Anterior Septal Reconstruction for Treatment of Severe Caudal Septal Deviation: Clinical Severity and Outcomes

• Published in: Otolaryngology-head and neck surgery 2015-07, Vol.153 (1), p.27-33
• Main Authors: Surowitz, Josh, Lee, Matthew K., Most, Sam P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Nasal Cartilages - transplantation; Nasal Obstruction - etiology; Nasal Obstruction - pathology; Nasal Obstruction - surgery; Nasal Septum - abnormalities; Nasal Septum - surgery; Retrospective Studies; Rhinoplasty - methods; Ribs - transplantation; Severity of Illness Index; Treatment Outcome; Young Adult
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599815582176

Objective To report the long-term efficacy of a modified extracorporeal septoplasty technique in the treatment of anterocaudal septal deviations. Study Design Case series with chart review. Setting Academic tertiary care medical center. Subjects and Methods Data were obtained by a retrospective review of patients treated by a single surgeon (S.P.M.) from December 2010 to April 2014. A total of 77 patients (52 male, 25 female) met inclusion criteria. The Nasal Obstruction Septoplasty Effectiveness (NOSE) scale and a visual analog scale (VAS) were administered to all patients preoperatively and at each postoperative visit. Statistical analysis was performed using a matched-pair t test comparing preoperative and postoperative NOSE and VAS scores. A recently described severity scale for nasal obstruction was applied to NOSE scores to demonstrate postoperative results. Results Average follow-up was 4.7 months. Average preoperative NOSE and VAS scores were 68.2 ± 17.4 and 7.2 ± 1.8, respectively, placing these patients in the “severe” symptoms classification. Average NOSE and VAS scores in the early postoperative period (1-3 months after surgery) were 21.1 ± 19.8 (P < .0001) and 2.1 ± 2.6 (P < .0001), respectively. Average NOSE and VAS scores in the late postoperative period (>3 months after surgery) were 15.8 ± 19.0 (P < .0001) and 1.4 ± 1.8 (P < .0001), respectively. Both early and late postoperative NOSE scores represented “mild” symptomatology. Conclusions Anterior septal reconstruction represents a powerful method for correction of nasal valve stenosis resulting from severe anterocaudal septal deviations.