Journal List > J Rhinol > v.23(2) > 1044372

Han, Oh, Park, Min, Shin, Lee, Kim, and Kim: Should the High Septal Deviation be Corrected to Improve Nasal Obstruction During Septal Surgery?

Abstract

Background and Objectives

High dorsal deflection of the nasal septum around cartilage or the perpendicular plate is technically difficult to correct. The objective of this study was to assess whether correction of high septal deviation during septoplasty is necessary to improve nasal airflow.

Patients and Surgical Method

Twenty-one patients with high septal deviation around the septal cartilage or the perpendicular plate were included in this study. In order to improve nasal obstruction, septoturbinoplasty was performed, but high septal deviation was not corrected. Subjective and objective improvements were evaluated using the visual analogue scale and acoustic rhinometry 1 month before and 3 months after surgery.

Results

After correction of nasal septum deviation except high septal deviation and reduction of turbinate mucosal volume, postoperative nasal volume and minimum cross-sectional area were significantly increased. Subjective symptom scales for nasal obstruction, rhinorrhea, sneezing, and posterior nasal drip were considerably improved after limited septoturbinoplasty in patients who still had high dorsal deflection of the nasal septum.

Conclusion

Our findings suggest that limited septoturbinoplasty without excessive resection of high dorsal deflection of the nasal septum can improve nasal airflow and reduce subjective symptoms, including nasal obstruction.

References

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Fig. 1.
A coronal view of paranasal sinus computed tomography for high septal deviation: Baumann's type II.
jr-23-85f1.tif
Fig. 2.
Comparison of pre-operative and post-operative MCA of patients with high septal deviation at second notch of concave nasal cavity. MCA: minimal cross sectional area.
jr-23-85f2.tif
Fig. 3.
Comparison of pre-operative and post-operative nasal volume of patients with high septal deviation.
jr-23-85f3.tif
Fig. 4.
Comparison of pre-operative and post-operative visual analogue scales for subjective symptoms.
jr-23-85f4.tif
Fig. 5.
A: Comparison of pre-operative and post-operative MCA at second notch of concave nasal cavity in patients without high septal deviation. B: Comparison of pre-operative and post-operative nasal volume in patients without high septal deviation. MCA: minimal cross sectional area.
jr-23-85f5.tif
Table 1.
Characcteristics of the patients
Patient nuber Sex Age F/u period (month) SD direction Turbinate hypertrophy
Convex Concave
1 M 53 3 R  
2 M 49 3 L  
3 M 19 3 L  
4 M 27 3 L
5 M 69 3 L  
6 M 56 3 R
7 F 62 3 R  
8 M 24 3 R
9 M 54 3 R  
10 M 21 3 L  
11 F 23 3 R
12 M 53 3 R  
13 F 34 3 R  
14 M 26 3 L  
15 F 29 3 R  
16 M 16 3 L
17 M 22 3 L  
18 M 28 3 L  
19 F 34 3 L  
20 F 25 3 L
21 M 23 3 L  

F/u: follow up, SD: septal deviation

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