| Endoscopic Septoplasty
Pastorek and Becker described a modified swinging-door technique for treatment of the caudal septum.13 The septal cartilage along the maxillary crest is dissected free but not excised. Instead, the caudal septum is flipped over the nasal spine, which acts as a "doorstop" and secures the caudal septum in a straighter position (Figure 5). Endoscopically guided septoplasty (Figure 6) is useful in difficult revision nasal surgeries in which obstructing septal deviation persists. Indications for endoscopic septoplasty include an isolated septal deformity, or a posterior septal deformity in a patient with densely adherent septal mucosal flaps, typically found in cases of revision septoplasty.
If septal deviation persists posteriorly after a septo‑plasty, persisting nasal obstruction may require revision septoplasty. Because the mucosal flaps are often densely adherent after a septoplasty, revision septoplasty involving a traditional approach may present technical difficulty, including significant risk of septal perforation. Endoscopic septoplasty is a relatively recent and important technique.
Figure 8. In a patient with a deviated septum, return of the septum to midline by means of septoplasty may actually diminish the airway on the side of a hypertrophied middle turbinate. Partial middle turbinectomy may be indicated in this situation. [Previous] [Continue]
Ask Dr. Becker a question or arrange an appointment for a nose
surgery consultation by calling 856-589-NOSE (6673) or emailing us
at info@therhinoplastycenter.com.
NOTE: CLICK HERE for information regarding privacy of your medical information. Additionally, all website users must agree to the terms and conditions of this site. Please CLICK HERE to review terms of use. |
