title: Anterior Septal Reconstruction for Treatment of Severe Caudal Septal Deviation: Clinical Severity and Outcomes.
abstract: OBJECTIVE
  To report the long-term efficacy of a modified extracorporeal septoplasty technique in the treatment of anterocaudal septal deviations.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Academic tertiary care medical center.
  
  
  METHODS
  Data were obtained by a retrospective review of patients treated by a single surgeon (S.P.M.) from December 2010 to April 2014. A total of 77 patients (52 male, 25 female) met inclusion criteria. The Nasal Obstruction Septoplasty Effectiveness (NOSE) scale and a visual analog scale (VAS) were administered to all patients preoperatively and at each postoperative visit. Statistical analysis was performed using a matched-pair t test comparing preoperative and postoperative NOSE and VAS scores. A recently described severity scale for nasal obstruction was applied to NOSE scores to demonstrate postoperative results.
  
  
  RESULTS
  Average follow-up was 4.7 months. Average preoperative NOSE and VAS scores were 68.2 ± 17.4 and 7.2 ± 1.8, respectively, placing these patients in the "severe" symptoms classification. Average NOSE and VAS scores in the early postoperative period (1-3 months after surgery) were 21.1 ± 19.8 (P < .0001) and 2.1 ± 2.6 (P < .0001), respectively. Average NOSE and VAS scores in the late postoperative period (>3 months after surgery) were 15.8 ± 19.0 (P < .0001) and 1.4 ± 1.8 (P < .0001), respectively. Both early and late postoperative NOSE scores represented "mild" symptomatology.
  
  
  CONCLUSIONS
  Anterior septal reconstruction represents a powerful method for correction of nasal valve stenosis resulting from severe anterocaudal septal deviations.
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Josh
authors.initials: J
authors.lastname: Surowitz
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA smost@ohns.stanford.edu.
authors.forename: Sam P
authors.initials: SP
authors.lastname: Most
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000637:transplantation; D015508:Nasal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D009300:Nasal Septum / Q000002:abnormalities* / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D012272:Ribs / Q000637:transplantation; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: anterior septal reconstruction; caudal septal deviation; nasal obstruction; rhinoplasty; septoplasty