Nasal Septal Reconstruction

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SEPTAL deformity is one of the most common findings on rhinoscopic examination. Often the deformity is minor, causes no disability, and therefore requires no therapy. Equally as often, however, the deformity produces symptoms or cosmetic defects which warrant treatment.

Etiologic Factors

The etiologic factors that usually are enumerated are heredity, development, and trauma. I have encountered several families in which a parent and at least one child have almost identical deformities, and an hereditary origin is assumed. Most of the angular bony deformities with sharp ridges and spurs are believed to be developmental and to result from disproportionate rates of growth of the bones of the face and of the skull. The majority of the deformities involving the cartilaginous septum, especially the caudal dislocations, probably are traumatic in origin.

Symptoms and Complications

Obstructive septal deflections produce definite symptoms that can be simulated by several other disease conditions, mainly the various types of vasomotor rhinitis and adenoidal hypertrophy. The prime symptom of the deflected septum is nasal obstruction, ranging from a feeling of fullness or stuffiness to almost complete unilateral or bilateral blockage. Associated with this symptom are excessive nasal and postnasal secretions, mouth breathing with attendant dryness and irritation of the mouth and pharynx, and the voice alteration termed rhinolalia clausa.

Complications of the obstruction include septal crusting and erosion with occasional epistaxis caused by localized drying of the mucosa, obstruction to normal sinus drainage with secondary sinusitis, and occasionally obstruction of the eustachian tube with a conductive type of. . .



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