A novel wedge technique to correct the curved deviation of the cartilaginous nasal septum.

OBJECTIVE: To introduce a novel wedge technique in endonasal septoplasty to correct the curved deviation of the cartilaginous septum and describe the surgical procedure and results.

METHODS: A retrospective analysis was performed on 17 patients who had septoplasty using the wedge technique to correct the curved deviation of their cartilaginous septum. A 2-2.5-cm-long wedge made of either septal cartilage or ethmoid/vomer bone was inserted through an incision located 1.5-2 cm caudal to the bony-cartilaginous junction near the dorsum. Materials used for the wedge, objective evaluation of the surgical results, subjective symptom improvement and surgical complications were investigated.

RESULTS: The degree of deviation was moderate to severe in all patients. Bony septum was used as the wedge material in 9 patients and septal cartilage in 8 patients. Among 17 patients, 15 had a completely straight septum while 2 had a minimal curvature remaining. Subjective symptoms of nasal obstruction evaluated by the Visual Analog Scale score and Nasal Obstructive Symptom Evaluation scale improved in all patients. In acoustic rhinometry, minimal cross-sectional area and nasal volume change showed some improvement without statistical significance. There were no major complications including saddle nose and revision surgery.

CONCLUSION: Our novel wedge technique can be an effective and safe technique to straighten the curved deviations of the cartilaginous septum in selected patients.