Counter Autografting of Dorsal Septum in Crooked Nose
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ORIGINAL ARTICLE
RHINOPLASTY
Counter Autografting of Dorsal Septum in Crooked Nose C ¸ ag˘layan Yag˘mur1 • Nuh Evin2 • Osman Kelahmetog˘lu3 • I˙smail Ku¨c¸u¨ker4 Enes Agah Kodalak5 • Ahmet Demir5
•
Received: 14 January 2020 / Accepted: 30 April 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Introduction The nasal septum plays an important role in nasal form and function. In this study, we describe a novel, alternative septoplasty approach that results in an aesthetically acceptable dorsal profile and improves airway function in patients with a crooked nose. Patients and Methods This study enrolled 26 patients who presented with crooked noses between 2012 and 2017. All patients underwent open rhinoplasty under general anesthesia. During correction of the cartilaginous part, a dorsal strip from the deviated septum was prepared and inverted in a 180° fashion to exert a counter-force to correct the remaining septum and fixed by suturation. This maneuver allowed application of the maximum possible force in the opposite direction to reset the deviation by its own force. Results The approach was used successfully in 26 patients with severe nasal septal deviations in the caudal septum and dorsal angulation of the nasal shape. There was no case of hematoma, synechia, septal perforation, dorsal irregularity, or saddle deformity. Temporary nasal obstruction occurred in 4 patients but improved in all of them by the & C¸ag˘layan Yag˘mur [email protected] 1
Caglayan Yagmur Aesthetic Surgery Clinic, Samsun, Turkey
2
Department of Plastic, Reconstructive, and Aesthetic Surgery, Ordu State Hospital, Ordu, Turkey
3
Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Bezm-I Alem Vakıf University, Istanbul, Turkey
4
Prive Clinic, Samsun, Turkey
5
Department of Plastic, Reconstructive, and Aesthetic Surgery, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
third postoperative month. One patient had a recurrence of the septal deviation, dorsal angulation, and persistent nasal obstruction, which were treated by revision nasal valve surgery 14 months postoperatively. There was no subsequent recurrence during the long-term follow-up. The improvement between the preoperative and postoperative 12-month deviation angle measurements, Nasal Obstruction and Septoplasty Effectiveness (NOSE) scores were significant (P \ 0.05), Improvement in the NOSE score correlated strongly and significantly with deviation angle changes and patient satisfaction. Conclusion Our counter-autografting technique in septoplasty is safe and effective in the correction of severe dorsal and/or caudal deviations, as long as the severely angulated cartilage septum remains in one piece after careful dissection. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the onli
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