CLOSED SEPTAL OSTEOTOMY

A technique is described that permits realignment of the bony septum ( perpendicular plate of the ethmoid, vomer, and vomerine ridge). It inv olves a closed fracture of the bones by means of a large, long nasal s peculum. Mere spreading of the septum fractures the bony septum, permi tting reasonable, midline realignment in most patients. Spreading with the speculum also infractures the turbinates in many instances and th ereby helps open up the airway even further. Of the 32 patients review ed, it was found that the perpendicular plate and vomer could be fract ured in 100% of patients, The vomerine ridge (premaxilla area), on the other hand, could only be fractured in 69%. Of the patients in whom f racture was possible, the bony septum was straightened dramatically in 82% of patients and improved greatly in 18% of patients.