Dorsal approach to septum in external septorhinoplasty.
OBJECTIVE
During external septorhinoplasty, access from the caudal septum into subperichondrial space often poses difficulties and challenges for proper elevation of the mucoperichondrial flap. The dorsal and caudal approaches were compared with respect to duration and mucosal integrity.


METHODS
The caudal approach was applied in 52 patients and the dorsal approach in 50 patients. The duration was recorded starting with septal incision, until the end of the completion of the bilateral subperichondrial and subperiosteal elevation. The mucosal integrity was inspected for any mucosal damage.


RESULTS
The elevation durations for the caudal approach and the dorsal approach were 450.3 seconds and 232 seconds, respectively. The impairment in mucosal integrity was observed in 33 cases (63%) with the caudal approach and in 16 cases (32%) with the dorsal approach. Statistically significant differences were found between the 2 groups in terms of duration and mucosal integrity.


CONCLUSIONS
The dorsal approach is a more advantageous choice that provides easier, safer, and faster access, ensures a comfortable and effective subperichondrial elevation, and is more advantageous for the protection of mucosal integrity as compared to the caudal approach from the anterior septal angle, since the perichondrium in the caudal septum is more attached to the underlying cartilage.
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey.
Orhan
O
Ozturan
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey dr.remzidogan@gmail.com.
Remzi
R
Dogan
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey.
Fadlullah
F
Aksoy
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey.
Selahattin
S
Tugrul
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey.
Sabri Baki
SB
Eren
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000002:abnormalities / Q000601:surgery*; D015203:Reproducibility of Results; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome
approach; caudal; dorsal; septorhinoplasty; septum