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Subtotal septal reconstruction: an update.

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Summary
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Subtotal septal reconstruction addresses severe nasal septum deviations using cartilage grafts. This complex surgical technique aims to restore nasal structure and function, requiring meticulous attention to detail to avoid complications.

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Rhinology

Background:

  • Severe septal deviations often require complex surgical repair.
  • Traditional methods may be insufficient for significant septal deformities, including fractures of the L-strut.

Purpose of the Study:

  • To describe the surgical technique of subtotal septal reconstruction for severe nasal septal deviations.
  • To outline indications, methods, and potential complications associated with this procedure.

Main Methods:

  • Subtotal septal reconstruction involves removing deviated segments and reconstructing the septum with autologous cartilage.
  • Key steps include replacing the caudal septum, fixating spreader grafts to the dorsal strut, and reconstituting the L-strut.

Main Results:

  • This technique is indicated for patients with septal fractures affecting the caudal or dorsal L-strut segments.
  • Careful management of nasal length, projection, rotation, and supratip break is crucial for successful outcomes.

Conclusions:

  • Subtotal septal reconstruction is a viable option for complex septal deformities like deviated nose or saddle nose.
  • Meticulous surgical technique is essential to prevent functional and aesthetic complications, such as upper lip deformities during smiling.