Journal archive · Rib, ear and septal grafts · Septum, valve and airway · Open versus closed approach · Adolescent and aging nose · 2022
Endonasal Septoplasty Using a Septal Cartilaginous Batten Graft for Managing Caudal Septal Deviation
Chi JC, Lee SD, Lee CY, Liu SY, Ting H, Tsai YJ.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on caudal septum.
Abstract
Caudal nasal septal deviation is an important condition altering nasal obstruction and cosmetic appearance and many surgical techniques have been published on how to correct caudal septal deviation, as successful management of caudal septal deviation is challenging. The goal of our study was to explore the effect of endonasal septoplasty using a septal cartilaginous batten graft for managing caudal septal deviation. We tested 26 participants with caudal septal deviation who received endonasal septoplasty using a septal cartilaginous batten graft from 1 April 2019 to 29 June 2022, and followed up for at least 6 months. Nasal Obstruction Symptom Evaluation (NOSE) Scale and visual analog scale (VAS) were recorded at baseline, 1 month, and 6 months after surgery. Valid samples were analyzed by repeated measures ANOVA and paired sample t-test. Average participant age was 36.15 ± 11.02 years old. The preoperative, 1-month postoperative, and 6-month postoperative NOSE scale decreased significantly (75.38 ± 15.62, 13.85 ± 7.79, and 14.04 ± 9.90; p < 0.001), while preoperative, 1-month postoperative, and 6-month postoperative VAS (convex/concave side) also improved (7.50 ± 0.81/3.38 ± 0.94, 2.27 ± 0.53/1.54 ± 0.58, and 2.31 ± 0.55/1.58 ± 0.58; p < 0.001). Our results showed that endonasal septoplasty using a septal cartilaginous batten graft had good surgical outcomes without an open scar or severe complications.
Abstract as indexed by PubMed; the article is open access (PubMed Central).
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Rib, ear and septal grafts
Modern rhinoplasty builds rather than removes, so the operation runs on cartilage: the septum first, then the ear, then the rib, and when none of those will do, a piece of donated rib from a tissue bank.
Septum, valve and airway
Every rhinoplasty is a breathing operation whether it intends to be or not: the septum holds the nose up as well as dividing it, and the narrowest part of the whole airway is the internal valve the surgeon is standing over.
Open versus closed approach
Whether the surgeon opens the nose through a small incision across the columella or works entirely through the nostrils has been argued in print since 1973, was put on facing pages of Plastic and Reconstructive Surgery by Jack Gunter and Jack Sheen in 1997, and was finally pooled in 2025: across twenty studies and 1,067 patients there is no significant difference in what patients report, in breathing, in complications or in swelling.
Adolescent and aging nose
The same operation is a different problem at twelve and at seventy: in a child the fear is stunting a nose that has not finished growing, and in an older patient the nose has kept changing, dropping at the tip, thinning at the skin and weakening at the cartilage, until it blocks the airway.
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