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Erschienen in: European Archives of Oto-Rhino-Laryngology 5/2019

02.02.2019 | Rhinology

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

verfasst von: Amir A. Sazgar, Yeganeh Teimouri, Sara Arjang, Amin Amali, Sam P. Most

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 5/2019

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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.
Literatur
1.
Zurück zum Zitat Gubisch W (2005) Extracorporeal septoplasty for the markedly deviated septum. Arch Fac Plast Surg 7:218–226CrossRef Gubisch W (2005) Extracorporeal septoplasty for the markedly deviated septum. Arch Fac Plast Surg 7:218–226CrossRef
2.
Zurück zum Zitat Cho GS, Jang YJ (2013) Deviated nose correction: different outcomes according to the deviation type. Laryngoscope 123:1136–1142CrossRefPubMed Cho GS, Jang YJ (2013) Deviated nose correction: different outcomes according to the deviation type. Laryngoscope 123:1136–1142CrossRefPubMed
3.
Zurück zum Zitat Song HM, Kim JS, Lee BJ, Jang YJ (2008) Deviated nose cartilage dorsum correction using a dorsal L-strut cutting and suture technique. Laryngoscope 118:981–986CrossRefPubMed Song HM, Kim JS, Lee BJ, Jang YJ (2008) Deviated nose cartilage dorsum correction using a dorsal L-strut cutting and suture technique. Laryngoscope 118:981–986CrossRefPubMed
4.
Zurück zum Zitat King ED, Ashley FL (1952) The correction of the internally and externally deviated nose. Plast Reconstr Surg (1946) 10:116–120CrossRef King ED, Ashley FL (1952) The correction of the internally and externally deviated nose. Plast Reconstr Surg (1946) 10:116–120CrossRef
5.
Zurück zum Zitat Most SP (2006) Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique. Arch Fac Plast Surg 8:202–207CrossRef Most SP (2006) Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique. Arch Fac Plast Surg 8:202–207CrossRef
6.
Zurück zum Zitat 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 153:27–33CrossRef 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 153:27–33CrossRef
7.
Zurück zum Zitat Wilson MA, Mobley SR (2011) Extracorporeal septoplasty: complications and new techniques. Arch Fac Plast Surg 13:85–90 Wilson MA, Mobley SR (2011) Extracorporeal septoplasty: complications and new techniques. Arch Fac Plast Surg 13:85–90
8.
Zurück zum Zitat Jang YJ, Kwon M (2010) Modified extracorporeal septoplasty technique in rhinoplasty for severely deviated noses. Ann Otol Rhinol Laryngol 119:331–335CrossRefPubMed Jang YJ, Kwon M (2010) Modified extracorporeal septoplasty technique in rhinoplasty for severely deviated noses. Ann Otol Rhinol Laryngol 119:331–335CrossRefPubMed
9.
Zurück zum Zitat Sazgar AA, Amali A (2014) Modified extracorporeal septoplasty: using a unilateral curved spreader graft with a septal caudal graft. Ann Plast Surg 73:124–127CrossRefPubMed Sazgar AA, Amali A (2014) Modified extracorporeal septoplasty: using a unilateral curved spreader graft with a septal caudal graft. Ann Plast Surg 73:124–127CrossRefPubMed
10.
Zurück zum Zitat Lee SB, Jang YJ (2014) Treatment outcomes of extracorporeal septoplasty compared with in situ septal correction in rhinoplasty. JAMA Fac Plast Surg 16:328–334CrossRef Lee SB, Jang YJ (2014) Treatment outcomes of extracorporeal septoplasty compared with in situ septal correction in rhinoplasty. JAMA Fac Plast Surg 16:328–334CrossRef
11.
Zurück zum Zitat Jang YJ, Wang JH, Lee BJ (2008) Classification of the deviated nose and its treatment. Arch Otolaryngol Head Neck Surg 134:311–315CrossRefPubMed Jang YJ, Wang JH, Lee BJ (2008) Classification of the deviated nose and its treatment. Arch Otolaryngol Head Neck Surg 134:311–315CrossRefPubMed
12.
Zurück zum Zitat Mondina M, Marro M, Maurice S, Stoll D, de Gabory L (2012) Assessment of nasal septoplasty using NOSE and RhinoQoL questionnaires. Eur Arch Otorhinolaryngol 269:2189–2195CrossRefPubMed Mondina M, Marro M, Maurice S, Stoll D, de Gabory L (2012) Assessment of nasal septoplasty using NOSE and RhinoQoL questionnaires. Eur Arch Otorhinolaryngol 269:2189–2195CrossRefPubMed
13.
Zurück zum Zitat Erdem T, Ozturan O (2008) Objective measurement of the deviated nose and a review of surgical techniques for correction. Rhinology 46:56–61 Erdem T, Ozturan O (2008) Objective measurement of the deviated nose and a review of surgical techniques for correction. Rhinology 46:56–61
14.
Zurück zum Zitat Rudy S, Moubayed SP, Most SP (2017) Lateral wall insufficiency after septal reconstruction. Fac Plast Surg 33:451–452CrossRef Rudy S, Moubayed SP, Most SP (2017) Lateral wall insufficiency after septal reconstruction. Fac Plast Surg 33:451–452CrossRef
15.
Zurück zum Zitat 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 130:283–290CrossRef 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 130:283–290CrossRef
16.
Zurück zum Zitat Kandathil CK, Moubayed SP, Chanasriyotin C, Most SP (2017) Natural history of nasal obstruction symptom evaluation scale following functional rhinoplasty. Fac Plast Surg 33:551–552CrossRef Kandathil CK, Moubayed SP, Chanasriyotin C, Most SP (2017) Natural history of nasal obstruction symptom evaluation scale following functional rhinoplasty. Fac Plast Surg 33:551–552CrossRef
17.
Zurück zum Zitat 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 47:175–179CrossRefPubMed 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 47:175–179CrossRefPubMed
18.
Zurück zum Zitat Bloom JD, Kaplan SE, Bleier BS, Goldstein SA (2009) Septoplasty complications: avoidance and management. Otolaryngol Clin N Am 42:463–481CrossRef Bloom JD, Kaplan SE, Bleier BS, Goldstein SA (2009) Septoplasty complications: avoidance and management. Otolaryngol Clin N Am 42:463–481CrossRef
Metadaten
Titel
Severe deviated nose treatment: importance of preserving the dorsal septal remnant
verfasst von
Amir A. Sazgar
Yeganeh Teimouri
Sara Arjang
Amin Amali
Sam P. Most
Publikationsdatum
02.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 5/2019
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05321-y

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