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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 5, pp 1349–1354 | Cite as

Severe deviated nose treatment: importance of preserving the dorsal septal remnant

  • Amir A. SazgarEmail author
  • Yeganeh Teimouri
  • Sara Arjang
  • Amin Amali
  • Sam P. Most
Rhinology
  • 141 Downloads

Abstract

Purpose

To compare the surgical outcomes of modified extracorporeal septoplasty and anterior septal reconstruction for the management of the severe deviated nose.

Methods

In a prospective cohort study, we selected 86 patients referred for septorhinoplasty to a tertiary center in May 2015–April 2017 with a primary complaint of nasal obstruction and deformity. They had moderate-to-severe septal deviation and severely deviated noses, particularly in the dorsum. Forty-three patients underwent each procedure. The cohorts were age- and sex-matched, and were operated at a similar time point. Surgical outcome was assessed and compared using anthropometric measurement of photographs, acoustic rhinometry, and The Nasal Obstruction Septoplasty Effectiveness questionnaire (including a visual analog scale).

Results

In all patients, MCA1 (initial minimum cross-sectional area) and MCA2 (minimum cross-sectional area after topical decongestion of the nasal mucosa), anthropometric angles (nasolabial, nasofacial and tip projection), and The Nasal Obstruction Septoplasty Effectiveness questionnaire significantly improved after surgery in both groups (p = 0001), with no significant difference in improvement between two groups. However, anthropometric angles and minimal cross-sectional area were better in anterior septal reconstruction group.

Conclusion

Both methods are effective in patients with a severely deviated nose for correction of deviation and obstruction. Anterior septal reconstruction is the preferable method in patients with more deviation.

Keywords

Septoplasty Rhinoplasty Deviated nose Nasal obstruction 

Notes

Acknowledgements

This study is supported by Tehran University of Medical Sciences; Grant no.: 94-04-48-31209 and Ethical code: IR.TUMS.REC.1394.1925.

Funding

This study was funded by Tehran University of Medical Sciences; Grant no.: 94-04-48-31209.

Compliance with ethical standards

Conflict of interest

There are no potential conflicts or financial relationships.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethical code: IR.TUMS.REC.1394.1925), and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Gubisch W (2005) Extracorporeal septoplasty for the markedly deviated septum. Arch Fac Plast Surg 7:218–226CrossRefGoogle Scholar
  2. 2.
    Cho GS, Jang YJ (2013) Deviated nose correction: different outcomes according to the deviation type. Laryngoscope 123:1136–1142CrossRefPubMedGoogle Scholar
  3. 3.
    Song HM, Kim JS, Lee BJ, Jang YJ (2008) Deviated nose cartilage dorsum correction using a dorsal L-strut cutting and suture technique. Laryngoscope 118:981–986CrossRefPubMedGoogle Scholar
  4. 4.
    King ED, Ashley FL (1952) The correction of the internally and externally deviated nose. Plast Reconstr Surg (1946) 10:116–120CrossRefGoogle Scholar
  5. 5.
    Most SP (2006) Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique. Arch Fac Plast Surg 8:202–207CrossRefGoogle Scholar
  6. 6.
    Surowitz J, Lee MK, Most SP (2015) Anterior septal reconstruction for treatment of severe caudal septal deviation: clinical severity and outcomes. Otolaryngol Head Neck Surg 153:27–33CrossRefGoogle Scholar
  7. 7.
    Wilson MA, Mobley SR (2011) Extracorporeal septoplasty: complications and new techniques. Arch Fac Plast Surg 13:85–90Google Scholar
  8. 8.
    Jang YJ, Kwon M (2010) Modified extracorporeal septoplasty technique in rhinoplasty for severely deviated noses. Ann Otol Rhinol Laryngol 119:331–335CrossRefPubMedGoogle Scholar
  9. 9.
    Sazgar AA, Amali A (2014) Modified extracorporeal septoplasty: using a unilateral curved spreader graft with a septal caudal graft. Ann Plast Surg 73:124–127CrossRefPubMedGoogle Scholar
  10. 10.
    Lee SB, Jang YJ (2014) Treatment outcomes of extracorporeal septoplasty compared with in situ septal correction in rhinoplasty. JAMA Fac Plast Surg 16:328–334CrossRefGoogle Scholar
  11. 11.
    Jang YJ, Wang JH, Lee BJ (2008) Classification of the deviated nose and its treatment. Arch Otolaryngol Head Neck Surg 134:311–315CrossRefPubMedGoogle Scholar
  12. 12.
    Mondina M, Marro M, Maurice S, Stoll D, de Gabory L (2012) Assessment of nasal septoplasty using NOSE and RhinoQoL questionnaires. Eur Arch Otorhinolaryngol 269:2189–2195CrossRefPubMedGoogle Scholar
  13. 13.
    Erdem T, Ozturan O (2008) Objective measurement of the deviated nose and a review of surgical techniques for correction. Rhinology 46:56–61Google Scholar
  14. 14.
    Rudy S, Moubayed SP, Most SP (2017) Lateral wall insufficiency after septal reconstruction. Fac Plast Surg 33:451–452CrossRefGoogle Scholar
  15. 15.
    Stewart MG, Smith TL, Weaver EM et al (2004) Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 130:283–290CrossRefGoogle Scholar
  16. 16.
    Kandathil CK, Moubayed SP, Chanasriyotin C, Most SP (2017) Natural history of nasal obstruction symptom evaluation scale following functional rhinoplasty. Fac Plast Surg 33:551–552CrossRefGoogle Scholar
  17. 17.
    Radulesco T, Penicaud M, Santini L, Thomassin JM, Dessi P, Michel J (2018) Outcomes of septorhinoplasty: a new approach comparing functional and aesthetic results. Int J Oral Maxillofac Surg 47:175–179CrossRefPubMedGoogle Scholar
  18. 18.
    Bloom JD, Kaplan SE, Bleier BS, Goldstein SA (2009) Septoplasty complications: avoidance and management. Otolaryngol Clin N Am 42:463–481CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Otorhinolaryngology Research CenterTehran University of Medical SciencesTehranIran
  2. 2.Division of Facial Plastic and Reconstructive SurgeryStanford University School of MedicinePalo AltoUSA
  3. 3.Department of Otolaryngology, Head and Neck Surgery, Vali-Asr Hospital, Imam Khomeini Medical ComplexTehran University of Medical SciencesTehranIran

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