Objective evaluation of caudal deviation of the nasal septum and selection of the appropriate septoplasty technique.

Auris Nasus Larynx

Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.

Published: February 2022

AI Article Synopsis

  • The study compares the effectiveness of open septorhinoplasty (OSR) versus septoplasty with a Killian incision (KI) in correcting caudal deviation of the nasal septum, using CT scans for measurement.
  • Results showed that OSR significantly improved both nasal airway resistance and patient-reported nasal obstruction symptoms, while KI did not.
  • The findings suggest that OSR is a more effective method for correcting caudal deviation than KI, highlighting the importance of evaluating nasal septum deviation through objective metrics like the anterior-posterior position.

Article Abstract

Objective: Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans.

Methods: We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined.

Results: The AP was significantly correlated with the VAS score (r=-0.58, p=0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14±0.06 to 0.03±0.03, p=0.004), but not by KI (0.09±0.08 to 0.04±0.03, p=0.25). OSR also improved nasal airway resistance (1.10±0.44 to 0.42±0.15, p=0.02), and the VAS score (79.11±14.74 to 5.78±7.89, p=0.004).

Conclusion: Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique.

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http://dx.doi.org/10.1016/j.anl.2021.04.012DOI Listing

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