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Updated: Dec 6, 2025
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Septoplasty by disarticulation
R Jankowski1, P Gallet2, D-T Nguyen3
1CHRU-Nancy, ORL et Chirurgie Cervico-Faciale, Hôpitaux de Brabois, Bâtiment Louis Mathieu, Allée du Morvan, 54600 Vandoeuvre les Nancy, France; EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations Cardio-Respiratoires et de la Motricité, Université de Lorraine, Faculté de Médecine de Nancy-Laboratoire de Physiologie, 9 Avenue de la Forêt de Haye, CS 50184, 54505 Vandoeuvre les Nancy, France; NGERE-UMR_S1256, Université de Lorraine, Inserm, NGERE, 54000 Nancy, France.
Abstract:
The difficulty of correcting nasal septum deformities using the classical Killian or Cottle techniques or derivatives has led in recent years to new suggestions such as extracorporeal septoplasty or various apposition grafts to counteract refractory deformity of the quadrangular cartilage. Naturally occurring septal deformities result from conflicts in growth between the quadrangular cartilage, perpendicular ethmoidal plate and vomer, which each have their own different evo-devo origin. Septoplasty by disarticulation consistently restores a level septum by completely resolving the growth conflicts. Conserving the quadrangular cartilage is essential for the stability of the nasal pyramid on condition that 1) the lateral flare of the superior edge of both the component septolateral cartilages that suspend it at the roof of the piriform orifice and 2) the height of its anterior edge are respected. The anterior edge is always high enough (except in case of fracture or malformation to project the retrolobular nasal dorsum in proportion to the height of the alar cartilage when it is repositioned on its natural premaxillary base.
