Septoplasty

The term refers to a septoplasty surgery to correct the deviated septum.

Anatomical bases

According to American Academy of Otolaryngology - Head and Neck Surgery 80 percent of people have a slightly shifted from the midline nasal septum. This mild form of Scheidewandverbiegung is usually asymptomatic and can therefore be considered as normal. A significant curvature, however, is often associated with airflow obstruction and is associated with hyperplasia of the nasal turbinates, because asymmetries of the nasal passage volume is compensated by the mussels. Nasenscheidewandverbiegungen can be congenital or caused by trauma.

Symptoms and consequences of deviated septum

Nasenscheidewandverbiegungen and accompanying turbinate hyperplasia can cause nasal congestion with sleep apnea and snoring, as well as co-morbidities such as sinusitis and pharyngitis. Also the occurrence of middle ear infections or smell disorders is favored by impaired nasal ventilation. Deflections in the nostril area sometimes have nosebleeds result, bony outgrowths with contact to the lateral nasal wall may cause headaches.

Diagnosis

For the diagnosis of Scheidewandverbiegung the external and internal inspection of the nose is usually sufficient, it is sometimes complemented by an endoscopy. X-rays are necessary only if in addition the sinuses are to be judged. The flow of air through the nose can be objectified with rhinomanometry. In symptomatic an olfactory testing can be done.

History of Septoplasty

From about 1900, the German physician Gustav Killian led by straightening the nasal septum in cocaine anesthesia. For more than 50 years, this was the standard operation for the treatment of nasal obstruction were removed radically in large areas of the bent nasal septum cartilage. Most also responsible for a respiratory disability bony nasal structures remained intact. The generous cartilage removal often led to an impairment of the nose stability and perforation of the nasal septum - and thus again to respiratory obstruction, the activities that should be treated. Because of these disadvantages, the radical Killian operation method is no longer used today and has been abandoned since the 1960s in favor of a tissue-conserving aligned septal surgery.

The end of the intervention

This modern functional nose surgery founded the American Maurice H. Cottle. The operation principle is based on not to resect bent cartilage structures of the nasal septum, but to straighten out by gentle processing and to leave to the support function in the nose. The bony structures of the nasal septum to be included in the correction.

After the procedure, an internal splinting of the nose is necessary to ensure a straight coalescence of the nasal septum and prevent bruising. This splint is usually with two plastic plates ( " splints " ) or made ​​with films that are sewn to both sides of the corrected nasal septum and stabilize them. The splints are about 50 mm long and 15 mm high, and give an idea of ​​the size of the nasal septum. After about 5-7 days, these supporting films are removed.