title: The Causes of Persistent and Recurrent Nasal Obstruction After Primary Septoplasty.
abstract: OBJECTIVE
  Septoplasty is the most frequently performed surgical procedure in patients with nasal obstruction. However, nasal obstruction may persist or recur after septoplasty in some patients. In this study, the authors aimed to determine the causes of nasal obstruction after septoplasty.
  
  
  METHODS
  Fifty consecutive patients who admitted to our clinic with the complaints of persistent or recurrent nasal obstruction after primary septoplasty and had revision surgery between 2011 and 2015 were included in this study. Demographic data and physical examination findings of the patients were recorded.
  
  
  RESULTS
  There were 33 men (66%) and 17 women (34%) with a mean age of 37.3 ± 10.5 (range, 21-57) years. Deviation of perpendicular plate of ethmoid bone (44%), inferior turbinate hypertrophy (36%), concha bullosa (26%), caudal septal deviation-nostril asymmetry (20%), and alar collapse (6%) were the pathologies that were unaddressed during primary surgery. The iatrogenic causes of nasal obstruction after septoplasty were collumellar retraction-nasal tip ptosis (46%), nasal synechiae (20%), nasal septal perforation (10%), and saddle-nose/flat nose deformity (10%).
  
  
  CONCLUSIONS
  Iatrogenic deformities due to surgery and pathologies ignored during primary surgery may cause persistent/recurrent nasal obstruction after primary septoplasty. A detailed physical examination and objective tests showing the site of nasal obstruction, an extensive surgical plan that covers all diagnosed pathologies, and a careful postoperative care must be undertaken to prevent undesired postoperative results.
authors.affiliation: *Department of Otorhinolaryngology †Department of Radiology, School of Medicine, Mugla Sitki Kocman University, Muğla ‡Department of Otorhinolaryngology, Kocaeli University School of Medicine, Kocaeli §Department of Anatomy, School of Medicine, Mugla Sitki Kocman University, Muğla, Turkey.
authors.forename: Serhan
authors.initials: S
authors.lastname: Derin
authors.forename: Murat
authors.initials: M
authors.lastname: Sahan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Deveer
authors.forename: Selvet
authors.initials: S
authors.lastname: Erdogan
authors.forename: Hasan
authors.initials: H
authors.lastname: Tetiker
authors.forename: Sabri
authors.initials: S
authors.lastname: Koseoglu
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D009667:Nose Deformities, Acquired / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012225:Rhinoplasty / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult