Problems of the septum in rhinoplastic surgery.

Abstract

NO SINGLE method of correction associated with reconstruction of an external nasal deformity is applicable in every case of anterior dislocation and deviation of the septum. A knowledge of the underlying abnormality and a command of several operative approaches to the problem must be combined with judgment on the part of the surgeon if the condition is to be treated successfully. In my experience, the Metzenbaum¹operation, altered by utilizing the rhinoplastic approach, has usually been a satisfactory method of correcting twisting or hypertrophy of the nose combined with dislocation and deviation of the septum. However, certain modifications of the procedure have materially increased its usefulness. As originally described, Metzenbaum's procedure consists essentially in shifting the anteriorly dislocated septal cartilage to the midline to avoid radical removal, the latter procedure having been advocated at the turn of the century by such authorities as St. Clair Thomson,²Freer³