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



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


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).


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.


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.


Septoplasty Rhinoplasty Deviated nose Nasal obstruction 



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


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.


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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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