Background:
Intranasal adhesions (synechiae) are among the most common complications following septoplasty and septoconchoplasty. Although often considered minor, they may impair nasal airflow, reduce patient satisfaction, and contribute to persistent nasal obstruction requiring additional treatment. Objective:
To review current evidence regarding the incidence, risk factors, prevention, and management of intranasal adhesions following septoplasty and septoconchoplasty. Materials and Methods:
A narrative review was conducted using the PubMed database. Nine studies directly addressing postoperative adhesions after septoplasty or septoconchoplasty were identified. Following manual reference screening and inclusion of relevant supporting publications, a total of 21 articles were reviewed. Original studies, comparative studies, randomized trials, cohort studies, and relevant reviews published in English were included. Results:
 Reported adhesion rates varied substantially across studies, ranging from approximately 3,1% to 26.75% in studies specifically evaluating septal surgery. Higher rates, 36,2%, have been reported, particularly following procedures involving the inferior turbinates. The main factors associated with adhesion formation were mucosal injury, contact between opposing raw surfaces, and postoperative management. Evidence regarding routine use of septal splints remains conflicting, although several studies demonstrated reduced adhesion rates, particularly in high-risk patients. Transseptal suturing appears to be an effective alternative to nasal packing, while traditional gauze packing may increase adhesion risk. Endoscopic techniques may reduce mucosal trauma and postoperative complications. Limited evidence suggests that topical mitomycin C may be beneficial in selected cases. Conclusions:
Intranasal adhesions remain a clinically relevant complication of septoplasty and septoconchoplasty. Preservation of mucosal integrity, minimization of tissue trauma, and appropriate postoperative care are essential for reducing their occurrence.