title: Cutting and suture technique of the caudal septal cartilage for the management of caudal septal deviation.
abstract: OBJECTIVE
  To introduce the cutting and suture technique of the caudal L-strut for the management of caudal septal deviation and to evaluate its efficacy and surgical outcomes.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary care rhinology clinic.
  
  
  METHODS
  Forty-five patients who underwent endonasal septoplasty using the cutting and suture technique of the caudal L-strut.
  
  
  METHODS
  After elevation of the mucoperichondrial flap, deviated portions of cartilage and bone were excised, leaving at least a 1.5-cm strip of L-strut. If caudal septal deviation persisted, the caudal strut was cut at the convex-most part, and the cut ends were slightly overlapped and sutured together.
  
  
  METHODS
  Improvement in the treatment of nasal obstruction using a visual analog scale and a questionnaire for subjective satisfaction were evaluated 2 to 6 months after septoplasty. To evaluate outcomes objectively, endoscopic photographs of the nasal cavity before and after surgery were evaluated by 2 independent surgeons.
  
  
  RESULTS
  Significant improvement in the treatment of nasal obstruction was achieved, with mean visual analog scale scores of 7.93 preoperatively and 3.63 postoperatively (P < .001). Subjective satisfaction was rated as much improved in 68% of patients, improved in 15%, and no change in 17%. Endoscopic examinations showed that 51% of patients had near-complete correction of the septum and that 47% had improved but a little persisting caudal deviation. One patient had no change in caudal septal deviation on endoscopic examination.
  
  
  CONCLUSIONS
  The cutting and suture technique of the caudal L-strut seems to be a useful technique that can be performed with relative ease and simplicity.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-gu, Seoul, South Korea. jangyj@amc.seoul.kr
authors.forename: Yong Ju
authors.initials: YJ
authors.lastname: Jang
authors.forename: Nam-Kyung
authors.initials: NK
authors.lastname: Yeo
authors.forename: Jong Hwan
authors.initials: JH
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000601:surgery*; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery; D009300:Nasal Septum / Q000002:abnormalities* / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D016896:Treatment Outcome