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Triangular excision and submucosal rejoining to correct horizontally folded caudal nasal septum.

Abstract

BACKGROUND

Surgical correction of severe caudal deviation of nasal septum using an endonasal approach is challenging for surgeons. Among cases of severe caudal septal deflection, fracture lines along the horizontal direction are occasionally encountered during the surgery. We devised a simple and efficient technique called "triangular excision and submucosal rejoining" to address this kind of deformity.

METHODS

A total of 9 patients with severe caudal septal deflection underwent "triangular excision and submucosal rejoining." After the removal of the deformed posteroinferior portion of the quadrangular cartilage, 2 incision lines were made on the remaining caudal septum, starting from a point at the most anterior portion of the fracture line and diverging posteriorly above and below the fracture line. After removing a triangular cartilaginous piece, the upper and lower remaining cartilage segments were approximated using a single or 2 simple interrupted sutures. Sutures exiting the mucosa were re-entered from the exit point so that all the sutures were buried underneath the mucosa while the mucosal flap was elevated only unilaterally.

RESULTS

This technique was effective in all cases. Septal batten grafts were applied in 3 patients, in whom the remaining quadrangular cartilage was weak and thin. One patient showed a mildly recurred septal deviation, but the nasal cavities remained patent with no symptoms. Serious complications such as dorsal saddling or tip ptosis did not occur in any cases.

CONCLUSION

"Triangular excision and submucosal rejoining" may be a safe and efficient septoplasty technique to correct a horizontally folded caudal septum.

Authors+Show Affiliations

Department of Otorhinolaryngology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.Department of Otorhinolaryngology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.Department of Otorhinolaryngology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.Department of Otorhinolaryngology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.Department of Otorhinolaryngology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.Department of Otorhinolaryngology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31442004

Citation

Jeon, Yung Jin, et al. "Triangular Excision and Submucosal Rejoining to Correct Horizontally Folded Caudal Nasal Septum." International Forum of Allergy & Rhinology, 2019.
Jeon YJ, Seo JH, Joo YH, et al. Triangular excision and submucosal rejoining to correct horizontally folded caudal nasal septum. Int Forum Allergy Rhinol. 2019.
Jeon, Y. J., Seo, J. H., Joo, Y. H., Cho, H. J., Jeon, S. Y., & Kim, S. W. (2019). Triangular excision and submucosal rejoining to correct horizontally folded caudal nasal septum. International Forum of Allergy & Rhinology, doi:10.1002/alr.22378.
Jeon YJ, et al. Triangular Excision and Submucosal Rejoining to Correct Horizontally Folded Caudal Nasal Septum. Int Forum Allergy Rhinol. 2019 Aug 23; PubMed PMID: 31442004.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Triangular excision and submucosal rejoining to correct horizontally folded caudal nasal septum. AU - Jeon,Yung Jin, AU - Seo,Jin Hyun, AU - Joo,Yeon-Hee, AU - Cho,Hyun-Jin, AU - Jeon,Sea-Yuong, AU - Kim,Sang-Wook, Y1 - 2019/08/23/ PY - 2019/04/04/received PY - 2019/06/20/revised PY - 2019/06/21/accepted PY - 2019/8/24/entrez KW - nasal cartilages KW - nasal septum KW - nose deformity KW - operative KW - septoplasty KW - surgical procedures JF - International forum of allergy & rhinology JO - Int Forum Allergy Rhinol N2 - BACKGROUND: Surgical correction of severe caudal deviation of nasal septum using an endonasal approach is challenging for surgeons. Among cases of severe caudal septal deflection, fracture lines along the horizontal direction are occasionally encountered during the surgery. We devised a simple and efficient technique called "triangular excision and submucosal rejoining" to address this kind of deformity. METHODS: A total of 9 patients with severe caudal septal deflection underwent "triangular excision and submucosal rejoining." After the removal of the deformed posteroinferior portion of the quadrangular cartilage, 2 incision lines were made on the remaining caudal septum, starting from a point at the most anterior portion of the fracture line and diverging posteriorly above and below the fracture line. After removing a triangular cartilaginous piece, the upper and lower remaining cartilage segments were approximated using a single or 2 simple interrupted sutures. Sutures exiting the mucosa were re-entered from the exit point so that all the sutures were buried underneath the mucosa while the mucosal flap was elevated only unilaterally. RESULTS: This technique was effective in all cases. Septal batten grafts were applied in 3 patients, in whom the remaining quadrangular cartilage was weak and thin. One patient showed a mildly recurred septal deviation, but the nasal cavities remained patent with no symptoms. Serious complications such as dorsal saddling or tip ptosis did not occur in any cases. CONCLUSION: "Triangular excision and submucosal rejoining" may be a safe and efficient septoplasty technique to correct a horizontally folded caudal septum. SN - 2042-6984 UR - https://www.unboundmedicine.com/medline/citation/31442004/Triangular_excision_and_submucosal_rejoining_to_correct_horizontally_folded_caudal_nasal_septum L2 - https://doi.org/10.1002/alr.22378 DB - PRIME DP - Unbound Medicine ER -