Abstract
Nasal obstruction is one of the most common problems that brings a patient into a physician’s office, and septal deviation is a frequent structural etiology that can contribute to the development of chronic inflammatory sinonasal diseases. Correction of septal deviation (septoplasty) is one of the most commonly performed procedures by otolaryngologists and aims to improve nasal form and function resulting in improved quality of life. Septoplasty is a particularly common procedure in the adult population, but it is performed relatively less in children. Despite this procedure’s long-standing history, there is no consensus in the literature regarding the clinical indications, the most proper technique, and the best age at which to intervene. The reticence to perform septoplasty in pediatric patients stems from concerns over adverse effects on nasal and facial growth. However, data from anthropometric studies suggest that pediatric septoplasty does not interfere with normal nasal or facial development, even after long-term follow-up. Furthermore, failure to perform septoplasty in pediatric patients with nasal obstruction may adversely affect the respiratory function and somatic, physical, and cognitive development. Early intervention to relieve nasal obstruction may reduce the risk of these serious conditions and delaying septoplasty on children affected by nasal septal deviation may be more deleterious. Numerous subsequent studies have provided evidence that septoplasty is a safe procedure, which does not affect nasal and facial growth when performed in appropriately selected pediatric patients. The aims of septal surgery in children should be to improve form and function at an optimal time of intervention considering the development of the nasal skeleton and mechanics of the nose and midface in growing children.
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Eryılmaz A, Kayalı Dinç AS, Dursun E. Endoscopic septoplasty. Turkiye Klinikleri J ENT-Special Topics. 2013;6(4):18–22.
Sood VP. Septoplasty in children. Indian J Otolaryngol. 1985;37(3):87–9.
Eryılmaz A, Demirbaş D. Pediatric septoplasty. Turkiye Klinikleri J Pediatr Sci. 2007;3(12):100–4.
Anderson K, Ritchie K, Chorney JM, Bezuhly M, Hong P. The impact of septoplasty on health-related quality of life in paediatric patients. Clin Otolaryngol. 2016;41(2):144–8.
Martins MB, Lima RG, Lima FV, Barreto VM, Santos AC, Junior RC. Demystifying septoplasty in children. Int Arch Otorhinolaryngol. 2014;18(1):54–6.
Lee VS, Gold RM, Parikh SR. Short-term quality of life outcomes following pediatric septoplasty. Acta Otolaryngol. 2017;137(3):293–6.
Yilmaz MS, Guven M, Akidil O, Kayabasoglu G, Demir D, Mermer H. Does septoplasty improve the quality of life in children? Int J Pediatr Otorhinolaryngol. 2014;78(8):1274–6.
Christophel JJ, Gross CW. Pediatric septoplasty. Otolaryngol Clin N Am. 2009;42(2):287–94.
Farrior RT, Connolly ME. Septorhinoplasty in children. Otolaryngol Clin N Am. 1970;3(2):345–64.
Gilbert JG, Segal S Jr. Growth of the nose and the septorhinoplastic problem in youth. AMA Arch Otolaryngol. 1958;68(6):673–82.
El-Hakim H, Crysdale WS, Abdollel M, Farkas LG. A study of anthropometric measures before and after external septoplasty in children: a preliminary study. Arch Otolaryngol Head Neck Surg. 2001;127(11):1362–6.
Bejar I, Farkas LG, Messner AH, Crysdale WS. Nasal growth after external septoplasty in children. Arch Otolaryngol Head Neck Surg. 1996;122(8):816–21.
Tasca I, Compadretti GC. Nasal growth after pediatric septoplasty at long-term follow-up. Am J Rhinol Allergy. 2011;25(1):e7–12.
Walker PJ, Crysdale WS, Farkas LG. External septorhinoplasty in children: outcome and effect on growth of septal excision and reimplantation. Arch Otolaryngol Head Neck Surg. 1993;119(9):984–9.
Lawrence R. Pediatric septoplasty: a review of the literature. Int J Pediatr Otorhinolaryngol. 2012;76(8):1078–81.
Cingi C, Muluk NB, Ulusoy S, Lopatin A, Sahin E, Passali D, et al. Septoplasty in children. Am J Rhinol Allergy. 2016;30(2):42–7.
D'Ascanio L, Lancione C, Pompa G, Rebuffini E, Mansi N, Manzini M. Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. Int J Pediatr Otorhinolaryngol. 2010;74(10):1180–3.
Adil E, Goyal N, Fedok FG. Corrective nasal surgery in the younger patient. JAMA Facial Plast Surg. 2014;16(3):176–82.
Matin MA, Islam N, Ali R, Azad AK. Septoplasty in children: results of 250 cases. Bangladesh J Otorhinolaryngol. 2015;21(2):110–4.
Schultz-Coulon HJ, Eckermeier L. Postnatal growth of nasal septum. Acta Otolaryngol. 1976;82(1–2):131–42.
Verwoerd CD, Verwoerd-Verhoef HL. Rhinosurgery in children: developmental and surgical aspects of the growing nose. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2010;9:1–29.
van der Heijden P, Korsten-Meijer AG, van der Laan BF, Wit HP, Goorhuis-Brouwer SM. Nasal growth and maturation age in adolescents: a systematic review. Arch Otolaryngol Head Neck Surg. 2008;134(12):1288–93.
Meng HP, Goorhuis J, Kapila S, Nanda RS. Growth changes in the nasal profile from 7 to 18 years of age. Am J Orthod Dentofac Orthop. 1988;94(4):317–26.
Akguner M, Barutcu A, Karaca C. Adolescent growth patterns of the bony and cartilaginous framework of the nose: a cephalometric study. Ann Plast Surg. 1998;41(1):66–9.
Bhuskute A. Septorhinoplasty in the pediatric patient. Facial Plastic Surg Clin North Am. 2016;24(3):245–53.
Stenner M, Rudack C. Diseases of the nose and paranasal sinuses in child. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2014;13:1–27.
Van Loosen J, Van Zanten GA, Howard CV, Verwoerd-Verhoef HL, Van Velzen D, Verwoerd CD. Growth characteristics of the human nasal septum. Rhinology. 1996;34(2):78–82.
Pirsig W. Surgery of the nose in childhood: growth and late results. Laryngol Rhinol Otol (Stuttg). 1984;63(4):170–80.
Keleş E, Karlıdağ T, Kaygusuz İ, Yalçın Ş, Yıldız M, Alpay C. Septoplasty in childhood. Kulak Burun Bogaz ve Baş Boyun Cerrahisi Dergisi. 2005;13(1):15–9.
Loh W, Chan KH. Septoplasty in children. Oper Tech Otolayngol. 2005;16(4):248–50.
Teul I, Zbislawski W, Baran S, Czerwinski F. Deformation of the nasal septum in children, adolescents, and adults in Western Pomerania province of Poland. Eur J Med Res. 2009;14(Suppl):4244–7.
Podoshin L, Gertner R, Fradis M, Berger A. Incidence and treatment of deviation of nasal septum in newborns. Ear Nose Throat J. 1991;70(8):485–7.
Ruano-Gil D, Montserrat-Viladiu JM, Vilanova-Trias J, Burges-Vila J. Deformities of the nasal septum in human foetuses. Rhinology. 1980;18(2):105–9.
Gray LP. Prevention and treatment of septal deformity in infancy and childhood. Rhinology. 1977;15(4):183–91.
Emami AJ, Brodsky L, Pizzuto M. Neonatal septoplasty: case report and review of the literature. Int J Pediatr Otorhinolaryngol. 1996;35(3):271–5.
Watson D. Septoplasty. Medscape. 2017. http://emedicine.medscape.com/article/877677-overview.
Etigadde Y, Majeed J. Clinical and radiological evaluation of deviated nasal septum in classifying and surgical management of the deviated septums. IOSR J Dent Med Sci. 2017;16(2):13–20.
Verwoerd CD, Verwoerd-Verhoef HL. Rhinosurgery in children: basic concepts. Facial Plast Surg. 2007;23(4):219–30.
Alpini D, Corti A, Brusa E, Bini A. Septal deviation in newborn infants. Int J Pediatr Otorhinolaryngol. 1986;11(2):103–7.
Teixeira J, Certal V, Chang ET, Camacho M. Nasal septal deviations: a systematic review of classification systems. Plast Surg Int. 2016;2016:7089123.
Mladina R, Cujic E, Subaric M, Vukovic K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol. 2008;29(2):75–82.
Yildirim I, Okur E. The prevalence of nasal septal deviation in children from Kahramanmaras, Turkey. Int J Pediatr Otorhinolaryngol. 2003;67(11):1203–6.
Gray LP. Deviated nasal septum. Incidence and etiology. Ann Otol Rhinol Laryngol Suppl. 1978;87(3 Pt 3 Suppl 50):3–20.
Ali DS. A statistical study on the nasal septum in 5,096 cases in Iraq. J Laryngol Otol. 1965;79:244–8.
Zielnik-Jurkiewicz B, Olszewska-Sosinska O. The nasal septum deformities in children and adolescents from Warsaw, Poland. Int J Pediatr Otorhinolaryngol. 2006;70(4):731–6.
Subaric M, Mladina R. Nasal septum deformities in children and adolescents: a cross sectional study of children from Zagreb, Croatia. Int J Pediatr Otorhinolaryngol. 2002;63(1):41–8.
Kawalski H, Spiewak P. How septum deformations in newborns occur. Int J Pediatr Otorhinolaryngol. 1998;44(1):23–30.
Sarnat BG, Wexler MR. Growth of the face and jaws after resection of the septal cartilage in the rabbit. Am J Anat. 1966;118(3):755–67.
Sarnat BG, Wexler MR. The snout after resection of nasal septum in adult rabbits. Arch Otolaryngol. 1967;86(4):463–6.
Squier CA, Wada T, Ghoneim S, Kremenak CR. A histological and ultrastructural study of wound healing after vomer resection in the beagle dog. Arch Oral Biol. 1985;30(11–12):833–41.
Stenstrom SJ, Thilander BL. Effects of nasal septal cartilage resections on young guinea pigs. Plast Reconstr Surg. 1970;45(2):160–70.
Bernstein L. Early submucous resection of nasal septal cartilage. A pilot study in canine pups. Arch Otolaryngol. 1973;97(3):273–8.
Cupero TM, Middleton CE, Silva AB. Effects of functional septoplasty on the facial growth of ferrets. Arch Otolaryngol Head Neck Surg. 2001;127(11):1367–9.
Ortiz-Monasterio F, Olmedo A. Corrective rhinoplasty before puberty: a long-term follow-up. Plast Reconstr Surg. 1981;68(3):381–91.
Dispenza F, Saraniti C, Sciandra D, Kulamarva G, Dispenza C. Management of naso-septal deformity in childhood: long-term results. Auris Nasus Larynx. 2009;36(6):665–70.
Triglia JM, Cannoni M, Pech A. Septorhinoplasty in children: benefits of the external approach. J Otolaryngol. 1990;19(4):274–8.
Costa DB, Anselmo-Lima WT, Tamashiro E, Enoki C, Valera FC. The impact of Metzembaum septoplasty on nasal and facial growth in children. Braz J Otorhinolaryngol. 2013;79(4):454–9.
Maniglia CP, Maniglia JV. Rhinoseptoplasty in children. Braz J Otorhinolaryngol. 2016;83(4):416–9.
Levi JM, McKee-Cole KM, Barth PC, Brody RM, Reilly JS. Outcomes of recalcitrant idiopathic epistaxis in children: septoplasty as a surgical treatment. Laryngoscope. 2016;126(12):2833–7.
Funamura JL, Sykes JM. Pediatric septorhinoplasty. Facial Plast Surg Clin North Am. 2014;22(4):503–8.
D'Ascanio L. Letter to the editor regarding “does septoplasty improve the quality of life in children?”. Int J Pediatr Otorhinolaryngol. 2014;78(12):2333–4.
Derkay CS. A conservative role for septoplasty in young children. Arch Otolaryngol Head Neck Surg. 1999;125(6):702–3.
Bhuskute A, Sumiyoshi M, Senders C. Septorhinoplasty in the pediatric patient. Facial Plast Surg Clin North Am. 2016;24(3):245–53.
Crysdale WS, Walker PJ. External septorhinoplasty in children: patient selection and surgical technique. J Otolaryngol. 1994;23(1):28–31.
Sooknundun M, Kacker SK, Bhatia R, Deka RC. Nasal septal deviation: effective intervention and long term follow-up. Int J Pediatr Otorhinolaryngol. 1986;12(1):65–72.
Pentz S, Pirsig W, Lenders H. Long-term results of neonates with nasal deviation: a prospective study over 12 years. Int J Pediatr Otorhinolaryngol. 1994;28(2–3):183–91.
Deka RC, Kacker SK. Septoplasty in children. Indian J Otolaryngol. 1990;42(1):39–40.
Can IH, Ceylan K, Bayiz U, Olmez A, Samim E. Acoustic rhinometry in the objective evaluation of childhood septoplasties. Int J Pediatr Otorhinolaryngol. 2005;69(4):445–8.
Healy GB. An approach to the nasal septum in children. Laryngoscope. 1986;96(11):1239–42.
D'Ascanio L, Manzini M. Safe and rapid approach to the deviated nasal septum in children. Laryngoscope. 2009;119(10):2000–3.
Riggs RH. The maxillary-premaxillary approach to septal surgery. Eye Ear Nose Throat Mon. 1960;39:157–62.
İleri F. Pediatric septoplasty. Curr Pract Otorhinolaryngol Head Neck Surg. 2006;2(3):42–5.
Kahveci OK, Miman MC, Yucel A, Yucedag F, Okur E, Altuntas A. The efficiency of NOSE Obstruction Symptom Evaluation (NOSE) scale on patients with nasal septal deviation. Auris Nasus Larynx. 2012;39(3):275–9.
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Coşkun, Z.Ö., Dursun, E., Myer, C.M., von Allmen, D.C. (2020). Pediatric Septoplasty. In: Cingi, C., Bayar Muluk, N. (eds) All Around the Nose. Springer, Cham. https://doi.org/10.1007/978-3-030-21217-9_56
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