Pediatric septoplasty

Babak Saedi

Associate Professor of Tehran University of Medical sciences

www:dr.babaksaedi.com

Chronic Mouth Breathing

www:dr.babaksaedi.com

Limitation of articleswww:dr.babaksaedi.com

HISTORICAL OVERVIEW: ANIMAL STUDIES Preserving septal mucoperichondrial flaps in young pups did

not result in any perceptible growth whether cartilaginous septum was removed or autotransplanted.

Interestingly,in septums from which cartilage was removed, there was evidence of cartilage regrowth at 10 months

HISTORICAL OVERVIEW: HUMAN STUDIES El-Hakim and colleagues followed the anthropometric

measurements of children who underwent septoplasty via an external approach with autotransplantation of the quadrilateral cartilage and compared their craniofacial development to that of age-matched control subjects.

There were no deleterious effects on the development of the nose or midface

Other literates The more recent literature mentioned above shows that septoplasty can be performed safely in a selected population

using mucoperichondrium- and cartilage-preserving techniques

Septoplasty indication Absolute indications for performing a septoplasty in a

pediatric patient include septal abscess, septal hematoma, severe deformity secondary to acute nasal fracture, dermoid cyst, and cleft lip nose

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Septal dislocation in neonateit is accepted that closed reduction is not efficacious in providing long-term relief of adult septal deviation, it can provide lasting results for the pediatric patient when correctly performed.

Septal dislocation in neonateThere is no need for splints or nasal packing. If the

procedure is unsuccessful, proceed to a surgical septoplasty

Imaginary Line Crysdale's group proposed two approaches. When the deviation is located caudally and posterior to an

imaginary line from the anterior nasal spine to the anterior aspect of the nasal bones, a hemitransfixion incision and limited excision of cartilage, maxillary crest, and vomer is indicated.

If the deviation is anterior to this line, they suggested an open approach removing the whole quadrilateral cartilage and replacing it using its posterior edge, creating a “new” septal midline

Open Techniques Cartilage weakening without resection Cartilage resection it is important to consider reimplantation of the cartilage after appropriate manipulations have been

performed to straighten the cartilage or trim excess length that causes bow in

Nasal growth after pediatric septoplasty at long-term follow-up Pediatric septoplasty may be indicated in selected cases of

obstructing nasal septum deformities. The operation, performed via endonasal approach, does not interfere with the normal growing nasal process

American Journal of Rhinology & Allergy

continuing article the obstructive deviation of anterior nasal septum

involving the valvular area required total removal of the quadrangular cartilage,

remodeling it outside the body and replacing it.

Open rhinoplasty in children.

Absolute indications for open rhinoplasty in children include dermoid cyst, cleft lip nose, and septal abscess. Relative indications include septal deviations causing severe nasal airway obstruction and or progressive distortion of the nose

Facial Plast Surg. 2007 Nov;23(4):259-66.

A Study of Anthropometric Measures Before and After External Septoplasty in Children Appropriate nasal septal surgery involving

excision and subsequent reinsertion of a remodeled segment of the quadrilateral cartilage has no deleterious effects on development of the nose and midface

Arch Otolaryngol Head Neck Surg. 2001;127:1362-1366