• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.21.1-21.6
• /
• 2016

Background: The Le Fort I osteotomy is one of the most widely used and useful procedure to correct the dentofacial deformities of the midface. The changes of the maxilla position affect to overlying soft tissue including the nasal structure. Postoperative nasal septum deviation is a rare and unpredicted outcome after the surgery. There are only a few reports reporting the management of this complication. Case Presentation: In our department, three cases of the postoperative nasal septum deviation after the Le Fort I osteotomy had been experienced. Via limited intraoral circumvestibular incision, anterior maxilla, the nasal floor, and the anterior aspect of the septum were exposed. The cartilaginous part of the nasal septum was resected and repositioned to the midline and the anterior nasal spine was recontoured. Alar cinch suture performed again to prevent the sides of nostrils from flaring outwards. After the procedure, nasal septum deviation was corrected and the esthetic outcomes were favorable. Conclusion: Careful extubation, intraoperative management of nasal septum, and meticulous examination of preexisting nasal septum deviation is important to avoid postoperative nasal septum deviation. If it existed after the maxillary osteotomy, septum repositioning technique of the current report can successfully correct the postoperative septal deviation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.1
• /
• pp.36-42
• /
• 2011

Introduction: The current study examined the morphological characteristics of maxillary sinus septum by computed tomography (CT). Materials and Methods: Two hundred and four patients (408 maxillary sinuses) who visited dental clinic were evaluated. CT were examined. The height of the septum measured from the sinus floor to the apex of the septum more than 3 mm was defined as "sinus septum". Results: The prevalence of sinus septa was 21.3% (87/408), and 31.4% (64/204) of patients had more than 1 sinus septum. Females showed higher and thinner sinus septa than males. The anatomic location of the septa were distributed in the 2nd molar region (43.7%), 1st molar region (31.0%), 2nd premolar region (21.8%) and 1st premolar region (3.5%). In 57 patients with chronic disease, there was no significant difference between sinus disease and the presence of sinus septa. The loss of remaining teeth and teeth adjacent to the sinus septum area was not related to the presence of sinus septa. Older subjects showed a reduced height and length of the septum, and a thicker septum. Conclusion: These results show that the maxillary sinus septum undergoes atrophy with age.

• Korean Journal of Bronchoesophagology
• /
• v.5 no.1
• /
• pp.85-89
• /
• 1999

Neurilemmoma is a benign, well-encapsulated neurogenic tumor that arises in cranial, peripheral, or autonomic nerves that have nerve sheaths containing schwann cells. From 16 to 45% of all neurilemmoma cases occur in the head and neck region and only about 4% of those cases are found in the nose and paranasal sinuses, but very rarely found in the nasal septum. Recently, we experienced a case of isolated neurilemmoma which arose from the nasal septum of a 30-year-old female patient who complained of nasal obstruction and postnasal drip. The mass was broadly based on the right anterior portion of the nasal septum and confined to the nasal cavity, displacing the lateral wall of the nasal cavity and middle turbinate, laterally and posteriorly, respectively. The tumor mass was completely excised through transnasal endoscopic surgery under general anesthesia. The final pathological diagnosis viewed under a microscope after H&E and anti S-100 protein stain was a benign neurilemmoma in which Antoni A type and B type both existed. This report presents a case of neurilemmoma which arose from the nasal septum with reviews of the clinicopathologic features.

• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.659-666
• /
• 2010

Purpose: Blepharoplasty plays a vital role in facial rejuvenation. Aging eyelids are the result of relaxation of lid structures as the skin, the orbicularis muscle, and mainly the septum, with subsequent protrusion or pseudoherniation of intraorbital fat contents. Traditional blepharoplasty has often involved the excision of excessive lax skin and muscle and removal of fat, leaving the eyelid unnatural and even causing the brow ptosis. The authors propose the septal approach through which the amount of skin excision can be decreased and solid fixation can be achieved in the upper blepharoplasty. Methods: From November 2007 to February 2010, total of 15 patients underwent upper blepharoplasty with septal approach. In 9 patients, orbital septum anchored into the orbital periosteum only. But in 6 patients, the attenuated septum was strengthened through shortening and fixing into orbital periosteum with non-absorbable suture. Results: Pleasing results were obtained from most of the patients. But one patient who had septum anchoring procedure complained of slight undercorrection, therefore secondary operation with septum shortening procedure was followed. Conclusion: We found that the method using orbital septum fixation into orbital periosteum has several advantages: less amount of skin excision, less recurrence rate, and more natural appearance. And the results were reliable and satisfactory.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.54.1-54.3
• /
• 2019

Background: The presence of septa increases the risk of Schneiderian membrane perforation during sinus lift procedure, and therefore, the chance of graft failure increases. We present a safe method of managing septa and, in particular, overcoming small and palatally located septa. Methods: After the elevation of the flap and the creation of a small bony window positioned anterior to the septum, the Schneiderian membrane is lifted carefully. A thin and narrow osteotome is then placed at the indentation created at the base of the septum, and mobilization of the septum is achieved by gentle malleting. The membrane is again carefully lifted up behind the septum. Results: There was one small membrane perforation case in all 16 cases, and none of these patients showed postoperative complications such as implant failure, infection, or maxillary sinusitis. Conclusions: This technique is useful for overcoming the problem of maxillary sinus septa hindering the sinus floor elevation procedure, leading to fewer complications.

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

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.22 no.2
• /
• pp.305-313
• /
• 1992

This study was designed to investigate the effects of the maxillary sinus development and nasal septum deviation on diseases of maxillary sinus with cleft palate. The materials was 152 cephalometric Waters' projections consist of 76 cleft patients and 76 normal subjects. The results were as follows: 1. The disease of maxillary sinus was present in 49% of a cleft group and 14% of a control group, and prevalent in cleft side. 2. It showed no statistically significant difference in size of the maxillary sinus in cleft plate patients compared to the control population and in the cleft side to the noncleft side(p>.05). 3. Nasal septum deviation was more severe in the cleft patient its average value was 3.55㎜, compared to the control group, 0.99㎜(p<0.01) and 77% of the deviated nasal septum was deviated to the cleft side.

• Journal of Chest Surgery
• /
• v.18 no.2
• /
• pp.273-278
• /
• 1985

The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

• Journal of Korean Neurosurgical Society
• /
• v.65 no.1
• /
• pp.138-144
• /
• 2022

To report two cases of type 1.5 split cord malformation (SCM), a subtype of SCM with combined characteristics of types I and II and to review the relevant literature and propose a new possible pathogenetic theory for type 1.5 SCM. A 52-year-old woman had hemicords within a single dural sac with a dorsal bony septum at the L5 level. A 9-year-old boy had hemicords within a single dural sac with a ventral bony septum and fibrous extension at the L3 level. Both patients underwent microsurgical treatments for removing the bony septum, detethering the spinal cord, and sectioning the filum terminale. The surgical procedure revealed an extradural partial bony septum and hemicords within an intact single dural sac in each patient. Both patients were discharged from the hospital without de novo nerve dysfunction. Published cases have validated that types I and II SCM can overlap. We recommend recent type 1.5 SCM as a normative terminology for this overlapping SCM and report two rare cases of this SCM. We propose an associated pathogenesis consisting of uneven distribution and regression to explain type 1.5 SCM. Furthermore, we postulate that the amount of condensing meninx primitiva might determine whether the left bony septum has fibrous extensions to the opposite dura in type 1.5 SCM.

• Archives of Craniofacial Surgery
• /
• v.24 no.3
• /
• pp.139-142
• /
• 2023

Fibrofolliculoma is a benign, perifollicular, connective tissue tumor that usually arises in the form of multiple lesions; it is rarely seen as a solitary lesion. The lesions are clinically asymptomatic, 2 to 4 mm skin-colored, soft dome-shaped papules. Here, we report a patient who visited our hospital with a palpable lesion on the nasal septum. The lesion did not cause pain upon palpation, and nasal endoscopy confirmed an irregular wart-like lesion measuring 6×6 mm in the left anterior nasal septum near the columella. Other otolaryngology findings were normal, and there were no similar lesions in other parts of the body. None of the patient's family members were known to have had such lesions. An excisional biopsy was performed on the mass for removal of the lesion, and histological examination confirmed the lesion as fibrofolliculoma. We report the first case of solitary fibrofolliculoma in the nasal septum in a healthy 62-year-old woman along with a review of the relevant literature.