Septal Cartilage Traction Suture Technique for Correction of Caudal Septal Deviation

Abstract

Objective: Correction of the caudal septum deviation is the most difficult part of the septoplasty and a common cause of revision septoplasty. The purpose of this study was to present authors' preliminary results in the treatment of patients with caudal septal deviation using the septal cartilage traction suture technique. Study Design: Prospective, single center, observational study. Materials and Methods: Sixty-seven patients with a caudal septal deviation underwent septal cartilage traction suture technique with endonasal septoplasty. After removal of excessive caudal cartilage, the caudal L-strut was sutured at two or more points using 5-0 Vicryl on the modified Killian incision site. Subjective outcomes using visual analog scales (VAS) and Nasal Obstruction Symptom Evaluation (NOSE) scale, objective endoscopic examination, and acoustic rhinometry data were assessed. Results: There was significant symptomatic improvement in the VAS and NOSE scale at 1, 3, and 6 months postsurgery. Complete correction in the endoscopy was observed in the 91.0% of patients at 3 months postsurgery. The results of acoustic rhinometry increased from 0.3 and 4.3 preoperatively to 0.7 and 7.7 at 3 months postoperatively. Furthermore, no patient experienced septal hematoma, septal perforation, and loss of nasal tip support at 6 months follow-up. Conclusions: The septal cartilage traction suture technique obtained significant improvement in subjective and objective outcomes in patients with caudal septal deviation. This technique is a simple, safe, and effective method to treat caudal septal deviation.

Long-term efficacy and safety of 3D printed implant in patients with nasal septal deformities

“…Surgical treatment of nasal obstruction is commonly performed worldwide [21], and the correction of a severely deviated nasal caudal septum is one of the most challenging issues in septoplasty [22]. Although various traction suture techniques and columellar struts have been reported for correcting caudal septum deviation [23][24][25][26], septal batten graft reconstruction using autologous bone or cartilage is a popular method [27][28][29]. Few cases have straight septal bone or cartilage, with only the caudal septum severely deviated.…”

A novel surgical technique to correct caudal and high dorsal septal deviations: L‐shape cutting and suturing on the septal L‐strut (L‐septoplasty)

“…In general, deviation of the L‐strut of the nasal septum is more challenging to correct than the middle and has less favorable results 2 . There are various techniques to correct the L‐strut, but there is no clear choice 3‐15 …”

“… 2 There are various techniques to correct the L‐strut, but there is no clear choice. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 …”

Perception of Caudal Septal Dislocation and Practices of Otolaryngologists in Saudi Arabia

“…Caudal septal deviation constitutes 8% of patients with nasal septal deviation [4,5]. Many causes of caudal septal deviations have been addressed in the literature and can be classified as either traumatic or iatrogenic.…”

“…The challenges of correcting caudal septal deviations are undeniable [8,9]. This attributable to the unique property of the nasal intrinsic cartilage memory [5].…”