Septoplasty and septorhinoplasty in children

Abstract

Surgical correction of the nasal septum in childhood remains a controversial issue. Due to concerns that destruction of growth zones in the trapezius cartilage during the procedure may have a significant impact on the later growth of the nose and facial part of cranium, for many years ENT specialists approached the issue of septoplasty in children in a very conservative manner. However, many more recent reports indicate that a conservatively and correctly performed procedure does not pose a threat to the development of the nose and can be safely performed in children with severe septal deviation after 5–6 years of age. In case of the coexistence of deformities in the shape of the external nose, it is recommended to simultaneously correct it, which guarantees an optimal final result. These age restrictions do not apply to urgent cases, such as inter alia: septal hematoma and abscess, tumors and developmental disorders. Most importantly, no or sparing (with preservation of cartilage growth centers) resection of the quadrangular cartilage is essential to avoid nasal growth disorder. Rhinoplasties have been reported to have a higher rate of repair and lower patient aesthetic satisfaction. The decision if to perform surgical treatment and its scope should be made after analyzing the potential benefits and consequences on the one hand and leaving a deviated septum on the other hand. In case of doubt, the operation should be postponed until the end of puberty.