Three-dimensional modeling of nasal septal deviation.

Abstract

Some deviated nasal septa can never be straightened completely due to their 3-dimensional (3-D) nature. Based on a study of models and clinical cases, a basic classification and treatment strategy was proposed for 3-D septal deviations. Basic types of 3-D septal L struts were crafted from pieces of thick plastic sheeting. By a carefully placed through-and-through incision in the angle area and overlapping the resultant segments, the models became 2 dimensional (2-D). We used this technique intraoperatively, in some cases resecting the overlapping area of septal tissue, along with a septal extension graft, in 11 patients who were followed up for more than 6 months. External nasal deviation due to a deviated septum was obvious in 5 cases, and all were relieved postoperatively. Preoperative breathing difficulties were improved in 7 of 8 patients. Correction of 3-D septal L deformity can be successfully performed by constructing 2-D L struts by making a full-thickness incision of the angle area and then overlapping the segments. This approach is especially beneficial in those having a septal extension graft that need a perfectly straight caudal septum upon which to fix the extension graft.