The impact of Metzembaum septoplasty on nasal and facial growth in children

“…Notably, a Van Peteghem et al investigation of cephalometric midface outcomes after FESS in pediatric patients with cystic fibrosis found no difference compared to healthy controls after 10 years of follow‐up . Similarly, Costa et al utilized cephalometric measures to assess potential impact of septoplasty on subsequent midfacial growth compared to normative data, finding no significant difference between groups …”

Section: Discussionmentioning

confidence: 99%

“…27,28 Although there have been concerns that iatrogenic damage to the nasal growth zones during endonasal surgery may impair midfacial growth in pediatric patients, [13][14][15][16] quantitative studies of pediatric patients undergoing functional endoscopic sinus surgery (FESS) and septoplasty have not demonstrated a discernable effect of these operations on midfacial growth, as measured through anthropometric and cephalometric analysis. 21,22,29,30 Notably, a Van Peteghem et al investigation of cephalometric midface outcomes after FESS in pediatric patients with cystic fibrosis found no difference compared to healthy controls after 10 years of followup. 21 Similarly, Costa et al utilized cephalometric measures to assess potential impact of septoplasty on subsequent midfacial growth compared to normative data, finding no significant difference between groups.…”

Section: Discussionmentioning

confidence: 99%

“…The endpoints of this study are cephalometric measurements using established radiologic landmarks as utilized previously by authors Green, Van Peteghem, and Costa. 18,21,22 We used the subspinale and not the anterior nasal spine to mark the anteriormost aspect of the palate to eliminate the risk that iatrogenic damage to the anterior nasal spine would affect postoperative measurements. 18 For each patient, measurements were taken from midsagittal sections of the baseline magnetic resonance imaging (MRI) as well as the most recent postoperative MRI.…”

Section: Data Collectionmentioning

confidence: 99%

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The impact of expanded endonasal skull base surgery on midfacial growth in pediatric patients

et al. 2019

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Objective Surgical resection of skull base tumors in children is increasingly accomplished through an expanded endonasal approach (EEA). We aim to evaluate the potential effect of the EEA on midfacial growth as a result of iatrogenic damage to nasal growth zones. Methods We performed a retrospective review of children undergoing craniopharyngioma resection via an open transcranial or EEA. Pre‐ and postoperative magnetic resonance imaging was evaluated for growth in four midfacial measurements based on established cephalometric landmarks: anterior midface height, posterior midface height, palatal length, and sella–nasion distance. Statistical analysis was conducted using a mixed‐effects linear regression model. Results Twenty‐two patients underwent an EEA (n = 12) or open transcranial approach (n = 10) for tumor resection with 3 years of imaging follow‐up. There was no difference in midfacial growth between groups for each measurement. Compared to the open group, patients undergoing EEA demonstrated relative anterior midface height growth of −0.42 mm (P = 0.880), posterior midface height growth of −0.44 mm (P = 0.839), palatal length growth of 0.35 mm (P = 0.894), and sella–nasion distance growth of −2.16 (P = 0.365). Conclusion We found no difference in midfacial growth measurements between patients undergoing craniopharyngioma resection via an EEA and the open transcranial route after 3 years of imaging follow‐up. Preliminary results on midfacial growth demonstrate that the EEA is a safe alternative to traditional transcranial approaches for the pediatric population. Further investigation with larger sample size and longer duration of follow‐up is warranted to more thoroughly investigate the long‐term implications of the EEA to the skull base. Level of Evidence 3 Laryngoscope, 130:338–342, 2020

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“…The second technique was resecting the lower border of the caudal L-strut septum from the nasal floor, removing the excessive strip on the lower margin of caudal septum, and repositioning the shortened caudal septum to the nasal spine in a manner similar to the Metzenbaum "swing door" technique. 18,19 We separated only one side of the nasal septal mucoperichondrium, whereas the opposite side and the upper lateral cartilage remained attached to the septal-dorsal L-strut, and we disconnected the septal-dorsal L-strut from the upper region of the ethmoid perpendicular plate via the tension-relaxing technique for strengthening. The connection of nasal bone and upper lateral cartilage was well retained.…”

Section: Surgical Techniquesmentioning

confidence: 99%