The Use of Spreader Grafts in Revision Septoplasty

Persistent nasal obstruction at internal nasal valve was a common problem seen after septoplasty and submucous resection, the 2 methods used for surgical treatment for deviation of nasal septum during the first half of twentieth century. The authors performed cartilage-grafting technique and retrospectively analyzed the patients after 12 months with Nasal Obstruction and Septoplasty Effectiveness scale to emphasize persistent nasal obstruction.

In this study, 115 (65 male, 50 female) patients operated between 2008 and 2013 who underwent revision septoplasty and complaints were evaluated with Nasal Obstruction and Septoplasty Effectiveness scale. The surgical technique was used in 32 (27.8%) of the patients "open" and in 83 (72.2%) "closed" approach. Wilcoxon sign test is used for the statistical analysis. Postoperative values were statistically significant compared with preoperative ones (P <0.05).

Septoplasty and submucous resection described by Cottle and Killian are similar techniques, but a septoplasty often includes less cartilage resection and septal cartilage modification or placement of a cartilage graft instead of resection. Most important disadvantage of these techniques is to be deficient in the correction of the caudal and/or dorsal deviations. In authors' experience these classical septoplasty techniques are not suitable for columellar and dorsal deviations and especially in revision surgery an internal nasal valve correction with cartilage grafts is a necessary alternative technique.