Objective: There are several types of septal deviation, including
horizontal, vertical, C-shaped, S-shaped, and high deviation. One of the
most difficult of these types to correct is the crooked dorsal septum,
which attaches to the upper lateral cartilage and causes a high septal
deviation. We propose a method for horizontal dorsal resection of a
crooked septum using a mucosal through-and-through suture technique for
the correction of high septal deviation. Design and setting: The medical
records of 30 patients (27 men) who underwent septoplasty by one author
of this study from 2019 to 2020 at our institute were reviewed
prospectively. The median follow-up was 11 months (range, 4–16 months).
All patients underwent a horizontal dorsal septal cartilaginous
resection with mucosal through-and-through suture. Data were collected
on demographics, symptoms, anatomic site of deviation, and postoperative
complications. Patient self-satisfaction scores were subjectively graded
using a visual analog scale ranging from 0 (excellent) to 10 (poor).
Results: One surgeon performed each septoplasty using the same method; 2
(6.7%) patients underwent additional valvuloplasty. The median scores
in subjective satisfaction for the 30 patients were 8.4±1.22 before
surgery and 2.07±1.26 after surgery (p<0.05). Furthermore, no
patient experienced a saddle deformity, septal hematoma, septal
perforation, or loss of nasal tip support during follow-up. Conclusions:
After horizontal dorsal resection from the upper lateral cartilage
during septoplasty, the patients experienced no stability problems. This
suggests that this surgical technique is a safe and effective method for
correcting high deviation due to a crooked dorsal septum.
Horizontal dorsal resection of a crooked septum in septoplasty
