Septal Reconstruction: Simple to Complex

Abstract

Nasal septal deviation is a frequent problem treated by otolaryngologists and facial plastic surgeons. Complete correction of the septal deformity is often essential both for straightening a crooked nose and for restoration of the nasal airway. While standard septoplasty techniques provide excellent outcomes in most patients, severe septal deformities may require treatment with more advanced maneuvers including adjacent grafting, caudal septal replacement, and even extracorporeal septoplasty. This article reviews a range of septoplasty techniques, with an emphasis on complex septal reconstruction and approaches that can be utilized to maintain keystone stability and establish a robust midline L-strut even in cases with challenging anatomy.

Keywords

septoplasty - keystone stability - extracorporeal septoplasty - cartilage grafting

Publikationsverlauf

Artikel online veröffentlicht:
02. August 2023

• References

• 1 Bateman ND, Woolford TJ. Informed consent for septal surgery: the evidence-base. J Laryngol Otol 2003; 117 (03) 186-189
• 2 Patel RG. Nasal anatomy and function. Facial Plast Surg 2017; 33 (01) 3-8
• 3 Hsu DW, Suh JD. Anatomy and physiology of nasal obstruction. Otolaryngol Clin North Am 2018; 51 (05) 853-865
• 4 Teymoortash A, Fasunla JA, Sazgar AA. The value of spreader grafts in rhinoplasty: a critical review. Eur Arch Otorhinolaryngol 2012; 269 (05) 1411-1416
• 5 Keeler JA, Moubayed SP, Most SP. Straightening the crooked middle vault with the clocking stitch: an anatomic study. JAMA Facial Plast Surg 2017; 19 (03) 240-241
• 6 Suh MK. Correction of the deviated tip and columella in crooked nose. Arch Plast Surg 2020; 47 (06) 495-504
• 7 Pontius AT, Leach Jr JL. New techniques for management of the crooked nose. Arch Facial Plast Surg 2004; 6 (04) 263-266
• 8 Wu PS, Hamilton III GS. Extracorporeal septoplasty: external and endonasal techniques. Facial Plast Surg 2016; 32 (01) 22-28
• 9 Gubisch W. Treatment of the scoliotic nose with extracorporeal septoplasty. Facial Plast Surg Clin North Am 2015; 23 (01) 11-22
• 10 Rezaeian F, Gubisch W, Janku D, Haack S. New suturing techniques to reconstruct the keystone area in extracorporeal septoplasty. Plast Reconstr Surg 2016; 138 (02) 374-382
• 11 Gubisch W, Hacker S, Neumann J, Haack S. 40 years of total extracorporeal septal reconstruction: the past, present, and future. Plast Reconstr Surg 2020; 146 (06) 1357-1367
• 12 Kamburoğlu HO, Bitik O. A new technique for robust stabilization in the keystone area during extracorporeal septorhinoplasty. Plast Reconstr Surg 2019; 143 (05) 956e-959e
• 13 Wilson MA, Mobley SR. Extracorporeal septoplasty: complications and new techniques. Arch Facial Plast Surg 2011; 13 (02) 85-90
• 14 Ross Mobley S, Long J. Extracorporeal septoplasty: assessing functional outcomes using the validated nasal obstruction symptom evaluation score over a 3-year period. Plast Reconstr Surg 2016; 137 (01) 151e-163e
• 15 Steele T, Funamura JL, Marcus BC, Tollefson TT. Correction of the severely deviated septum: extracorporeal septoplasty. Ear Nose Throat J 2013; 92 (09) 421-424
• 16 Most SP. Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique. Arch Facial Plast Surg 2006; 8 (03) 202-207
• 17 Porter P, Kriet JD, Humphrey CD. Autologous rib grafts in the management of the crooked nose. Facial Plast Surg 2015; 31 (03) 228-237