Abstract

BackgroundSurgical correction of caudal septal deviation is a technically challenging step of functional rhinoplasty. Multiple surgical techniques have been described in the literature but comparing the efficacy of each in relieving obstruction presents a challenge. Outcome measures are necessary to adequately compare techniques. This study aims to describe the current caudal septoplasty techniques of Otolaryngologists and Facial plastic and reconstructive surgeons (FPRS), as well as their use of outcome measures, and to compare these practices with surgical trends described in the literature.MethodsAn online survey was sent to three Otolaryngology and FPRS associations in Canada and the United States. A systematic review was conducted on SCOPUS and PubMed to classify the caudal septoplasty techniques described in the literature and the outcome measurement tools used.ResultsOur survey identified that caudal septoplasty is more commonly performed by surgeons with an FPRS training background. The most common techniques were the swinging door technique (69.5%), extracorporeal septoplasy (46.7%), cartilage scoring (45.3%), and splinting with bone (25.4%). Despite using a vast array of surgical techniques, North American physicians rarely rely on standardized outcome assessment tools. Patient reported outcome measures (PROMs) are used almost twice as frequently in the literature as they are by surgeons in their clinical practice.ConclusionWe recommend that future studies of caudal septoplasty include an assessment of both form and function using a validated PROM such as the Standardized Cosmesis and Health Nasal Outcomes Survey.

Highlights

  • Surgical correction of caudal septal deviation is a technically challenging step of functional rhinoplasty

  • Removal of the deviated caudal nasal septum results in loss of tip support, shortening of the columella and complications ranging from tip ptosis [1] to severe valve collapse

  • The survey was distributed via email to members of the following associations; the Association of Otolaryngology-Head and Neck Surgery of Quebec (ORLQC), the Canadian Society of Otolaryngology– Head and Neck Surgery (CSOHNS) and the American Association of Facial Plastic and Reconstructive Surgery (AAFPRS)

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Summary

Introduction

Surgical correction of caudal septal deviation is a technically challenging step of functional rhinoplasty. Multiple surgical techniques have been described in the literature but comparing the efficacy of each in relieving obstruction presents a challenge. This study aims to describe the current caudal septoplasty techniques of Otolaryngologists and Facial plastic and reconstructive surgeons (FPRS), as well as their use of outcome measures, and to compare these practices with surgical trends described in the literature. Surgical correction of caudal septal deviation is technically challenging and classifies as a functional rhinoplasty procedure because of its impact on the external nasal valve. Multiple different surgical techniques have been described in the literature but comparing the efficacy of each in relieving functional symptoms presents a challenge. The use of PROMs, VAS, AR and RM to report functional outcomes after caudal septoplasty varies widely in the literature

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