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Counter Autografting of Dorsal Septum in Crooked Nose

  • Original Article
  • Rhinoplasty
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Aesthetic Plastic Surgery Aims and scope Submit manuscript

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 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

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Acknowledgements

A report of this work was presented at National Congress of Turkish Society of Plastic Reconstructive and Aesthetic Surgery, Antalya, Turkey 2016.

Funding

The authors received no financial support for the research, authorship, and publication of this article.

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Authors and Affiliations

  1. Caglayan Yagmur Aesthetic Surgery Clinic, Samsun, Turkey

    Çağlayan Yağmur

  2. Department of Plastic, Reconstructive, and Aesthetic Surgery, Ordu State Hospital, Ordu, Turkey

    Nuh Evin

  3. Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Bezm-I Alem Vakıf University, Istanbul, Turkey

    Osman Kelahmetoğlu

  4. Prive Clinic, Samsun, Turkey

    İsmail Küçüker

  5. Department of Plastic, Reconstructive, and Aesthetic Surgery, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey

    Enes Agah Kodalak & Ahmet Demir

Authors
  1. Çağlayan Yağmur
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  2. Nuh Evin
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  3. Osman Kelahmetoğlu
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  4. İsmail Küçüker
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  5. Enes Agah Kodalak
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  6. Ahmet Demir
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Correspondence to Çağlayan Yağmur.

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The authors declare that they have no conflict of interest.

Ethical Approvals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This study has been reviewed and approved by institutional ethics committee.

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Informed consent was obtained from all individual participants included in the study.

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Yağmur, Ç., Evin, N., Kelahmetoğlu, O. et al. Counter Autografting of Dorsal Septum in Crooked Nose. Aesth Plast Surg 44, 1707–1715 (2020). https://doi.org/10.1007/s00266-020-01756-5

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  • DOI: https://doi.org/10.1007/s00266-020-01756-5

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