Application of Submucosal Trans-Septal Suturing Technique in a Septal Extension Graft With Porous High-Density Polyethylene and Concurrent Nasal Lateral Osteotomy

Abstract

Background: Recently, a submucosal trans-septal suturing (STSS) technique was introduced to obviate the dead space of septum after septal extension graft (SEG) with porous high-density polyethylene (pHDPE). Objective: To investigate STSS technique after SEG with pHDPE and concurrent nasal lateral osteotomy (LO). Methods: A retrospective study was conducted in 53 patients who underwent a STSS technique after SEG with pHDPE and concurrent LO. The postoperative discomfort (nasal pain and obstruction), the width of the nasal bony base, Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcomes Evaluation (ROE), and complications were recorded and assessed. Results: The mean surgical duration of STSS was 862.53±227.73 seconds. The maximal mean score of postoperative nasal pain and nasal obstruction was 2.132±0.921 and 1.868±0.8995, respectively. The values on the width of the nasal bony base and ROE were significantly improved after surgery. There was no significant difference in NOSE values preoperatively versus 6 months postoperatively. An infection was found in 1 patient, a recurrent minor bleeding of septum in another patient, and a symptomatic nasal obstruction in other 2 patients. There was no major bleeding, hematoma, foreign body sensation, septal perforation, and other infection. Conclusion: STSS can eliminate the postoperative dead space of nasal septum with low discomfort and complications, and help to avoid a lateral displacement of osteotomized nasal bony segment (ONBS) in patients undergoing SEG with pHDPE and concurrent LO.