms include nasal blockage (often one-sided), crusting, discharge and reduced smell.
Treatment is a short procedure to divide the band, usually with silicone splints placed to stop it re-forming.

What are nasal synechiae?

The inside of the nose is a narrow space. When the lining of the septum and the lining of a turbinate (or the side wall) are both injured in the same area, they can heal together, forming a bridge of scar tissue. This adhesion ranges from a thin thread to a thick band that obstructs a large part of the airway.

Why do adhesions form?

Nasal and sinus surgery, including septoplasty, turbinate reduction and endoscopic sinus surgery
Nasal packing, especially older gauze packing that abrades the lining
Trauma and fractures
Cauterisation for nosebleeds
Infections and chronic inflammation
Nasogastric tubes or prolonged intubation through the nose

Modern techniques reduce the risk: gentle tissue handling, soft silicone splints instead of gauze, and careful post-operative cleaning. Read about splint and tampon use in rhinoplasty.

Symptoms

Nasal congestion that does not improve, often on one side
A feeling of something "stuck" inside the nose
Crusting and discharge
Reduced sense of smell
Recurrent sinus problems if drainage is blocked

Small adhesions may cause no symptoms and need no treatment.

Diagnosis

Adhesions are diagnosed by looking inside the nose with a light and an endoscope. The surgeon identifies their location, thickness and whether they affect the airway or sinus drainage. A CT scan is rarely needed unless sinus disease is suspected.

Treatment: adhesion release

The adhesion is divided with fine instruments, a laser or a radiofrequency device, often under local anaesthesia for simple bands, or under general anaesthesia when combined with other procedures.
Thin silicone splints or spacers are placed between the surfaces for 1–2 weeks while the lining heals separately.
Saline rinses and ointment keep the area moist and prevent re-adhesion.
If a deviated septum or enlarged turbinate caused the surfaces to touch, it is corrected at the same time.

Prevention after nose surgery

Attend follow-up visits so that early adhesions can be gently separated before they mature.
Use saline sprays and prescribed ointments as instructed.
Do not pick crusts or insert objects into the nose.
Avoid smoking, which impairs mucosal healing.

Frequently asked questions

Can nasal adhesions go away on their own?

Thin, early adhesions may break with cleaning, but established bands usually need to be divided.

Is adhesion release painful?

It is a quick procedure; mild discomfort is controlled with simple painkillers.

Can adhesions come back?

Recurrence is possible, which is why splints and follow-up cleaning are used.

Can adhesions occur after rhinoplasty?

They are uncommon after cosmetic rhinoplasty but can occur when septal or turbinate surgery is also performed.

How are nasal adhesions treated?

Thin bands are divided under local anaesthesia in the clinic and a silicone sheet or splint is placed for a short period so that the two raw surfaces cannot stick together again. Extensive adhesions need a short operation under anaesthesia.

Can adhesions be prevented?

To a large extent, yes. Careful handling of the lining during surgery, splints that keep the septum and the turbinate apart, regular saline rinses and never pulling crusts off by force all reduce the risk.

Next step

If you have persistent blockage after nose surgery, contact Prof. Dr. Suleyman Tas Clinic for an endoscopic evaluation with Prof. Dr. Suleyman Tas.

About the author

Prof. Dr. Suleyman Tas is a European Board-certified plastic, reconstructive and aesthetic surgeon based in Istanbul with over 20 years of experience, author of Rhinoplasty in Practice (CRC Press) and founder of the Closed Atraumatic Rhinoplasty Course. Read verified patient reviews or book a consultation.

This article is for general information and does not replace an individual medical consultation.