Reconstruction of caudal end of septum. A case for transplantation.

OBJECTIVE: To examine the results of complete removal and reconstruction of the caudal end of the septum with emphasis on long term success.

DESIGN: A case series reviewing the surgical outcome of 45 consecutive cases of transplantations for severely deformed of absent caudal ends of the septum. After at least 18 months, all 45 patients were given a postoperative evaluation.

SETTING: All procedures were performed at Mayo Clinic, Rochester, Minn.

PATIENTS: Forty-five patients (36 male and nine females) ranged in age from 7 to 78 years, with a mean age of 38 years. Twenty-seven patients had severe caudal end deformities, and 18 patients had absent or flaccid caudal end.

OUTCOME MEASURES: Subjective assessment included the opinion of the patient, rhinologic examination, and photographic analysis. Anterior mask rhinomanometry was performed to measure nasal resistance. Clinically noted complications were documented when present.

RESULTS: Subjectively, 36 (80%) of the 45 patients reported "normal" nasal breathing, and seven patients (15.6%) reported improved nasal breathing. Objective preoperative and postoperative rhinomanometry data, available in 28 cases, was related to the subjective findings. The longevity of the caudal end transplant was confirmed by reviewing the data from the 33 patients who were followed up more than 1 year. Ninety percent of the patients were free of complications.

CONCLUSION: Objective and subjective results showed excellent long-term results. The caudal end of the nasal septum can be removed safely and reconstructed.