Closed septal osteotomy.
A technique is described that permits realignment of the bony septum (perpendicular plate of the ethmoid, vomer, and vomerine ridge). It involves a closed fracture of the bones by means of a large, long nasal speculum. Mere spreading of the septum fractures the bony septum, permitting reasonable, midline realignment in most patients. Spreading with the speculum also infractures the turbinates in many instances and thereby helps open up the airway even further. Of the 32 patients reviewed, it was found that the perpendicular plate and vomer could be fractured in 100% of patients. The vomerine ridge (premaxilla area), on the other hand, could only be fractured in 69%. Of the patients in whom fracture was possible, the bony septum was straightened dramatically in 82% of patients and improved greatly in 18% of patients.
Gruber
R
R
Stanford University, CA, USA.
Lesavoy
M
M
D006801:Humans; D009300:Nasal Septum / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*