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All Things Septum Anil R. Shah MD
Epidemiology ,[object Object],[object Object],Vainio-Mattila J: Correlations of nasal symptoms and signs in random sampling study. Acta Otolaryngol Suppl 1974; 318: 1-48
Septum ,[object Object],[object Object],[object Object],[object Object]
Anatomy ,[object Object],[object Object],[object Object],[object Object]
Vasculature and Nervous Supply ,[object Object],[object Object],[object Object],Answer:  Nasopalatine Nerve, Anesthesia Of anterior portion of hard palate and Incisors
Bony articulations ,[object Object]
Bony articulations ,[object Object],[object Object],[object Object]
What is that?
Vomeronasal organ ,[object Object],[object Object],[object Object],[object Object],[object Object]
Autonomic supply of nasal cavity ,[object Object],[object Object]
Perichondrium ,[object Object],[object Object]
Physics 101 (revisited) ,[object Object],[object Object],[object Object]
[object Object]
Ventilation ,[object Object],[object Object],Cole P.  Nasal and oral airlfow resistors:  Site, function, and assessment.  Arch Otolaryngol Head Neck Surg 118:790-793, 1992
Nasal cycle ,[object Object],[object Object]
Preoperative assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Anosmia/hyposmia ,[object Object],[object Object],[object Object],[object Object]
Rhinomanometry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acoustic rhinomanometry ,[object Object],[object Object]
Optimizing acoustic rhinomanometry ,[object Object],[object Object],[object Object]
Goals of surgery ,[object Object],[object Object],[object Object],[object Object]
 
[object Object]
Classification of Septal Deviations ,[object Object],[object Object],[object Object]
Local anesthetics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Uh… Oh!! ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Incisions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Technique ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classic Book Teaching
Keystone areas ,[object Object],[object Object]
Submucous resection limitations ,[object Object],[object Object],[object Object]
Reconstitution ,[object Object],[object Object],[object Object]
Scoring the cartilage ,[object Object]
Deviated caudal septum
 
Caudal margin & Inferior margin to the left of the maxillary spine
Eliminate all posterior bony attachments to  mobilize the anterior septum
Shift caudal  margin & inferior margin to  opposite side of the  Maxillary spine
CONSIDER RELAXING INCISIONS ON CAUDAL MARGIN
1 . Anterior septum separated from  Vomer and Ethmoid
Maxillary Spine 1 . Anterior septum separated from  Vomer and Ethmoid
Maxillary Spine 1 . 2 . Anterior septum separated from  Vomer and Ethmoid
Maxillary Spine 1 . 2 . 3 . Anterior septum separated from  Vomer and Ethmoid
Maxillary Spine 1 . 2 . 3 . Anterior septum separated from  Vomer and Ethmoid Anterior septum to midline
Deviated Dorsal Septum ,[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
Correct Dorsal septal deviation with suture suspension to nasal bone
 
 
 
 
 
Warping Theory Fry H.  Nasal skeletal trauma and the interlocked stresses of the nasal septal cartilage.Br J Plast Surg. 1967 Apr;20(2):146-58. Gibson, T. Davis W.B. The distortion of autologous cartilage grafts: Its cause and prevention. Br J. Plast. Surg. 10; 257, 1958
 
Poor tip support ,[object Object],[object Object],[object Object],[object Object]
Septal spur ,[object Object],[object Object]
Disarticulation of Bony and cartilaginous septum ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prior surgery ,[object Object],[object Object],[object Object]
Postoperative care ,[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Septal Perforation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Septal Perforation ,[object Object]
Physical Exam ,[object Object],[object Object],[object Object]
What tests do I order? ,[object Object],[object Object],[object Object],[object Object]
Principle ,[object Object],[object Object]
Medical Therapy ,[object Object],[object Object],[object Object]
Surgical therapy ,[object Object],[object Object],[object Object],[object Object]
Surgical therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
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