How to resolve the caudal septal deviation? Clinical outcomes after septoplasty with bony batten grafting.

OBJECTIVES/HYPOTHESIS: Caudal septal deviation interrupts normal nasal breathing, due to the narrowing of the external valve area and nasal valve angle. In this study, we found a different approach for correction of caudal septal deviation with no associated deformity of the external nose.

STUDY DESIGN: Individual case-control study.

METHODS: The 39 patients completed questionnaires by interviews postoperatively for assessment of nasal obstruction. In addition, patients assessed the severity of their nasal symptoms (i.e., mouth breathing, mouth dryness, hyposmia, rhinorrhea, epistaxis, snoring, postnasal drip, and headache) preoperatively and postoperatively using a visual analog scale (VAS). Improvement in the treatment of nasal obstruction using a VAS and a questionnaire for subjective satisfaction were evaluated 3 months after septoplasty. To evaluate outcomes objectively, endoscopic photographs of the nasal cavity and acoustic rhinometry before and after surgery were evaluated. For comparison between preoperative and postoperative status, the Wilcoxon signed ranks test was used.

RESULTS: Patients reported a significant decrease in the VAS severity of all nasal symptoms. The minimal cross-sectional area (MCA1) of the convex side after vascular constriction using acoustic rhinometry showed significant widening. Patients were divided into a turbinoplasty group and a nonturbinoplasty group, and the turbinoplasty group showed a significant increase in both the convex side and concave side in MCA1 and in the convex side in the anterior portion of the inferior turbinate.

CONCLUSIONS: Endonasal septoplasty using bony batten grafting for caudal septal deviation resulted in an improvement of nasal obstruction symptoms and acoustic rhinometry components.