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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2007 September;57(3):113-9
Extracorporeal septoplasty. Our experience in more than 2500 cases
Gubisch W. 1, Sinha V. 2
1 Department of Facial Plastic Surgery Marienhospital Stuttgart, Germany
2 Department of Otorhinolaryngology and Head and Neck Surgery BJ Medical College (Gujarat Univercity) Civil Hospital, Ahmedabad,India
Aim. Septoplasty is one of the most common procedures in the ENTfield, but even today the difficult septum presents a surgical problem. A severe septum deformity is caused mostly by an accident or is seen in patients with malformation such as cleft lip and palate deformity. It influences not only function, but form too. It is characterised by severe deformation in all levels which consecutive blocking of one or both airways. Such severe septal deformities can not be corrected properly by standard septoplasty techniques.
Methods. In such cases we recommend an extracorporeal septoplasty, which we described first in 1984. The whole septum is taken out, the bony and the cartilaginous one and a new septal plate is reconstructed by different techniques, followed by reinsertion and reconstruction of the cartilagenous dorsum. From January 1, 1981 to June 31, 2007, a total of 2554 patients were operated with this technique at the Department of Facial Plastic Surgery of the Marienhospital, Stuttgart, Germany. During that period the first author kept on improving this technique constantly, focusing on a safe septal fixation and rebuilding of cartilaginous dorsum.
Results. Follow-up showed that even in severe deformities a revision rate of only 5% and 7%, respectively, were observed.
Conclusion. Therefore the extracorporeal septoplasty is recommended for all types of severe septal deformities, even for less experienced rhinosurgeons.