This article describes a novel septoplasty technique to correct a cartilaginous deflection. Although it took a while to understand it as the operative photographs were not very helpful it is an interesting concept. The author excises an inferior strip and performs a posterior chondrotomy. Then a slit is made in the quadrilateral cartilage anterior to the posterior chondrotomy. A small cartilaginous or bony strut (or ‘wedge’) is created and placed to run from the vomer to the slit via the convex side. This acts as a lever to pull the deflected septum to the midline. Whilst it’s difficult to appreciate without the aid of the diagram in the article the concept seems very interesting. The paper describes a series of 17 consecutive patients and demonstrates both subjective and some objective measures of improvement although the acoustic rhinometry data is incomplete. My main concern would be thickening of the septum at the level of the strut, which the author concedes does happen but as this is well behind the nasal valve area this doesn’t seem to be problematic. Limited numbers and data but an interesting concept and potentially a worthwhile addition to the array of techniques to try and correct the difficult cartilaginous septal deformity.

A novel wedge technique to correct the curved deviation of the cartilaginous nasal septum.
Ji-Eun L, Hahn JJ, Munyoung C, Hong RJ.
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Ravi Thevasagayam

Clinical Lead, Department of ENT, Sheffield Children’s Hospital, Sheffield, S10 2TH, UK.

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