Correcting Deviations of the Lower Third of the Nose

2017 ◽  
Vol 33 (02) ◽  
pp. 157-161 ◽  
Author(s):  
Sami Moubayed ◽  
Sam Most
Keyword(s):  
Airway Obstruction ◽  
Nasal Septum ◽  
Suture Techniques ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Effective Technique ◽  
Deviated Nose ◽  
Extracorporeal Septoplasty ◽  
Functional Problems

AbstractBy convention, a “deviated nose” is one in which the lower third is asymmetric with regard to the midline. The lower third of the nose is composed of the lower cartilages, as well as the dorsal and caudal nasal septum. Not only does the deviated nose cause a cosmetic deformity that is often disconcerting for patients, but it may also be associated with functional problems. Airway obstruction may result from a narrowed internal nasal valve in the middle third or from a deviated caudal septum in the lower third. The most common deviation involves both the middle and lower thirds and often requires addressing the underlying dorsal and caudal septum. The most effective technique to correct this type of deviation is the principle of extracorporeal septoplasty, either the traditional or modified, such as the anterior septal reconstruction (ASR) technique combined with the clocking suture. An isolated middle third deviation may be treated with a camouflage graft or a unilateral spreader graft. An isolated lower third deviation involving the septum should be treated with ASR. When an isolated lower third deviation only involves the lower cartilages, it may be corrected using suture techniques, cartilage division techniques, or grafting.

scholarly journals Extracorporeal Septoplasty for anterior septal deviation and deviated nose

2020 ◽  
Vol 13 (2) ◽  
pp. 144-148
Author(s):  
Brihaspati Sigdel
Keyword(s):  
Nasal Obstruction ◽  
Nasal Septum ◽  
Septal Deviation ◽  
P Value ◽  
Deviated Nasal Septum ◽  
Deviated Nose ◽  
Extracorporeal Septoplasty ◽  
Airway Function ◽  
The Aesthetic ◽  
The Right

Background: Deviated nose and septum is challenging, which results in functional and cosmetic problems. It blocks the nose and makes person ugly. The classical septoplasty approach becomes unsuitable for such severe deviations. Extracorporeal septoplasty is a surgical technique for correcting a severely deviated nasal septum, which also corrects the aesthetic part of the nose. The objective of this study was to describe extracorporeal septoplasty for Deviated nose and anterior septal deviation. Methods: A prospective observational outcome study was done in patients with Deviated nose and anterior septal deviation who underwent extracorporeal septorhinoplasty. Preoperative and postoperative evaluation was performed using a photographs, computerized tomography (CT) scan, and Nasal obstruction symptoms evaluation scale. Results: A total of 38 consecutive patients were enrolled, out of which majority were male (24, 63.2%) with only 14 (36.8%) female. The ratio of male female was 1.7:1. All the subjects had deviated nasal septum. Among these, nose deviation was externally noticeable in 20 (52.6%) cases, whereas in remaining cases it was inconspicuous. There were 21(55.3%) patients where Nasal Septum was deviated to the right side followed by 17(44.7%) with left side deviation. There was a significant improvement in mean nasal obstruction symptoms evaluation postoperatively (71.2 versus 22.7 with p value equal to 0.01). According to the pre and postoperative photographs 17(44.7%) patients had good improvement, nine (23.6%) showed excellent improvement and the result was fair in six (15.7%) patients. Conclusions: Extracorporeal septoplasty is effective in improving both nasal airway function and aesthetics in patients with severe Nasal Septal deviation.  

scholarly journals The Deviated Nose and the Nasal Airway

1979 ◽  
Vol 72 (11) ◽  
pp. 848-851
Author(s):  
A G D Maran
Keyword(s):  
Airway Obstruction ◽  
Experimental Work ◽  
Septal Cartilage ◽  
Nasal Airway ◽  
Deviated Nose ◽  
Bony Segment ◽  
Submucous Resection ◽  
And Cartilage ◽  
Valve Area ◽  
Taking Care

The pathology of the deviated nose is discussed in relation to its bony and cartilaginous components. The importance of the interlocking stresses within the septal cartilage is pointed out especially with respect to continuing deformation after trauma. The methods of rhinometry are analysed and normal airflow through the nose is described. The effects on the nasal airway of a caudal dislocation of the septum, an angulation at the valve area, a high septal deflection and an excessively wide choana are discussed. In the treatment of a deviated bony segment the difficulties of medial and lateral osteotomies are described. The indications for a septoplasty are thought to be a dislocated caudal end, a tip deviation and an external lateral angulation. The submucous resection of the septum should be reserved for resolved haematoma and cartilage absorption. The importance of the patient's priorities in deciding what operation to do are pointed out. Finally the experimental work on the effect of cartilage and mucoperichondrium resection on nasal growth is reviewed. It is suggested that a child with a severe septal deflection and airway obstruction should be offered a septoplasty taking care not to damage the mucoperichondrium.

scholarly journals Functional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Maged Baher Naguib ◽  
Mohamed Rifaat Ahmed ◽  
Yasser Taha Madian ◽  
Tarek Mohamady Elnahriry ◽  
Wael Elshahat Eldeeb
Keyword(s):  
Nasal Obstruction ◽  
Operative Time ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Spreader Flap ◽  
The Mean ◽  
The Difference ◽  
A New Technique ◽  
Nasal Valve Collapse ◽  
Duration Of Operation

Abstract Background Following the reduction of the nasal hump to a desired level, spreader grafts are usually positioned to prevent the complication of nasal valve collapse. Auto-spreader flap is a new technique that gained more popularity recently and can be used as an alternative to spreader graft. This RCCT compared between both techniques aesthetically and functionally as well as the operative time. Results Forty patients, 17 males (42.5%) and 23 females (57.5%), were included. The mean duration of operation in auto-spreader flap was 11.8 ± 3.4 min, while it was 19.2 ± 3.2 min in spreader graft. The difference between the two procedures was statistically significant (P < 0.05). Functional assessment of nasal obstruction was done for all patients in both groups preoperative that was (75.6 ± 19.9) which showed marked improvement when re-evaluated 3 moths postoperatively (18.9 ± 14.7), and after 6 months NOSE scale was (29.1 ± 20.2). The overall aesthetic satisfaction was 62.5% (25 of 40) irrespective of the surgery done. Sixteen out of 20 patients in spreader group and 9 out of 20 in auto-spreader flap group. Conclusion Auto-spreader flap and spreader graft are very effective surgical procedure for treatment of nasal obstruction due to internal nasal valve dysfunction, but the auto-spreader flap had shorter operative time. However, spreader graft has a superior aesthetic outcome.

Significance of Inner Nasal Valve In Septoplasty

2021 ◽  
Vol 8 (1) ◽  
pp. 3-8
Author(s):  
Dr. Shraddha Subhash Bhoyar ◽  
Dr. Gajanan Mohniraj Kashid ◽  
Dr. Ashok Gaikwad ◽  
Dr. Siddharth Ashok Purohit ◽  
Dr. Amit Shekhar Gupta ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Symptomatic Improvement ◽  
Functional Improvement ◽  
Nasal Valve ◽  
Nasal Surgery ◽  
Spreader Graft ◽  
Persistent Symptoms ◽  
Septal Surgery ◽  
Valve Angle ◽  
Valve Area

Background: Nasal obstruction due to deviated septum is commonly treated with conventional septoplasty. This surgery however is inadequate in cases of compromised nasal valves and leads to persistent symptoms. Hence, we stressed the evaluation of nasal valves before septal surgery & studied the outcome of  the patients with valve area correction. Aim: To prove the significance of inner nasal valve in nasal surgery. Objective : To analyse the outcome of  Open septoplasty. Methodology:A  retrospective review of  our patients undergoing Open septoplasty was analysed from April 2016 to January 2021. The preoperative and post operative evaluations were calculated & statistically analysed. Results : A total of 400 patients underwent Open septoplasty. Out of which 392(98%) showed symptomatic improvement in breathing difficulty &   380(95%) were happy with the asthetic improvement.  Conclusion: Open septoplasty and Spreader grafts is best solution to improve Internal Nasal valve angle. Rim graft to improve external valve collapse. Spreader graft also gives asthetic & functional improvement

The nose and paranasal sinuses

2021 ◽  
pp. 455-496
Author(s):  
Daniel R. van Gijn ◽  
Jonathan Dunne
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Septum ◽  
Side Wall ◽  
Nasal Valve ◽  
Nasal Tip ◽  
Nasal Cartilages ◽  
Nasal Bones ◽  
External Nose ◽  
Nasal Side ◽  
Nose And Paranasal Sinuses

The external nose is pyramidal and consists of a bony cartilaginous framework. The root/radix is continuous with the forehead an inferiorly terminates at the nasal tip. The dorsum of the nose is formed by two lateral surfaces that converge in the midline. The cartilaginous structure of the nose is formed by paired upper (lateral) cartilages that contribute to the internal nasal valve with the nasal bones, and lower lateral cartilages, combined with additional minor nasal cartilages that surround the ala. The nasal septum relies upon anastomoses from five vessels: two from the ophthalmic, two from the maxillary and one from the facial. Collectively, they form Kieselbach’s plexus. The paranasal sinuses are the frontal, sphenoidal, ethmoidal and maxillary – located within the bones of the same name. They are paired structures lined with mucosa that is continuous with the lateral nasal side wall into which they drain, facilitating clearance of mucus by way of the mucociliary escalator.

A novel technique for spreader graft placement without dorsum resection during septoplasty

2015 ◽  
Vol 129 (10) ◽  
pp. 1025-1027 ◽  
Author(s):  
E Kaya ◽  
T Catli ◽  
H Soken ◽  
C Cingi
Keyword(s):  
Operation Time ◽  
Graft Material ◽  
Open Approach ◽  
Nasal Valve ◽  
Surgical Team ◽  
Spreader Graft ◽  
Graft Placement ◽  
Novel Technique ◽  
Novel Method ◽  
Valve Angle

AbstractObjective:This paper presents a novel method for spreader graft placement without dorsum resection in patients who have a deviated septum with a narrow internal nasal valve angle.Methods:A Killian incision was used for the endonasal septoplasty, and all spreader grafts were harvested from excised deviated septal cartilages. Procedures were conducted under general anaesthesia at the same centre by the same surgical team that performed the endonasal procedure. Successful placement of spreader grafts was achieved endonasally.Conclusion:Although the endonasal placement of spreader grafts seems to be more difficult than placement conducted by an open approach technique, an endonasal procedure has many advantages. Our technique provides surgeons with the opportunity to shorten operation time, obtain autologous septal graft material and secure the columellar architecture. Surgeons familiar with the classical (endonasal) septoplasty procedure can easily apply this technique to widen a narrow internal nasal valve angle, without corrupting nasal integrity.

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