Correction of nasal septum deviation
10.3760/cma.j.cn114453-20190228-00073
- VernacularTitle:鼻中隔偏曲的形态矫正
- Author:
Yanfeng ZHAO
1
;
Yuan HU
;
Dongchao GUO
;
Liping HU
Author Information
1. 上海玫瑰医疗美容医院 200070
- Keywords:
Nasal septum deviation;
Treatment;
Septoplasty
- From:
Chinese Journal of Plastic Surgery
2020;36(6):617-622
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the correction of nasal septum deviation.Methods:From August 2016 to August 2018, a total of 47 patients with nasal septum deviation were treated in Shanghai Mei-gui Medical Cosmetology Hospital, including 11 males and 36 females, aged from 18 to 43 years old, with an average age of 23 years old. After the L-shaped stent was retained during the operation, the nasal septum cartilage was cut off. Firstly, stress and volumetric correction of the dorsal deviation of nasal septum was done by nicked and grafted on the opposite side of the deviation of the nasal septum cartilage, then deviation of caudal of the nasal septum was corrected according to different cases.(1)CategoriesⅠ: The anterior nasal crest is centered. The posterior septum angle is attached to the anterior nasal crest. Caudal septum is arc curved to one side. The concave surface of the bent cartilage was scratched and a cartilage slat was placed on one side to form a unilateral splint and correct the bending.(2) CategoriesⅡ: The anterior nasal crest is centered. The posterior septum angle is attached to the anterior nasal crest and the nasal septum is tilted in a straight line in the forward direction. Volume correction was done by placing the graft forward from the anterior nasal crest on the opposite side of the caudal deflection to ensure that the anterior angle is centered.(3) CategoriesⅢ: The anterior nasal crest is centered. The posterior septum angle emerges from the anterior nasal crest and is tilted to one side. The nasal septum is curved or deviated in a straight line. The posterior angle was detached from the dislocation point and repositioned on the anterior nasal crest. The caudal length should be excised appropriately. Cartilage strengthening transplantation was performed according to the strength and deviating tendency of the caudal cartilage.(4) CategoriesⅣ: The anterior nasal crest is tilted to one side, and the posterior septum angle is connected to the misplaced anterior nasal crest, about 2 mm of cartilage remains above the anterior nasal crest. The anterior nasal crest is detached from the posterior end and repositioned toward the midline. When the displacement distance is large, small cartilage is filled in the gap between the broken ends. If the original anterior nasal crest is too prominent, it can be chiselled out. Then cartilage augmentation grafts were performed according to the strength and inclination of the caudal end. Postoperative effects were observed.Results:A total of 47 cases were included. 8 cases wereⅠ class, 13 cases were Ⅱ class, 5 cases were Ⅲ class and 21 cases were Ⅳ class. The average follow-up period was 3 months to 1 year. Deviation recurrence occurred within 1-3 months after surgery in 1 case of Ⅱ class and 2 case of Ⅳ class. The second adjustment half a year after operation was satisfactory. One side of the nasal cavity was obstructed postoperatively in one case of Ⅲ class. Examination revealed hypertrophy of the inferior turbinate on this side. Nasal congestion is relieved after correction of hypertrophy of inferior turbinate. The other 43 cases recovered well after operation. Dorsal of the nose and the tip and columellar are basically centered. Both nostrils are basically symmetrical, and no other complications occurred.Conclusions:According to different circumstances of dorsal and caudal deviation of the nasal septum L-shaped stent and carry out targeted correction , nasal deformity caused by nasal septum deviation can be effectively treated.
