Dorsocaudal reconstruction of previous caudal septal resections with partial split spreader graft: Septal reconstruction with partial split spreader graft

Can Ekinci; Bilgen Can; Atacan Emre Koçman

doi:10.28982/josam.1115725

Authors

Can Ekinci Department of Plastic, Reconstructive and Aesthetic Surgery, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey https://orcid.org/0000-0002-5200-3305
Bilgen Can Department of Plastic, Reconstructive and Aesthetic Surgery, Balıkesir University School of Medicine, Balıkesir, Turkey https://orcid.org/0000-0001-7354-4015
Atacan Emre Koçman Private Practice, Barbaros, Hoca Ahmet Yesevi Cd. No: 149, 34203 Bağcılar/İstanbul, Turkey https://orcid.org/0000-0001-8196-1142

DOI:

https://doi.org/10.28982/josam.1115725

Keywords:

Partial-split, Spreader grafts, Reconstruction of dorsocaudal septum, Nasal tip deprojection, Deprojection of dorsum

Abstract

Background/Aim: Nasal obstruction is caused mainly by nasal septal deviation, and submucosal resection is usually performed to treat this problem. However, if over-resected, nasal tip deprojection, deprojection of the dorsum, or pseudo-hump formation may be seen. Spreader grafts are used to restore the nasal septum in these cases, and different techniques have been described for this restoration; however, these techniques may not be the best fit for such restoration. This study presents a novel and effective method for septal reconstruction in patients with previous septal resections.

Methods: Between March 2012 and October 2014, a case series of 14 male patients with tip deprojection and pseudo-hump formation who had undergone corrective surgery in our clinic was retrospectively examined. Partial-split, caudal extension costal spreader grafts were used and were fixed to the dorsum of the remnant septum cranially to prevent warping while avoiding nasal dorsum widening. Pre- and post-operative comparisons were performed, and the Nasal Obstructive Symptoms Evaluation questionnaire for the functional results and subjective Esthetic Appearance test for the esthetic outcomes were administered.

Results: The mean age was 36.8 years (19–56 years), and the mean follow-up time was 14.6 months. Functional outcomes and esthetic appearance led to significantly improvements in all post-operative categories (P < 0.05) without any major complications. Common complaints were usually the same as seen in conventional rhinoplasty procedures, such as facial swelling, nasal stuffiness, pain, and/or epistaxis. None of the patients requested revision surgery.

Conclusion: Using partial-split, caudal extension costal spreader grafts in the reconstruction of dorsocaudal septum in patients with previous septal resections appears to provide favorable functional and esthetic results.

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