Surgical repair of the caudal end of the septum

Area of Science:

• Otolaryngology
• Plastic Surgery
• Rhinologic Surgery

Background:

• Correction of caudal septal deviation has historically posed surgical challenges.
• Previous techniques often left the caudal septum undisturbed, leading to persistent deformity.
• The caudal end is frequently the most prominent part of septal deviation.

Purpose of the Study:

• To describe a new surgical procedure for repairing the caudal end of a severely deviated septum.
• To address the limitations of historical septal surgery techniques.
• To provide a method for complete exposure and correction of caudal septal deformities.

Main Methods:

• Utilizes the maxilla-premaxillary approach for septal access.
• Employs a rhinoplasty laporotomy to expose upper lateral cartilages.
• Submucously uncovers and separates upper lateral cartilages from the septal cartilage.
• Removes a cartilage strip at the fracture line causing deflection.
• Reattaches the caudal septum to the mucoperichondrium and maxillary spine.
• Uses chromic cat gut sutures for fixation.
• Sutures upper lateral cartilages to the dorsal septum as a splint.

Main Results:

• Achieves complete exposure of the fracture line responsible for caudal septal deflection.
• Allows for secure repositioning and stabilization of the caudal septum.
• Upper lateral cartilages act as a splint to maintain septal alignment during healing.

Conclusions:

• The described maxilla-premaxillary approach offers an effective solution for severe caudal septal deviation.
• This technique provides improved exposure and fixation compared to historical methods.
• Successful repair leads to a stabilized and straightened caudal septum post-operatively.