Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-22T01:20:02.744Z Has data issue: false hasContentIssue false
  • English
  • Français

A new technique of revision septoplasty using semi-penetrating straight and circular incisions of the nasal septum

Published online by Cambridge University Press:  30 May 2019

L Wei ,
L Wang ,
W Lu ,
T Jiang ,
Z Liu ,
M Wang ,
X Wu  and
Z Wang
L Wei
Affiliation:
Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
L Wang
Affiliation:
Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
W Lu
Affiliation:
Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
T Jiang
Affiliation:
Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
Z Liu
Affiliation:
Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
M Wang
Affiliation:
Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
X Wu
Affiliation:
Otolaryngology Department, Friendship Hospital, Dalian, China
Z Wang*
Affiliation:
Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
*
Author for correspondence: Dr Zhiqiang Wang, Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, 6# Jiefang Street, Zhongshan District, Dalian 116001, China E-mail: [email protected] Fax: +86 411 628 93555
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study aimed to investigate endoscopic revision septoplasty with semi-penetrating straight and circular incisions in patients for whom septoplasty was unsuccessful.

Method

Patients in this study (n = 14) had a deviation of the nasal septum after septoplasty. Pre-operative and post-operative assessments were performed using a visual analogue scale and nasal endoscope. Semi-penetrating straight and circular incisions in front of the caudal septum and at the margin of the nasal septal cartilage–bone defect, respectively, were made. The mucoperichondrium and mucoperiosteum were bilaterally dissected until interlinkage with the cartilage–bone defect was achieved. Mucous membranes within the circular incision as well as the right mucoperichondrium and mucoperiosteal flaps were protected by pushing them to the right. This exposed the osteocartilaginous framework and allowed correction of the residual deviation. The patients were followed up for 30–71 months.

Results

For nasal obstruction and headaches, a significant improvement was noted in post-operative compared to pre-operative visual analogue scale scores. No patients had septal deviations, saddle nose, false hump nose or contracture of the nasal columella.

Conclusion

The technique allowed exposure of the septal osteocartilaginous framework and a broad operational vision, which enabled successful correction of various deformities of the nasal septum.

Keywords

Nasal SeptumRhinoplastyReoperationEndoscopesIncision
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 6 , June 2019 , pp. 494 - 500
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr Z Wang takes responsibility for the integrity of the content of the paper

References

1Samad, I, Stevens, HE, Maloney, A. The efficacy of nasal septal surgery. J Otolaryngol 1992;21:88–91Google Scholar
2Bohlin, L, Dahlqvist, A. Nasal airway resistance and complications following functional septoplasty: a ten-year follow-up study. Rhinology 1994;32:195–7Google Scholar
3Illum, P. Septoplasty and compensatory inferior turbinate hypertrophy: long-term results after randomized turbinoplasty. Eur Arch Otorhinolaryngol 1997;254(suppl 1):89–92Google Scholar
4Siegel, NS, Gliklich, RE, Taghizadeh, F, Chang, Y. Outcomes of septoplasty. Otolaryngol Head Neck Surg 2000;122:228–32Google Scholar
5Dinis, PB, Haider, H. Septoplasty: long-term evaluation of results. Am J Otolaryngol 2002;23:85–90Google Scholar
6Uppal, S, Mistry, H, Nadig, S, Back, G, Coatesworth, A. Evaluation of patient benefit from nasal septal surgery for nasal obstruction. Auris Nasus Larynx 2005;32:129–37Google Scholar
7Harrison, L, Jones, NS. Intranasal contact points as a cause of facial pain or headache: a systematic review. Clin Otolaryngol 2013;38:8–22Google Scholar
8Rudmik, L, Mace, J, Ferguson, BJ, Smith, TL. Concurrent septoplasty during endoscopic sinus surgery for chronic rhinosinusitis: does it confound outcomes assessment? Laryngoscope 2011;121:2679–83Google Scholar
9Manoukian, PD, Wyatt, JR, Leopold, DA, Bass, EB. Recent trends in utilization of procedures in otolaryngology-head and neck surgery. Laryngoscope 1997;107:472–7Google Scholar
10You, X, Gao, Q, Liu, Z, Cui, Y. The value of nasal endoscopy in the resection of upper and posterior nasal septum deviation [in Chinese]. Lin Chuang Er Bi Yan Hou Ke Za Zhi 1999;13:392–3Google Scholar
11Gillman, GS, Egloff, AM, Rivera-Serrano, CM. Revision septoplasty: a prospective disease-specific outcome study. Laryngoscope 2014;124:1290–5Google Scholar
12Xiao, HJ, Kong, WJ, Wang, GP, Yang, CZ, Le, JX. Revision of submucous resection of nasal septum [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2006;41:184–6Google Scholar
13Sillers, MJ, Cox, AJ 3rd, Kulbersh, B. Revision septoplasty. Otolaryngol Clin North Am 2009;42:261–78Google Scholar
14Becker, SS, Dobratz, EJ, Stowell, N, Barker, D, Park, SS. Revision septoplasty: review of sources of persistent nasal obstruction. Am J Rhinol 2008;22:440–4Google Scholar
15Grymer, LF, Hilberg, O, Elbrønd, O, Pedersen, OF. Acoustic rhinometry: evaluation of the nasal cavity with septal deviations, before and after septoplasty. Laryngoscope 1989;99:1180–7Google Scholar
16Metzenbaum, M. Replacement of the lower end of the dislocated septal cartilage versus submucous resection of the dislocated end of the septal cartilage. Arch Otolaryngol 1929;9:282–6Google Scholar
17Pastorek, NJ, Becker, DG. Treating the caudal septal deflection. Arch Facial Plast Surg 2000;2:217–20Google Scholar
18Pham, AM, Tollefson, TT. Correction of caudal septal deviation: use of a caudal septal extension graft. Ear Nose Throat J 2007;86:142–4Google Scholar
19Giacomini, P, Lanciani, R, Di Girolamo, S, Ferraro, S, Ottaviani, F. Caudal septal deviation correction by interlocked graft technique. Ann Plast Surg 2010;65:280–4Google Scholar
20Constantine, FC, Ahmad, J, Geissler, P, Rohrich, RJ. Simplifying the management of caudal septal deviation in rhinoplasty. Plast Reconstr Surg 2014;134:379e–88eGoogle Scholar
21Stupak, HD. Book review: functional reconstructive nasal surgery. Ann Otol Rhinol Laryngol 2016;125:522Google Scholar