Open Technique Septoplasty For Treatment of Severe Anterior Septal Dislocation

Severe Anterior Septal Deviation

Caudal septal dislocation


Severe anterior septal deviation is the type of nasal septum deviation that can cause the most problems in aesthetics. In this case, only removal and resection of curved cartilage areas are not sufficient for treatment. Dislocation of the most important part of the nasal detective, the anterior septum or the caudal septum, to one side is usually due to traumatic reasons. In the treatment of classical closed technique septoplasty operation; open technique septoplasty operation, the nasal type of cartilage support is intended to be re-established. The commonly performed submucous resection technique is not a suitable to fixing the severe anterior septal deviation. Anterior nasal septum deviations or caudal septal dislocations, despite not being the most common type of nasal septum deviation, cause much complaint, both obstructive as well as cosmetic to the nasal tip.

Usually, after severe blows to the tip of the nose, the caudal septum dislocates to the right or left. When you touch the columella region with your index finger and press upwards or lift the tip of the nose upwards, the dilated septum region in the caudal region can be easily understood. Patients often have asymmetry in the nostrils.

In patients with severe anterior septal deviation, after removal of the curved septum cartilage, the nasal tip upoort should be reconstructed by placing a proper cartilage grafts.

Causes of Anterior Septal Dislocation

Several factors can lead to anterior septal dislocation:

• Trauma: A significant blow to the nose, such as from a sports injury, accident, or physical altercation, is the most common cause.
• Congenital Issues: Some individuals may be born with a deviated septum due to developmental abnormalities.
• Previous Surgery: Complications from prior nasal surgeries can result in dislocation of the septum.
• Chronic Inflammation: Conditions like chronic infection or inflammation can weaken the nasal structures over time, potentially leading to dislocation.

Symptoms of Anterior Septal Dislocation

The symptoms of anterior septal dislocation can vary in severity and may include:

• Nasal Obstruction: Difficulty breathing through one or both nostrils.
• Snoring: Increased airway resistance can lead to snoring and sleep disturbances.
• Nasal Congestion: Persistent feeling of congestion not relieved by typical decongestants.
• Epistaxis: Frequent nosebleeds due to the exposed and irritated nasal mucosa.
• Facial Pain: Discomfort or pain around the nasal area, especially when the nose is touched.

Diagnosisof Anterior Septal Dislocation

Diagnosing anterior septal dislocation involves a thorough examination by an otolaryngologist (ENT specialist). The process typically includes:

• Medical History: Discussing symptoms, previous injuries, and any prior nasal surgeries.
• Physical Examination: Inspecting the nose externally and internally using a nasal speculum.
• Endoscopy: Using a nasal endoscope to get a detailed view of the nasal passages and septum.
• Imaging: In some cases, CT scans or X-rays may be necessary to assess the extent of the dislocation and any associated abnormalities.





Surgical techniques for treatment of severe anterior septal deviation >>

• Septal replacement (source link: Septal replacement for severe anterior septal deviation)
• The maxilla-premaxilla technique (source link: Surgical treatment of anterior septal deviations)
• Modified extracorporeal septoplasty technique (source link: Anterior Septal Reconstruction)
• Two-level septocolumellar suture technique (source link: Two-level septocolumellar suture technique for correction of septal caudal dislocation)
• Modified mattress suture technique (source link: Modified Mattress Suture Technique to Correct Anterior Septal Deviation)
• Caudal septoplasty  (source link: Caudal septoplasty: efficacy of a surgical technique-preliminnary report)
• Swinging door technique (source link: Replacement of the lower end of the dislocated septal cartilage versus submucous resection of the dislocated end of the septal cartilage)

Apart from these techniques, there are different techniques that can be modified or combined in different ways. I usually prefer to have a "nose tip plasty" operation with open technique septoplasty operation.



In the photo above, the nasal photographs of the patient with caudal septum dislocation are seen before and after the operation.

In the photograph above, it is seen that the caudal part of the nasal septum is dislocated into the right nostril (yellow arrows) and after the open technique type plasty - caudal septoplasty operation, the part inside the right nostril is treated. The patient underwent a single operation at the same time for both nasal congestion and nasal deformity complaints.

Open Technique Septoplasty + Nose Tip Lifting Operation in Men Video

 

 

Similar links >>

• Open Technique Septoplasty + Nose Tip Lifting Operation in Istanbul ...
• Septoplasty Operation in Istanbul

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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