The Endoscopic Septal Spur Pushback Technique

Area of Science:

• Otolaryngology
• Surgical Innovation
• Endoscopic Procedures

Background:

• Septoplasty is a common otolaryngological procedure.
• Elevating mucosal flaps over complex septal spurs presents a significant surgical challenge due to thin, friable mucosa.
• Dissection tension increases the risk of iatrogenic mucosal injury and complications.

Purpose of the Study:

• To introduce and evaluate the septal spur pushback technique for managing complex septal spurs.
• To assess the efficacy of this endoscopic approach in minimizing mucosal tension and iatrogenic injury.
• To report the complication rates associated with the septal spur pushback technique.

Main Methods:

• A stepwise endoscopic approach was utilized for dissecting large and complex septal spurs.
• The technique leverages endoscopic visualization to reduce mucosal tension during dissection.
• Data from 493 consecutive patients undergoing the procedure were analyzed.

Main Results:

• The septal spur pushback technique resulted in a low rate of iatrogenic flap lacerations (3.0%, 15 out of 493 patients).
• All lacerations were small (<1 cm) and did not result in mucosal defects upon suturing.
• No post-operative haematomas or septal perforations were reported in the series.

Conclusions:

• The septal spur pushback technique is a safe and effective endoscopic method for dissecting complex septal spurs.
• This approach significantly reduces the incidence of iatrogenic mucosal lacerations and associated complications.
• The technique offers a valuable advancement in septoplasty for challenging septal deviations.