Functional septal surgery: computer simulated surgery

Septal surgery is one of the most commonly performed nasal surgeries. It aims at restoring nasal patency and symmetrical air passages. However classical surgery may narrow the originally wider side necessitating additional surgery at the level of the turbinates. This study was performed to demonstrate that properly targeted and tailored surgery with limited interference at the level of specific areas may not only be enough but it may also more efficacious than more extensive surgery. The coronal CT scans of 16 patients with septal deviation were transferred to a computer and the cross-sectional areas (CSA) of both passages calculated before and after various simulations of septal surgery. In 8/16 cases the more limited surgery resulted in a wider total CSA and also more symmetrical right and left passages. This is more physiological both in terms of function and subjective feeling by the patients. We suggest that for all patients planned to undergo septal surgery a pre-operative coronal CT should be studied and the surgery planned to achieve the most optimal result rather than remove indiscriminately all deviated elements.