A Practical Classification of Septonasal Deviation and an Effective Guide to Septal Surgery

Abstract

To examine the effects of single-dose dexamethasone use on edema, ecchymosis, and intraoperative bleeding in rhinoplasty, a double-blind, randomized trial with placebo control was planned. A total of 55 consecutive patients were included in the study. The dexamethasone (10 mg) was given intravenously just before surgery (preoperative group, n=18) or at the end of surgery (postoperative group, n=20). In the placebo group, 17 patients received saline preoperatively or postoperatively. Intraoperative blood loss was recorded for each patient. Postoperative scoring of eyelid swelling and ecchymosis was begun after approximately 24 hours and lasted into postoperative day 9. Only for the first 2 days was the difference between steroid groups (preoperative and postoperative) and the placebo group statistically significant for a decrease in eyelid edema (p < 0.05). A statistically significant difference in upper eyelid ecchymosis for both preoperative and postoperative steroid groups versus the placebo group also existed in the first 2 days (p < 0.05). Preoperative or postoperative steroid administration had no influence on the ecchymosis of the lower eyelid. When the results of the preoperative and postoperative steroid groups were compared, no significant difference was detected between the two groups in either edema or ecchymosis. To determine whether steroid use shortened the recovery period, the days on which edema and ecchymosis reached a minimum level were compared among the groups; no statistically significant difference was found among them. Using single-dose dexamethasone preoperatively did not alter intraoperative blood loss. Use of single-dose dexamethasone (either preoperatively or postoperatively) in rhinoplasty has a significant effect in decreasing upper and lower eyelid edema and upper eyelid ecchymosis for the first 2 days when compared with a placebo group. However, the effect of dexamethasone was lost after the first 2 days, and its use did not shorten the recovery period.

The diagnosis and management of rhinitis: An updated practice parameter

“…The type of deviation varies, with the most common classifications septal tilt (40%), C-shaped anteroposterior deviation (32%), and S-shaped anteroposterior (9%). 972 Typically there is also unilateral compensatory turbinate hypertrophy on the side opposite the deviation, which may even be bilateral with an S-shaped deviation. The surgical procedures for correction of a deviated septum usually used are submucosal resection and septoplasty.…”

Frequency of the Preoperative Flaws and Commonly Required Maneuvers to Correct Them

“…Residual dorsal asymmetry is often the consequence of proper detection, inadequate anterior septoplasty, improper use of spreader grafts, failure to replace the dislodged posterocaudal septum, or failure to use the septal rotation suture. 16,17 Dorsal asymmetry can also be the result of ineffective nasal bone osteotomies. To control the nasal bones, medial, transverse percutaneous, and low-to-low lateral osteotomies were performed in 60 percent of the secondary rhinoplasties, whereas these osteotomies were carried out in 98 percent of primary rhinoplasties in our previous study.…”

The Use of Spreader Grafts in Primary Rhinoplasty

“…They adopt the unilateral placement of spreader grafts, stressing their importance in the correction of high deviations of the septum. [13][14][15][16][17] The purpose of this article is to describe 3 high-risk groups of patients potentially liable to postoperative complications after primary rhinoplasty. In these cases, the immediate use of spreader grafts prevents any problems from arising over time.…”