A signifi cant proportion of the population has nasal septal deviation of varying degrees. Recent reports of such deviation occurring at younger ages suggest a congenital etiology. To the best of our knowledge, no previous clinical studies have compared the septal deviation of adult and pediatric populations with a uniform measure that focuses on the degree of deviation. We retrospectively analyzed computed tomography (CT) and magnetic resonance imaging (MRI) scans obtained from 81 patients who had undergone head and neck imaging for a variety of reasons. Th ese subjects were divided into four age groups: younger than 4 months; 4 months to less than 5 years; 5 to 15 years; and more than 15 years. We used a measure of tortuosity to examine and compare nasal septal deviation among the diff erent age groups. Th e tortuosity of the septum was measured at four precise points along the length of the septum on thin-section sinus CT and MRI. Tortuosity was defi ned as the ratio of the "actual" length of the septum to the "ideal" length of the septum, which was defi ned as the length of a straight line drawn from the superior to the inferior aspect of the septum. We found that subjects younger than 5 years of age exhibited signifi cantly less tortuosity (p ≤ 0.017459) than did the older children and the adults. Th erefore, we conclude that nasal septal deviation occurs at a higher frequency in older children and in adults when calculations of tortuosity are used as a measure. Our data may suggest that a noncongenital etiology is responsible for nasal septal deviation. However, given that the growth of the septum continues throughout childhood, our results do not preclude the possibility of a genetic predisposition to the later development of a deviated nasal septum.
To determine the impact of interventions on the degree of warping of costal cartilage. Methods: The project was conducted at a large university animal research laboratory. The costal cartilage of eight 30-kg domestic pigs was harvested. The cartilage was cut into central and peripheral segments with a standard cutting die. Two sizes of rectangular cubes were compared. The central portions of costal cartilage were segmented and glued with octyl-2-cyanoacrylate. The shape of the cartilage was documented with both digital and film photography. The cartilage was placed into subdermal pockets on the dorsum of the pigs. The animals were killed at 4 weeks, and the cartilage was photographed. Adobe Photoshop software was used to measure the degree of warping. Statistical analysis was calculated by t test analysis. Results: A total of 115 rectangular costal cartilage blocks were treated. Large blocks warped less than small blocks (PϽ.02). Centrally cut blocks warped less than peripherally cut blocks (PϽ.03). The octyl-2-cyanoacrylate incited a significant sterile inflammatory response such that the blocks could not be accurately assessed for warpage. Conclusion: Costal cartilage can be effectively used for grafting in rhinoplasty with minimal warping if large grafts from the central portion of cartilage are used.
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