Author(s)
Ahmed S. Abdelhamid MD 1,2
Nathalia Castillo BS 3
Cherian K. Kandathil MD1
Kyle S. Kimura MD1
Ahmed El Abany MD DDS 1,4
Sam P. Most MD1
Affiliation(s)
1 Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA 2 Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, Kafrelsheikh University, Egypt. 3 Albany Medical College, Albany, NY, USA 4 Department of Maxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.;
Abstract:
Background
Anterior septal reconstruction (ASR) is a modified extracorporeal septoplasty technique achieved via open rhinoplasty. This conservative technique is designed to address severe anterior septal deviation by concomitantly addressing nasal obstruction and external contour deformities.
Learning Objective
Is ASR an effective technique to address severe anterior septal deviation?
Study Objective
To explore the effectiveness of ASR in reducing nasal obstruction symptoms and improving nasal aesthetics.
Study Design
Retrospective Cohort Study
Methods
All patients who underwent ASR from January 2009 to December 2021 at a tertiary referral center by a single surgeon were reviewed. Post-operative follow up period were < 6 months (PO1) and >/= 6 months (PO2). Nasal Obstruction Symptom Evaluation (NOSE), Standardized cosmesis health nasal survey (SCHNOS), visual analog scales (VAS Functional and Cosmetic), and lateral wall insufficiency (LWI) scores were recorded and analyzed.
Results
Review identified 516 patients (male 308 (60%), female 208 (40%)) who underwent ASR for functional 334 (65%), cosmetic 23 (4%), and both 158 (31%) reasons over a period of 12 years. The majority of the cases were primary 363 (70%) with 153 (30%) being secondary. The Mean age (SD) was 40 (13) years. The mean follows up period (SD) for PO1 was 2.7 (1.5) months, and 14.8 (11.8) months for PO2. All the preoperative outcome scores (SD) for the entire cohort [LWI ZONE1 right: 0.46 (0.72), LWI ZONE 2 right: 0.2 (0.6), LWI ZONE1 left: 0.44 (0.72), LWI ZONE1 left: 0.2 (0.58); NOSE: 68.7 (21.4), SCHNOS-Obstruction: 68.4 (25.1), SCHNOS- Cosmetic: 45.1 (30.6), VAS-Functional: 6.9 (2.1), VAS-Cosmetic: 5 (2.93)] were found to be significantly lower at both PO1 and PO2. The revision rate was 4%
Conclusion
ASR is an effective technique to address severe anterior septal deviation.