Revision and Reconstructive Septoplasty

Choi, Ji Yun

Abstract

Nasal airway obstruction is one of the most common chronic complaints of patients seen in the day-today practice of the general otolaryngologist. While a variety of potential etiologies, both structural and nonstructural, must be considered when evaluating these patients, a deviated nasal septum is identified as the root source of unilateral or bilateral nasal obstruction in many. In the present study, we investigated the causes that underlie various problems in the revision septoplasty and reviewed treatment procedures. A total of 41 patients who had revision septoplasty due to nasal obstruction were studied retrospectively. Weakening of septal cartilage was observed in most cases during revision septoplasty. Excessive resection and scoring can cause weakening of septal cartilage and deviation. Various surgical procedures such as swing door technique, batten graft, caudal septal reconstruction, extracorporeal septoplasty and spreader graft were performed for the patients. Making a complete and correct diagnosis of the persistent obstruction is very important. Open approach and bilateral dissection gives excellent visualization and release external forces. Surgeons should be familiar with septal reconstruction and reinforcement for revision septoplasty. This will help to ensure a complete understanding of septal dynamics and, consequently, appropriate and effective surgical intervention.