title: Consistent ipsilateral development of the posterior extension of the quadrangular cartilage and bony spur formation in nasal septal deviation.
abstract: OBJECTIVE
  Septal spurs are exceedingly common structural deformities that contribute to nasal obstruction and often require surgical correction. The posterior extension of the quadrangular cartilage (PEQC) and its relationship with septal spurs have not been previously examined. We seek to examine the anatomic and histologic relationship of the PEQC and concurrent septal spurs in patients undergoing septoplasty.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Facial plastic and rhinology center in tertiary hospital setting.
  
  
  METHODS
  Thirty patients with septal deviation are described in this series. The quadrangular cartilage and associated septal spur were removed en bloc from patients undergoing septoplasty. The length of the PEQC, the side of spur deviation, and the relationship of the PEQC to the spur (ipsilateral vs contralateral) were recorded.
  
  
  RESULTS
  The mean length of the PEQC, beyond the bony-cartilaginous junction, was 30.06±6.06 mm. The PEQC was present on the ipsilateral side of the spur deviation in all 30 patients (100%).
  
  
  CONCLUSIONS
  At sites of septal spur formation, the quadrangular cartilage possesses an average 3-cm extension beyond its junction with the bony components of the septum. This cartilaginous extension is exclusively found on the same side of spur deviation. These findings have implications on our understanding of the ontogeny of commonly found septal spurs and deviations, as well as treatment strategies and cartilage graft harvesting.
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran saedi@tums.ac.ir.
authors.forename: Babak
authors.initials: B
authors.lastname: Saedi
authors.affiliation: Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Ali R
authors.initials: AR
authors.lastname: Rashan
authors.affiliation: Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lipan
authors.affiliation: Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Jayakar V
authors.initials: JV
authors.lastname: Nayak
authors.affiliation: Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Sam P
authors.initials: SP
authors.lastname: Most
mesh_terms: D000293:Adolescent; D000328:Adult; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000601:surgery*; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D054850:Osteophyte / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: bony-cartilaginous junction; development; embryology; nasal obstruction; nasal septum; quadrangular cartilage; septal deviation; septal spur; septoplasty