OBJECTIVES: Cross-hatching incisions have been considered mandatory for correcting cartilaginous septal deviation. We evaluated the clinical outcome of septoplasty without cross-hatching incisions to determine the necessity for making septal cartilage incisions. METHODS: The reconstructed septal components during septoplasty were categorized into four anatomical areas: vomer, maxillary crest, perpendicular plate of ethmoid (PPE) and septal cartilage (the area for cross-hatching incisions). During septoplasty, we attempted to complete the surgery only by removing or fracturing the bony part of the septum without cross-hatching incisions on the cartilage. Only in the cases that the deviation was not immediately corrected, the cross-hatching incisions were made onto the cartilage at the end of the procedure. We analyzed the frequency of manipulating the septal components. The changes of symptoms were evaluated using a modified nasal obstruction symptom evaluation (NOSE) scale and a visual analog scale (VAS) preoperatively, 1 and 3 months after the surgery. RESULTS: Seventy five percents of the deviated septums were immediately corrected only by removing or fracturing of the bony septal components. In decreasing order of frequency, the sepal components for correcting septal deviation were the vomer (59%), maxillary crest (49%), septal cartilage (cross-hatching only: 25%) and PPE (15%). The modified NOSE scale and the VAS demonstrated significant improvement of the nasal symptoms postoperatively (P<0.05). CONCLUSION: Most of septal deviations could be corrected by manipulating only the bony septum. The results of this procedure were not different from conventional septoplasty with cross-hatching incisions. Our data suggest cross-hatching incisions during septoplasty might have been overemphasized and that the main cause for cartilaginous deviation may be the extrinsic forces that are generated by the neighboring bony structures.
Cartilage ; Nasal Obstruction ; Nasal Septum ; Nose ; Symptom Assessment ; Vomer

OBJECTIVES: Cross-hatching incisions have been considered mandatory for correcting cartilaginous septal deviation. We evaluated the clinical outcome of septoplasty without cross-hatching incisions to determine the necessity for making septal cartilage incisions. METHODS: The reconstructed septal components during septoplasty were categorized into four anatomical areas: vomer, maxillary crest, perpendicular plate of ethmoid (PPE) and septal cartilage (the area for cross-hatching incisions). During septoplasty, we attempted to complete the surgery only by removing or fracturing the bony part of the septum without cross-hatching incisions on the cartilage. Only in the cases that the deviation was not immediately corrected, the cross-hatching incisions were made onto the cartilage at the end of the procedure. We analyzed the frequency of manipulating the septal components. The changes of symptoms were evaluated using a modified nasal obstruction symptom evaluation (NOSE) scale and a visual analog scale (VAS) preoperatively, 1 and 3 months after the surgery. RESULTS: Seventy five percents of the deviated septums were immediately corrected only by removing or fracturing of the bony septal components. In decreasing order of frequency, the sepal components for correcting septal deviation were the vomer (59%), maxillary crest (49%), septal cartilage (cross-hatching only: 25%) and PPE (15%). The modified NOSE scale and the VAS demonstrated significant improvement of the nasal symptoms postoperatively (P<0.05). CONCLUSION: Most of septal deviations could be corrected by manipulating only the bony septum. The results of this procedure were not different from conventional septoplasty with cross-hatching incisions. Our data suggest cross-hatching incisions during septoplasty might have been overemphasized and that the main cause for cartilaginous deviation may be the extrinsic forces that are generated by the neighboring bony structures.
Cartilage ; Nasal Obstruction ; Nasal Septum ; Nose ; Symptom Assessment ; Vomer

Defect or perforation of the nasal septum may arise from diverse causes such as trauma, infection, drug abuse, inhalant irritants and neoplasia. The septal defect or perforation is usually located at the anterior half of the nasal septum regardless of etiologic factors. However, posterior nasal septal defect is infrequent. Moreover, congenital vomer defect is very rare. Recently, we have experienced three cases of congenital vomer defect of the nasal septum detected during nasal endoscopy. We report these cases with review of literature.
Congenital Abnormalities ; Endoscopy ; Irritants ; Nasal Septum ; Substance-Related Disorders ; Vomer

BACKGROUND AND OBJECTIVES: The nasal septum, centrally located in the nasal cavity, has dynamic relations with other craniofacial structures and is also influenced by them during development. Moreover, the mosaic structure of the septum is constituted through ossification. The purpose of this study was to evaluate the anatomical characteristics of the deviated nasal septum with preoperative computed tomography (CT) and calculations during surgery. SUBJECTS AND METHOD: We studied 62 patients with nasal septal deviation on one side, who underwent septoplasty between July 2008 and February 2009. The area of the septal cartilage, vomer, and perpendicular plate of the ethmoid bone was calculated with sagittal imaging using preoperative CT. The angle of deviation was also measured with coronal imaging. The length between the anterior nasal spine and sphenoidal sinus and that of the sphenoidal process was measured during surgery. RESULTS: The deviation angle increased significantly with the length of the sphenoidal process (p<0.01). The area of the septal cartilage decreased with age due to the progression of ossification. CONCLUSION: Nasal septal deviation without a history of trauma is influenced by the progression of nasal septal ossification.
Bone Development ; Cartilage ; Ethmoid Bone ; Humans ; Nasal Cartilages ; Nasal Cavity ; Nasal Septum ; Spine ; Vomer

PURPOSE: To know the normal CT appearance of the anterior skull base and nasal septum after birth. MATERIALS AND METHODS: Coronal CT scans with a helical mode were performed from the nasal bone to the sphenoid sinus in 99 children whose ages ranged from 27 days to 14 years. We investigated the CT appearance of the developing anterior skull base and nasal septum with particular attention to the anteroposterior length of the anterior skull base and the ossification patterns of the cribriform plate, perpendicular plate, crista galli, and vomer. RESULTS: The anteroposterior length of the anterior skull base statistically significantly increased with age. The cribriform plate showed partial or complete ossification in at least one segment at more than 3 months of age and in all three segments at more than 6 months of age. Ossification of the cribriform plate occurred earlier in the middle segment than in the anterior and posterior segments. It began exclusively in the region of the lateral mass of the ethmoid and proceeded medially toward the crista galli. Partial ossification of the perpendicular plate was noted as early as 9 months of age, and complete ossification as early as 13 months of age. All children at 18 months and older showed at least partial ossification of the perpendicular plate. Partial ossification of the crista galli was noted as early as 27 days of age, and complete ossification as early as 3 months of age. CT showed complete ossification of the crista galli in all but two children at 6 months and older. The superior aspect of the vomer exhibited a V- or Y-shape on all CT scans in 66%(65/99) of children at any age. It appeared as an undivided single lump anteriorly and a V or Y posteriorly in 34%(34/99). CONCLUSION: Knowledge of the normal developing patterns of ossification of the anterior skull base and nasal septum could help prevent errors in interpreting CT scans in this region, especially in infants and young children.
Child ; Ethmoid Bone ; Humans ; Infant ; Nasal Bone ; Nasal Septum* ; Parturition ; Skull Base* ; Skull* ; Sphenoid Sinus ; Tomography, X-Ray Computed ; Vomer

Among the variety of local and systemic causative factors of nasal septal defects, the most frequent cause is the iatrogenic perforation found during septal surgery. We report a 10-year-old boy who showed a defect at the posteroinferior portion of the septum that appeared to coincide with the location of the vomer. He didn't have nasal surgery, any trauma, infectious disease or drug Abuse. These findings suggests that a developmental abnormality of the vomer taken place during the prenatal period may have resulted in a congenital defect of the vomer. To the best of our knowledge, this report is the first case of a congenital defect of the vomer reported in Korea.
Child ; Communicable Diseases ; Congenital Abnormalities* ; Humans ; Korea ; Male ; Nasal Septum ; Nasal Surgical Procedures ; Substance-Related Disorders ; Vomer*

Septochoanal polyp is a rare entity in the nasal septum. This type of polyp can extend into the choana to cause nasal obstruction and snoring, similar to the symptoms of an antrochoanal polyp. Septochoanal polyps may therefore be confused with antrochoanal polyps because of their similar appearances. The authors report a case of a seven-year-old boy who was diagnosed with a septochoanal polyp. The patient was successfully treated via an endoscopic surgical approach.
Humans ; Nasal Obstruction ; Nasal Septum ; Polyps ; Snoring

We studied whether the structure and size of nasal cavity around osteotomy site had an influence on the success rate of endoscopic endonasal dacryocystorhinostomy [DCR]. Endoscopic endonasal DCR was performed on 80 eyes of 72 patients who had obstruction of nasolacrimal system.We graded nasal cavity around osteotomy site according to the diameter of drill which could pass[grade I:7 mmdrill can pass, grade II:5 mmdrill can pass, grade III:3 mmdrill can pass, grade IV:3 mmdrill cannot pass].The primary success rate is 70%[56 eyes] and final success rate is 81.3%[65 eyes]after secondary operation was perfomed on 14 eyes of 24 failed eyes in primary operation.Primary success rate was 78.8%[41/52 eyes]and 53.6%[15/28 eyes]in grade I-II and grade III-IV, respectively.Final success rate was 86.5%[45/52 eyes]and 71.4%[20/28 eyes]in grade I-II and grade III-IV, respectively.The difference of success rates according to nasal cavity size is stastically significant[P<0.05] and the relation of nasal septum deviation to small nasal cavity is stastically significant[P<0.05].We found canalicular obstruciton in 5 of 14 eyes during secondary operation which was not found in primary speration, and it was suspected to have been caused by mechanical trauma to canalicular system during operation.
Dacryocystorhinostomy* ; Humans ; Nasal Cavity* ; Nasal Septum ; Osteotomy

Septoplasty is one of the most commonly performed operations in Otolaryngology. It is often considered an easy operation. Yet it is still accompanied by a relatively high rate of failure and complications. It is definitely not an operation in which one surgical technique can suffice for all circumstances. Rather it requires a variety of techniques in accordance to the various septal pathologies in order to achieve a favorable outcome. This study provides a comprehensive review of septoplasty including current concepts, historical background, classification, updated surgical techniques, and management of complications. In particular, the surgical techniques that ensure a successful correction and minimal complications are highlighted.
Dietary Sucrose ; Nasal Septum ; Otolaryngology

A retrospective study on 273 patients who suffer from vomer trauma were conducted at ENT from Jan 2001 to Dec 2003. The result showed that: the number of patients in the following year often higher in the previous year, most of them are Kinh ethnic. Most of patients who suffered from fracture on vomer operated within 10 days so the result are good, no after effect and complication later. The simple nose bone fracture is higher than multiple trauma, rate in males is 5 times higher than in females. The rate for female in 2003 is higher than in 2002. The number of patients in the provincial level hospitals is higher than in the urban level hospitals. Reason: highest is traffic accident, then fighting accidents and lowest is labor accident. The bone nose fracture caused by fighting in the following year is higher than previous year. In 2002, the traffic accident lessen significantly to compare with 2001 but in 2003, there is an increase of traffic accident cases.
Nasal Septum ; Wounds and Injuries ; Epidemiology