SEPTOPLASTY

Clinical indications of septoplasty:

• Deviation of the nasal septum with partial or complete unilateral or bilateral obstruction of airflow
• Persistent or recurrent epistaxis
• Evidence of sinusitis secondary to septal deviation
• Headaches secondary to septal deviation and contact points
• Anatomic obstruction that makes indicated sinus procedure difficult to perform efficiently
• Obstructive sleep apnea
• As an approach to transseptal transsphenoidal approach to pituitary fossa

 Technique/ Procedure

• Used as an alternative for Sub Mucosal Resection(SMR)
• Tissue sparing procedure where septa’ deviation is corrected by minimal resection of cartilage and bone

• Freer’s hemi transfixation incision on the concave side of the cartilage
• Mucoperichondrial elevation is done on the side of incision and 3 tunnels are created
  • • Anterior tunnel → exposure of quadrangular septal cartilage on the concave side
    • Inferior tunnel → anterior nasal spine and maxillary crest on both sides are exposed
    • Posterior tunnel → perpendicular plate of ethmoid and vomer are exposed