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Septoplasty

Nasal septum
- Bony
- Cartilaginous
- Membranous and LLC
Types of deviated septum
Structural causes of nasal obstruction
- Septum
- IT
- Internal nasal valve
- External nasal valve
Issues with DNS
1. Memory of curvature
- "Extrinsic": Memory of surrounding tissue that causes it to be bent
- "Intrinsic": Cartilage itself is bent
2. Breakage of cartilage
- Chisel the crest before cutting the inferior strip
3. Be careful of keystone area while dislocating the osteocartilaginous
junction
- Take into consideration need for a subsequent humpectomy
4. Deviated dorsal strut
- Can use assymetrical suturing
5. S-shaped deviation
- Spreader graft
6. Dislocated dorsal strut
- Swinging door flap
7. Lower lateral cartilage
8. Bony problems
- Deviated maxillary crest
- Deviated anterior nasal spine
- Broad maxillary crest
- Bony spur

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