BACKGROUND: Severe nasoseptal deviations still represent challenging situations for plastic surgeons. Septal surgery plays a central role in the management of complex cosmetic and functional problems, and should be considered as a basic procedure in nasal surgery. The classic septoplasty approach seems to be unsuitable for severe septal deviations. Other authors have found the standard extracorporeal septoplasty approach more reliable for a correct functional and cosmetic surgery. However, a drawback of this technique is the destabilization of the keystone area. In an effort to minimize the risk of destabilization, we have modified the classic technique with a more conservative approach that spares the dorsal cartilage and a portion of the caudal septum. METHODS: This study included 153 patients who underwent primary rhinoplasty from January 2006 to June 2009. The purpose was to evaluate the effectiveness of this technique in terms of objective (Active Anterior Rhinomanometry) and subjective (Nasal Obstruction Symptom Evaluation [NOSE] scale) improvements of the respiratory function and in terms of postoperative complications. There was a significant improvement in mean NOSE score at 3 and 6 months postoperatively. Rhinomanometrical assessment showed a significant increase of the nasal inspiratory flow at 3 and 6 months after surgery. No complications were reported. CONCLUSIONS: The results obtained with NOSE score and with rhinomanometrical assessment revealed that this technique increases patient's quality of life and nasal respiratory function, respectively. Furthermore, our approach avoids the most important complication of classic extracorporeal septoplasty, thus preserving a structured support of the nasal archway.
BACKGROUND: Severe nasoseptal deviations still represent challenging situations for plastic surgeons. Septal surgery plays a central role in the management of complex cosmetic and functional problems, and should be considered as a basic procedure in nasal surgery. The classic septoplasty approach seems to be unsuitable for severe septal deviations. Other authors have found the standard extracorporeal septoplasty approach more reliable for a correct functional and cosmetic surgery. However, a drawback of this technique is the destabilization of the keystone area. In an effort to minimize the risk of destabilization, we have modified the classic technique with a more conservative approach that spares the dorsal cartilage and a portion of the caudal septum. METHODS: This study included 153 patients who underwent primary rhinoplasty from January 2006 to June 2009. The purpose was to evaluate the effectiveness of this technique in terms of objective (Active Anterior Rhinomanometry) and subjective (Nasal Obstruction Symptom Evaluation [NOSE] scale) improvements of the respiratory function and in terms of postoperative complications. There was a significant improvement in mean NOSE score at 3 and 6 months postoperatively. Rhinomanometrical assessment showed a significant increase of the nasal inspiratory flow at 3 and 6 months after surgery. No complications were reported. CONCLUSIONS: The results obtained with NOSE score and with rhinomanometrical assessment revealed that this technique increases patient's quality of life and nasal respiratory function, respectively. Furthermore, our approach avoids the most important complication of classic extracorporeal septoplasty, thus preserving a structured support of the nasal archway.
Authors: Myriam Loyo; Jeffrey D Markey; Deniz Gerecci; Edward El Rassi; Ryan J Li; C Blake Sullivan; Tom D Wang Journal: JAMA Facial Plast Surg Date: 2018-01-01 Impact factor: 4.611