B. Guyuron et al., A practical classification of septonasal deviation and an effective guide to septal surgery, PLAS R SURG, 104(7), 1999, pp. 2202-2209
The conventional designation of septal pathology is a deviated septum, and
the common treatment of choice is submucous resection of the septum. These
limited generic terms leave the surgery open to frequent failure and render
the education of this topic suboptimal. During 1224 septal surgeries, we h
ave observed six different categories of septal deviation requiring differe
nt surgical treatments. A study was conducted to investigate the frequency
of different classes of septal deviation and to develop guidelines for a mo
re successful surgical correction of each category.
Ninety-three consecutive patients who underwent septoplasty were carefully
evaluated for the type of septal deformity, age, gender, history of trauma,
and previous septal surgery. The surgical technique was reviewed for each
category of the septal deformity.
Of the 93 patients, 71 were women and 22 were men. Ages ranged from 13 to 7
6, with an average age of 31.5. Most patients exhibited a "septal tilt" def
ormity (40 percent; 37 of 93) or a C-shape anteroposterior deviation (32 pe
rcent; 30 of 93). The other deformities were C-shape cephalocaudal (4 perce
nt; 4 of 93), S-shape anteroposterior (9 percent; 8 of 93), S-shape cephalo
caudal (1 percent; 1 of 93), or localized deviations or large spurs (14 per
cent; 13 of 93).
Each of the six categories of septal deviation requires specific management
. If a single procedure is selected for all of the septal deformities, disa
ppointing results may ensue.