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Original Article |

Correction of Caudal Septal Deviation and Deformity Using Nasal Septal Bone Grafts

Judy W. Lee, MD; Shan R. Baker, MD
JAMA Facial Plast Surg. 2013;15(2):96. doi:10.1001/2013.jamafacial.73.
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Objectives  To describe our technique of using septal bone grafts for correction and stabilization of caudal septal deviation and to evaluate the effectiveness of this technique in the treatment of the deviated caudal septum.

Methods  A retrospective review of 81 patients who underwent open septorhinoplasty using septal bone grafts for correction of a caudal septal deviation or deformity and nasal obstruction. We reviewed medical records to determine postoperative outcomes in nasal obstruction and caudal septal position.

Results  Of the 81 patients, we included 66 with adequate follow-up information in the analysis. Follow-up duration ranged from 1 to 72 (mean, 8) months. Postoperative examination revealed a midline septum in 55 of the 66 patients (83%). Fifty-seven patients (86%) reported resolution of nasal obstruction; 49 (74%) had a midline septum and resolved nasal obstruction at the longest follow-up. Nine patients (14%) reported postoperative nasal obstruction, of whom only 3 required revision surgery.

Conclusion  Nasal septal bone grafts can be an effective tool in stabilizing severe cartilaginous deformities or deviations and correcting caudal septal deviation.

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Figures

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Figure 1. Configurations of the deviated or deformed caudal septum. A, The caudal septum can be straight but deviated from the midline, usually displaced from the maxillary crest. B, The C-shaped septal deformity in the vertical plane. C, The C-shaped septal deformity in the horizontal plane. D, The S-shaped septal deformity in the horizontal plane. E, The S-shaped septal deformity in the vertical plane.

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Figure 2. Septal bone grafts. A, Graft used to straighten deformities or deviations in the dorsal septum. B, Graft used to straighten the caudal septum. C, Graft used to straighten the anterior septal angle.

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Grahic Jump Location

Figure 3. Bone grafts used as splints to straighten caudal septum. A and B, Preoperative configuration. C, Scoring of the cartilage to straighten. D and E, Bone splint positioned on the left side. F, Second bone splint placed on the right side to assist with straightening.

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