• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.288-292
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• 2018

Objectives. To investigate the common causes of persistent septal deviation in revision septoplasty and to report the surgical techniques and results to correct them. Methods. A total of 100 consecutive patients (86 males) who had revision septoplasty due to persistent septal deviation from 2008 and 2014 were included in the study. Their mean age was 35.6 years and the mean follow-up duration was 9.1 months. Presenting symptoms, sites of persistent septal deviation, techniques used to correct the deviation, and surgical results were reviewed. Results. The mean interval between primary and revision surgery was 6.2 years. Forty-eight patients received revision septoplasty and 52 received revision septoplasty combined with rhinoplasty. Nasal obstruction was the most presenting symptom in almost all patients. The most common site of persistent septal deviation was middle septum (58%) followed by caudal septum (31%). Correcting techniques included further chondrotomy and excision of deviated portion in 76% and caudal batten graft in 39%. Rhinoscopic and endoscopic exams showed straight septum in 97% and 92 patients had subjective symptom improvement postoperatively. Conclusion. Middle septum and caudal septum were common sites of persistent deviation. Proper chondrotomy with excision of deviated middle septum and correction of the caudal deviation with batten graft are key maneuvers to treat persistent deviation.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.61-65
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• 2009

Purpose: Most nasal bone fractures involve the septum; either or both of the ethmoidal perpendicular plate(EPP) and quadrangular cartilage(QC). Unlocked tension from the underlying quadrangular cartilage and poorly reducted bony septum are obstacles to the successful reduction of nasal bone. So we compared the preliminary outcome of septoplasty as a primary treatment with the untreated septum in nasal bone fractures. Methods: We performed a retrospective study of 215 patients underwent reduction of nasal fracture between January 2002 and February 2008. We graded patients into four groups according to the amount of deviation and direction of force by CT. Our indication for septoplasty and combined procedures was the deviation of EPP or QC over 50% from the midline. We interviewed part of the patients by telephone regarding the subjective esthetic and functional outcomes. Results: Forty five of 215 patients (21 percent) underwent septoplasty and combined procedures (cartilage graft, etc) after the informed consent. Patients who underwent septoplasty significantly satisfied with the outcome of esthetic appearance and nasal patency compared with patients who underwent simple closed reduction despite of having septal deviation over 50 percent from the midline. (p < 0.05) Conclusion: Septal surgery and esthetic consideration shoud be made even in simple nasal reductions. And if CT scans reveal severe deviation of septum, septoplasty should be considered as a primary treatment.

• Journal of Rhinology
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• v.25 no.2
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• pp.86-90
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• 2018

Background and Objectives: Although polyvinyl acetate ($Merocel^{(R)}$) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet ($Rhinocel^{(R)}$) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty. Subjects and Method: Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with $Rhinocel^{(R)}$ and the other one with $Merocel^{(R)}$. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated. Results: Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, $Rhinocel^{(R)}$ was significantly more comfortable while in situ and less painful on removal than $Merocel^{(R)}$, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost. Conclusion: The use of $Rhinocel^{(R)}$ after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to $Merocel^{(R)}$ packing. Therefore, $Rhinocel^{(R)}$ may be a useful packing material after septoplasty.

• Archives of Plastic Surgery
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• v.47 no.6
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• pp.522-527
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• 2020

Nasal septoplasty is often required to correct a cosmetic deformity, which is a common reason for patients to present to a plastic surgeon. If nasal septoplasty is insufficient, a residual deformity or nasal obstruction may remain after surgery. Even if the nasal septum is corrected to an appropriate position, nasal congestion could be exacerbated if the turbinate on the other side is not also corrected. Therefore, appropriate treatment is required based on the condition of the turbinates. Herein, we survey recent trends in treatment and review previous research papers on turbinoplasty procedures that can be performed alongside nasal septoplasty.

• The Journal of the Korean dental association
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• v.38 no.10 s.377
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• pp.969-973
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• 2000

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.379-383
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• 2018

Septoplasty/septorhinoplasty is a common ear, nose and throat procedure offered for those patients with deviated septum who are suffering from nasal obstruction and functional or cosmetic problems. Although it is a basic and simple procedure, it could lead to catastrophic complications including major skull base injuries which result in cerebrospinal fluid (CSF) leaks. We describe two different cases of traumatic CSF leaks following septoplasty/septorhinoplasty at two different sites. The first patient suffered a CSF leak following septoplasty and presented to Alexandria University Hospital. The leak was still active at presentation and identified as coming from a defect in the roof of the sphenoid sinus and was repaired surgically. The second patient presented 4 days after her cosmetic septorhinoplasty with a CSF leak and significant pneumocephalus. She was managed conservatively. Understanding the anatomical variations of the paranasal sinuses and implementing proper surgical techniques are crucial in preventing intracranial complications when performing either septoplasty or septorhinoplasty. A good quality computed tomography of the nose and paranasal sinuses is a valuable investigation to avoid major complications especially CSF leaks following either procedure.

• Development and Reproduction
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• v.22 no.1
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• pp.105-109
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• 2018

A 40-year-old G1 P0 L0 A1 woman was referred to our clinic with 6-year history of infertility. Before visiting the clinic, she had 3 cycles of In-Vitro Fertilization (IVF) procedures (2 cycles of Controlled Ovarian Stimulation-IVF and 1 cycle of frozen-thawed Embryo Transfer (ET)) at other clinic. She had medical history of abortion at early gestation following FET (frozen-thawed-ET). The patient had complete type of septate uterus, double cervix and longitudinal vaginal septum. Vaginal septotomy was done first and 1 month later, hysteroscopic septoplasty was followed using ballooning filled with dye. After septoplasty, we inserted ballooning and left for several days to compress septal endometrium on the septectomy area. All procedures were done in the ambulatory operating room without laparoscopy or admission. 3 months later, she had in vitro fertilization-embryo transfer (IVF-ET) and FET procedures in our clinic. She had successful pregnancy and now is at 22 weeks of gestation. New ambulatory septoplasty using dye-filled ballooning is easy, safe and minimally invasive surgery for treatment of complete septate uterus.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.43-48
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• 2005

Septal deviations interfere with the nasal airflow and contribute to the deformities in the external appearance of the nose. An aesthetically and functionally satisfactory correction of severe septal deformities often requires temporary intraoperative removal of the septal cartilage for appropriate remodeling. This article describes septoplasty through dorsal approach for the correction of septal deviation. From March 2001 to April 2004, the author performed septoplasty through dorsal approach for the correction of septal deviations on 45 patients, of whom 22 of whom had nasal obstruction. Open rhinoplasty was used for dorsal approach in all patients and operation was performed under the general anesthesia or local anesthesia. The follow-up period of the patients ranged from 3 to 15 months with a mean of 10 months, and postoperative results were quite satisfactory. There was neither incidences of patients' complaints, nor any complications such as hematoma, septal perforation, supratip deformity, or recurrence. And there was some improvement of nasal obstruction in 15 patients. In conclusion, Septoplasty through dorsal approach is an effective method for the correction of septal deviation and improvement of the nasal airway obstruction.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.626-632
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• 2010

Purpose: Nasal bone fractures are often classified as minor injury. However, the incidence of posttraumatic nasal deformity remains alarmingly high. It is because of unnoticed septal fracture. This study was conducted to determine the necessity of septoplasty for patients with nasal bone fracture accompanying grade I septal fractures. Methods: Among 105 patients with nasal bone fractures, 52 who had grade I septal fracture were diagnosed based on physical examination and computed tomography. Patients' age ranged from 14 to 65 years (mean 29.25 years), and 35 were male and 17 female. Patients were divided into 2 groups according to surgical treatment methods: patients who underwent closed reduction only (group 1, n=28) and those who underwent simultaneous closed reduction and septoplasty (group 2, n=24). The treatment outcomes were evaluated by comparing changes in nasal airway volume measured by acoustic rhinometry before the surgery, 3 months and 6 months after the surgery according to the timing of surgical repair and surgical treatment methods. Results: Nasal airway volume increased after the surgery by 17.8% in 3 months after the surgery, 25.2% in 6 months in group 1 and by 22.7% in 3 months, 35.8% in 6 months in group 2. The increase in airway volume after the surgery by 26.3% in 3 months after the surgery, 34.2% in 6 months after the surgery in operation within 1 week after trauma and by 12.1% in 3 months, 22.2% in 6 months after the operation later 1 week after trauma. The difference was statistically significant. Three patients in group 1 complained of intermittent nasal obstruction, two of whom showed a decrease in nasal airway volume by acoustic rhinometry. Conclusion: Most patients with nasal bone fractures accompanying grade I septal fractures have been treated with closed reduction in clinical settings. However, the results of this study suggest that septoplasty be performed after a correct diagnosis of septal fracture is made through comprehensive physical examination and computed tomography. Septoplasty is important to obtain more favorable outcomes and reduce complication.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.199-207
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• 2001

Background: Septoplasty with turbinate surgery is common surgical treatment in patients with septal deviation and chronic hypertrophic rhinitis. The aim of this study was to evaluation objective outcomes of septoplasty with turbinate surgery by analysis of subjective symptom score with objective acoustic rhinometric test before and after surgery, prospectively. Materials and Methods: We reviewed 45 adult patients which were done septoplasty with bilateral turbinectomy or turbinoplasty and followed up at least 3 months by one rhinologist from November 1999 to April 2000, prospectively. We analyzed subjective symptom score, minimal cross-sectional area (MCA), C-notch cross-sectional area, and total volume of both nasal cavity before and after surgery. Correlation test was studied between symptom improvement and acoustic rhinometric results. Results: Twenty nine cases were male and sixteen cases female. The average age was 26.9 year-old (range: 17 to 57 years). There was significantly improvement of symptom score in postoperative 3 months (p<0.05). There was significantly increased C-notch cross-sectional area and total volume in postoperative 3 months. Symptoms improvement were associated with acoustic rhinometric profiles, but, there was not significantly correlation. Conclusion: Septoplasty with turbinate surgery is considered to be effective for nasal obstruction in patients with septal deviation and turbinate hypertrophy. Acoustic rhinometric test is favorable objective test for evaluation of symptom improvement after septal surgery.