Reconstructive technique provides option for difficult nasal plastic surgery

CHICAGO A surgical technique that requires the removal, restructure and re-implantation of the nasal septum (the partition of the nose between the nostrils) appears to be a useful option for repairing the hard-to-treat severely deviated septum, according to an article in the July/August issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.

Severe nasal septal deviations, usually the result of trauma, previous surgery or congenital malformations such as cleft palate, pose a particular challenge to plastic surgeons, according to background information in the article. The nasal septum affects both the appearance and the airway passages of the nose. Usual plastic surgical techniques often prove insufficient for reliably correcting severe septal deformities, the author suggests, necessitating the complete removal and correction of the septum to achieve good functional and aesthetic results.

Wolfgang Gubisch, M.D., of Marienhospital, Stuttgart, Germany, reviewed the medical charts of patients undergoing septoplasty (surgery of the nasal septum), either performed by him or under his supervision, at a facial plastic surgery center. Of the 2,119 patients from 1981 to 2004 with severe nasal septal deviations undergoing the surgery developed and refined by Dr. Gubisch, the charts of two groups were reviewed: 459 procedures performed by Dr. Gubisch from January 1, 1981 through July 31, 1987 and 108 patients whose procedures were supervised by Dr. Gubisch in 1996.

In the first group of patients, "Based on the subjective opinion of the surgeon and patients and the findings of the clinical examinations, a good to excellent functional result was obtained in 96 percent," the author writes. "Despite the complex deformity and complicated operative procedure, postoperative complications were rare and only 20 patients (four percent) elected to have revision septoplasty. Fifty-seven complications (12 percent) occurred, with the most com

Contact: Wolfgang Gubisch, M.D.
JAMA and Archives Journals

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