Septoplasty

SEPTOPLASTY
Clinical indications of septoplasty:
  • Deviation of the nasal septum with partial or complete unilateral or bilateral obstruction of airflow
  • Persistent or recurrent epistaxis
  • Evidence of sinusitis secondary to septal deviation
  • Headaches secondary to septal deviation and contact points
  • Anatomic obstruction that makes indicated sinus procedure difficult to perform efficiently
  • Obstructive sleep apnea
  • As an approach to transseptal transsphenoidal approach to pituitary fossa
Technique/ Procedure
  • Used as an alternative for Sub Mucosal Resection(SMR)
  • Tissue sparing procedure where septa' deviation is corrected by minimal resection of cartilage and bone
  • Freer's hemi transfixation incision on the concave side of the cartilage
  • Mucoperichondrial elevation is done on the side of incision and 3 tunnels are created
  • Anterior tunnel — exposure of quadrangular septal cartilage on the concave side
  • Inferior tunnel —anterior nasal spine and maxillary crest on both sides are exposed
  • Posterior tunnel — perpendicular plate of ethmoid and vomer are exposed

Exam Question
Clinical indications of septoplasty:
  • Deviation of the nasal septum with partial or complete unilateral or bilateral obstruction of airflow
  • Persistent or recurrent epistaxis
  • Evidence of sinusitis secondary to septal deviation
  • Headaches secondary to septal deviation and contact points
  • Anatomic obstruction that makes indicated sinus procedure difficult to perform efficiently
  • Obstructive sleep apnea
  • As an approach to transseptal transsphenoidal approach to pituitary fossa
Used as an alternative for Sub Mucosal Resection(SMR)
Tissue sparing procedure where septa' deviation is corrected by minimal resection of cartilage and bone

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