Saddle Deformity After Septoplasty and Immediate Correction

Abstract

Objective: The aim of this study is to assess the saddle deformity after septoplasty and the usefulness of immediate correction. Design: Retrospective study. Setting: University medical center. Patients: Of 658 patients who underwent endonasal septoplasty from January 2011 to July 2018, 14 underwent immediate cartilage dorsal augmentations following septoplasty for saddle deformity and were enrolled in this study. Main Outcome Measures: A total of 14 patients received immediate cartilage augmentation and were followed for >3 months after surgery. External nose status, patterns of septal deformity, and surgical results were investigated with profile view photographs, paranasal sinus computed tomography scans, and nasal endoscopy. Symptom improvement was measured using the Nasal Obstruction Symptom Evaluation scale. Results: All patients had middle to high site septal deviation. Anterior deviation and central deviation have statistical significance compared to posterior part deviation (P = 0.025, P = 0.002) and mid part deviation has statistical significance compared to basal part deviation (P = 0.005). Postoperative subjective nasal symptoms of the 14 patients were improved from preoperation (18.54 ± 2.46) to 1 month (7.54 ± 2.16) and 3 months (1.72 ± 1.55) postoperatively. Conclusions: Immediate endonasal cartilage augmentation for iatrogenic saddle deformity after septoplasty is easy, safe, and effective. Furthermore, this corrective treatment for post op complication is very important for both of surgeon and patient. Predispositions to postoperative saddle deformity included site and severity of preoperative nasal septal deviation.

Is There a Risk of Saddle Nose Deformity after Spreader Grafts and Flaps?

“…It has been reported to occur in 0.4 to 3.4% of septoplasty procedures. 29,30 Among the five patients who developed saddle deformity in the present cohort, four of them had septoplasty as part of their procedures, while the fifth patient (patient number 4 in ►Table 2) had had a septoplasty performed previously elsewhere. However, septal cartilage was harvested from that patient to use as spreader grafts during the septorhinoplasty procedure included in this series.…”