Questionable Effect of Crosshatching Incision in Septoplasty

Abstract

Objectives. Crosshatching incision has been considered a useful method for correcting cartilaginous septal deviation. The aim of this study was to determine the utility and limitations of this approach.Methods. This retrospective case-control study included 353 patients who underwent septoplasty performed by a senior surgeon between January 2004 and December 2010. Patients were classified into two groups according to whether crosshatching incision was performed (n=151) during septoplasty or not (n=202). All other techniques performed during septoplasty were identical. The parameters of surgical success (improvement of nasal obstruction, correction of deviation, and acoustic rhinometry results) and adverse effects were compared between the groups.Results. There were no significant differences in the parameters of surgical success between the groups (improvement of nasal obstruction, P=0.333; correction of deviation, P=0.608; acoustic rhinometry results, P=0.322 for the difference in the minimal cross-sectional area; P=0.919 for difference in volume). Relative to patients who did not undergo the cross-hatching incision, patients with whom the technique was performed showed a significantly higher incidence of saddle nose (0/202 vs. 4/151 cases, P=0.033) and overcorrection (0/202 vs. 5/151 cases, P=0.014).Conclusion. Crosshatching incision during septoplasty did not produce better surgical outcomes; however, it caused adverse effects such as saddle nose and overcorrection. Therefore, the use of crosshatching incision should be re-evaluated.

A novel surgical technique to correct caudal and high dorsal septal deviations: L‐shape cutting and suturing on the septal L‐strut (L‐septoplasty)

“…In general, deviation of the L‐strut of the nasal septum is more challenging to correct than the middle and has less favorable results 2 . There are various techniques to correct the L‐strut, but there is no clear choice 3‐15 …”

“…If the L‐strut curvature remains, the nasal valve narrowing is not resolved. A simple cross‐hatching incision weakens the L‐struts support and may result in even more deviation 4 . Batten graft for straightening the caudal septum is useful but may make it too broad or worsen dorsal septal deviation 5 …”

“… 2 There are various techniques to correct the L‐strut, but there is no clear choice. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 …”

Comparison of Subjective and Objective Success of Septoplasty in Patients with Nasal Septum Deviation: A Before and After Study

“…Septoplasty is the surgical correction of the deviated or deformed nasal septum, the first examples of which date back to ancient Egypt (7). Nowadays, a variety of techniques are performed by surgeons in septoplasty operations; the types of nasal septal deviation (NSD) and surgeon's preferences are important to decide which technique to be applied (8,9). Cottle's septoplasty with a hemitransfixion incision is one of the most frequently used techniques in the world (9).…”

Crosshatching Incision in Septoplasty: Abandoning an Old Myth

“…The primary drawbacks of the crosshatching incision are the unpredictability of straightening the curved cartilage and the potential for a weakening of the septum over time. In an issue of Clinical and Experimental Otorhinolaryngology, Kim and Heo [4] compared their experience of crosshatching incision septoplasty with non-incision septoplasty. They reviewed 151 patients who underwent septoplasty using crosshatching incision and 202 patients who did not.…”