This open approach allowed visualization of the cartilaginous and bony vault to facilitate accurate dissection of nasal pocket overlying the lower lateral cartilages, septal cartilage
, and nasal bones.
In some studies it has been stated that to achieve hemostasis of a bleeding nasal septal vessel, only the mucosa requires cautery, nevertheless, the underlying perichondrium and septal cartilage
are also affected by cauterization, which may result in septal perforation as in few studies it was found that nasal cautery was the causal factor in 7% of septal perforations especially in bilateral cauterization15.
In 6 (60%), only septal muochondrial graft were used while in 4 (40%) patients septal cartilage
as well as septal mucoperichondrial graft was used.
The septal cartilage
graft is then sutured to the undersurface of the lateral lobule skin flap.
(4) The use of mastoid cortical bone and nasal septal cartilage
in the reconstructive surgery of the middle ear was introduced by Hugh and Jensen respectively.
A radiofrequency knife was used to perform a wide excisional biopsy of the lesion along with the adjoining part of the septal cartilage
. The postoperative period was uneventful.
Most of the surgeons adopted Killian's technique with preservation of caudal and dorsal struts of the septal cartilage
to minimise the complications.
The material used for graft is autologous cartilage harvested from right 7th costal cartilage, septal cartilage
The most commonly reported sequela is a loss of septal cartilage
support, which can result in a nasal deformity.
(1, 2) 'Extracorporeal septoplasty' as described by Gubisch in 1995 has failed to correct a difficult nasal septum because the deformed nasal septal cartilage
had to be segmented into several smaller sections.
One splint was inserted into each nasal cavity and fixed with a 3-0 Mersilk suture that crossed both septal flaps and splints anteriorly and posteriorly; a through-and-through mattress suture was used to cross the remaining septal cartilage
if possible (figure 1).
Endoscope also aided limited resection and thus more conservation by guiding precise shaving by septal cartilage