Reconstruction of Nasal Septal Deformities by L-Shaped Nasal Septal Cartilage

The most common cause of nasal septal deformity are congenital anomalies and traumatic injury. The nasal deformities are caused by various structures such as upper lateral cartilage, septal cartilage and nasal bone, rather than deformity of single structure. In addition, the nose requires not only aesthetical elements but functional elements, which should be considered during surgery. Toriumi and Russell Ries in 1993 introduced subtotal reconstruction of nasal septum. Severe deformities of the supportive segments of the nasal septum were reconstructed with L-shaped septal cartilage harvested from the posteroinferior region of the nasal septum. We reconstructed 5 patients with secondary cleft lip nose deformity(N = 3) and serious traumatic nasal septal deviation(N = 2) between October 1999 and October 2001. The age of patients ranged from 18 to 45 years(mean 27.4 years). Four were men, one was woman. The follow up period was 4 to 18 months(mean 8 months). All of the patients were pleased with the outcome. There were no occurrences of saddle nose deformity, loss of nasal tip projection, retraction of the columella, perforation of the nasal septum or recurrence of nasal septal deviation. In conclusion, subtotal reconstruction of the nasal septum was performed for patients with severe deformities of the supportive segments of the nasal septum which resulted in success without recurrence and side effects. A longer follow-up period and more cases are necessary to adequately evaluate the efficacy of this method of septal cartilage.

The Causes and Frequency of Neonatal Septal Deformities / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal septal deformities have been reported at all ages and in all races. Many factors have been reported as being causative factors in nasal septal deformities. Among the factors, birth trauma was first reported by Metzenbaum as being a causative factor in nasal septal deformities, and has since been reported by many other authors. The aim of this study was to find if birth trauma is a cause of nasal septal deformities and to assess the frequency of neonatal septal deformities in Korean neonates. MATERIAL AND METHOD: The experiment was performed in a randomized group of neonates. A number of 602 neonates aged 1- 2 days have been examined in a two-month period. A number of 278 neonates were born by natural vaginal delivery (group A), 264 by elective cesarean section (group B) and 60 by emergency cesarean section (group C). The nasal septa of neonates were examined by otoscope, cotton wool test and strut test. RESULT: The septal deformities have been found in 66 neonates of group A (23.74%), in 32 of group B (12.12%) and in 11 of group C (18.33%). The Frequency of septal deformities was higher in group A compared to group B and C (p<0.05). In the group A neonates with septal deformity, however, the correlations between parity and septal deformity and between birth weight and septal deformity were not statistically significant (p <0.05). The overall incidence of septal deformities in the investigated neonates was 18.1% in this study. CONCLUSION: Birth trauma is a causative factor of neo natal septal deformities.

The Effects of Pregnancy Conditions on the Incidence of Nasal Septal Deformities in Neonates

BACKGROUND AND OBJECTIVES: To study the incidence of nasal septal deformities (NSD) in neonates and to identify pregnancy conditions related with NSD occurrence. MATERIALS AND METHODS: Prospective study of 131 women and their newborns. Incidences of neonatal NSD were looked for with a cotton wool test and through direct visual examination of the neonatal nasal cavity with an otoscope. Under study were arbitrary but possibly related factors of neonatal NSD : the mother's age, parity, medical history, the duration of total labor, the duration of second-stage labor, the delivery type, neonatal birth weight and gestational age. The contributions of these factors were analyzed statistically. RESULTS: The incidence of neonatal NSD as identified through otoscopic examination was 11.5%. All studied factors indicated no statistically significant relationship with neonatal NSD. CONCLUSION: Probable nasal trauma during pregnancy and delivery is likely not a factor in the occurrence of NSD in neonates.

Effects of External Nasal Dilators on Nasal Respiration and Patency in Patients with Deformity of the Nasal Septum: An Acoustic Rhinometric Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Some types of deformities of the nasal septum (DNSs) interfere with the nasal valve function. External nasal dilators (ENDs) were developed to improve the nasal airway by mechanically dilating the nasal valve. The aim of this study is to evaluate the effects of ENDs on nasal respiration and patency in patients with DNS. MATERIALS AND METHODS: Fifty-four patients with DNS (37 males and 17 females, aged 18 to 46 years) without other sinonasal diseases were included in this study. All subjects were required to assess their own sensation of nasal respiration on a 100 mm visual analog scale. Minimal cross-sectional areas (MCAs) and volumes of 0 to 5 cm from the nostril (V 5s) of both nasal cavities were measured by acoustic rhinometry, respectively. All measurements before application of an END were compared with those 5 minutes after application. RESULTS: The subjective sensation of nasal respiration improved significantly after application of an END in both male and female. The END increased MCA and V5 significantly in both sexes. However, there were no significant correlations between changes in the subjective and objective parameters. CONCLUSION: ENDs offer an effective, nonsurgical therapeutic approach in the management of DNS by improving nasal respiration and by increasing MCA and nasal cavity volume. However, it should be kept in mind that this improvement in nasal patency does not always coincide with the improvement in subjective sensation of nasal respiration.