Cutting and suture technique of the caudal septal cartilage for the management of caudal septal deviation

Yong Ju Jang, Nam-Kyung Yeo, Jong Hwan Wang
Archives of Otolaryngology—Head & Neck Surgery 2009, 135 (12): 1256-60

OBJECTIVES: To introduce the cutting and suture technique of the caudal L-strut for the management of caudal septal deviation and to evaluate its efficacy and surgical outcomes.

DESIGN: Retrospective study.

SETTING: Tertiary care rhinology clinic.

PATIENTS: Forty-five patients who underwent endonasal septoplasty using the cutting and suture technique of the caudal L-strut.

INTERVENTIONS: After elevation of the mucoperichondrial flap, deviated portions of cartilage and bone were excised, leaving at least a 1.5-cm strip of L-strut. If caudal septal deviation persisted, the caudal strut was cut at the convex-most part, and the cut ends were slightly overlapped and sutured together.

MAIN OUTCOME MEASURES: Improvement in the treatment of nasal obstruction using a visual analog scale and a questionnaire for subjective satisfaction were evaluated 2 to 6 months after septoplasty. To evaluate outcomes objectively, endoscopic photographs of the nasal cavity before and after surgery were evaluated by 2 independent surgeons.

RESULTS: Significant improvement in the treatment of nasal obstruction was achieved, with mean visual analog scale scores of 7.93 preoperatively and 3.63 postoperatively (P < .001). Subjective satisfaction was rated as much improved in 68% of patients, improved in 15%, and no change in 17%. Endoscopic examinations showed that 51% of patients had near-complete correction of the septum and that 47% had improved but a little persisting caudal deviation. One patient had no change in caudal septal deviation on endoscopic examination.

CONCLUSION: The cutting and suture technique of the caudal L-strut seems to be a useful technique that can be performed with relative ease and simplicity.

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