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Updated: Jun 6, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Engineering analysis of an unreported complication of septoplasty
Curtis Gaball1, Scott Lovald, Tariq Khraishi
1Department of Otolaryngology, Naval Medical Center San Diego, 34520 Bob Wilson Dr, Suite 200, San Diego, CA 92134-2200, USA.
Objectives:
To describe a cause of recurrent nasal obstructive symptoms after septoplasties including the creation of a sizable submucous window and to suggest treatments for this complication.
Methods:
Case report of a woman presenting with side-changing nasal dyspnea approximately 1 year after undergoing septoplasty and engineering analysis of nasal cavity airflow. We created a computer model of the airway, analyzed varying sizes of surgical defects, and optimized the geometry of the submucous window.
Results:
An optimum area of resection to maximize the area of cartilage and/or bone resected and to minimize deflection of the septal area of iatrogenic litheness is a rectangular shape approximately 44 mm long by 12 mm high in our model.
Conclusions:
A large submucous window can result in obstruction of nasal airflow after septoplasty owing to displacement of this compliant area with respiration under the forces described in the Bernoulli theorem. Treatment may include turbinate reduction and/or septal reconstruction.

