Septoplasty. Rational surgery of the nasal septum

The Submucous Resection (S.M.R.) operation ascribed to Killian, still widely taught as the standard surgical treatment of obstructive septal deformities, has serious deficiencies in many common clinical situations. The reasons for this are critically discussed in the light of the surgical anatomy and physiology of the nose as a whole. The rational, conservative and versatile principle of septoplasty has evolved over half a century, until today the author considers that it should largely supersed the old S.M.R. The principles and the indications for septoplasty are discussed. The basic septoplasty procedure used by the author is described with practical details, together with all the variations and extensions possible as far as a complete septo-rhinoplasty. The importance is stressed of accurate assessment of the whole nasal problem and precise correction of all primary and secondary obstructive factors.