Total Septal Cartilage Reconstruction in the Severely Deviated Nose

ABSTRACT

BACKGROUND AND OBJECTIVES: Surgical correction of the severe septal deviation associated with the twisted nose is a difficult surgical challenge. Many maneuvers have been devised to correct and maintain correction of a severely deviated nose, especially a deviated caudal septum or a dorsally deviated L-shaped strut. But few of these reported techniques have corrected and maintained correction satisfactorily. Total septal cartilage reconstruction is a technique by extramucosal excision of the cartilaginous septum (total harvest of deviated septum) and replacement as a free graft (reinsertion of surgically straighten septum). We evaluated the validity of total septal cartilage reconstruction with regard to functional results as well as aesthetic results. MATERIALS AND METHODS: This retrospective study reviewed the patients' records in case of total septal cartilage reconstruction for a severely deviated nose. Information included the patient's age, sex, pre/postoperative gross view, pre/postoperative acoustic rhinometry, and subjective satisfaction rate as well as complications. Ten patients underwent total septal cartilage reconstruction from 1996 to 1999. Their age ranged from 17 to 46 years. 8 patients were men and 2 patients were women. RESULTS: All patients noted marked improvement of nasal blockade. Aesthetic improvement of the nose was obtained in all patients. No infections, hematoma, graft extrusions, saddle nose deformity, or distortion occurred in this series. CONCLUSION: Total septal cartilage reconstruction is a good technique suitable for those patients in whom severe obstruction, especially high in the vault in combination with severe deviation of the external nose so that more conservative techniques are insufficient to achieve the desired results.