[Secondary operations for the treatment of nasal septum deformities]

The objective of the present retrospective study was to improve the methods of secondary surgical intervention for the treatment of nasal septum (NS) deformations and evaluate their immediate outcomes. A series of 56 re-operations on NS is represented. Two main approaches to the treatment of secondary deformation were applied: repeated septoplasty with autocartilage and bone re-implantation and tissue-preserving endoscopic submucous resection of deviated septal portions. Endoscopic studies, CT of the nasal cavity and paranasal sinuses, anterior active rhinomanometry, and acoustic rhinometry were used to clarify the character of deformation and to objectively assess the resulting disorders of nasal breathing. The differential approach to the choice of the surgical correction strategy made it possible to restore nasal breathing in all 40 patients followed up during 3 months after re-operation. The results of anterior active rhinomanometry indicate that the mean total volumetric flow increased after the secondary treatment from the initial value of 467.7±89.1cm3/s to 901.1±115.4 cm3/s within the following three months. The cases of postoperative perforation or the development of other possible complications were not documented.