Strategies for the Previously Operated Septum

Area of Science:

• Otolaryngology
• Surgical Innovation

Background:

• Standard septoplasty involves resecting quadrangular cartilage while preserving an L-strut for nasal structure.
• Nasal deviations can recur due to contractile forces acting on the L-strut, leading to flexure or torsion.
• Insufficient correction during initial septoplasty can also result in persistent or recurrent deviations.

Purpose of the Study:

• To explore methods for reducing septal deviation recurrence after septoplasty.
• To discuss techniques for managing L-strut deformities and posterior septal angle displacement.
• To evaluate extracorporeal septoplasty as an option for severe septal deformities.

Main Methods:

• Modification of the L-strut chondrotomy shape to mitigate contractile forces.
• Application of grafting techniques to correct L-strut deviations.
• Repositioning of the posterior septal angle when displaced from the anterior nasal spine.
• Consideration of extracorporeal septoplasty for complex cases.

Main Results:

• Modifying chondrotomy shape may reduce L-strut flexure and torsion.
• Grafting techniques offer solutions for existing L-strut deviations.
• Posterior septal angle repositioning addresses specific displacement issues.
• Extracorporeal septoplasty demonstrates efficacy in severe septal deformities.

Conclusions:

• Recurrence of septal deviation can be managed through targeted L-strut modifications and advanced techniques.
• Grafting and repositioning are crucial for addressing structural nasal issues post-septoplasty.
• Extracorporeal septoplasty provides a viable alternative for complex and severe nasal septal deformities.