Facial plast Surg 2006; 22(4): 217-222
DOI: 10.1055/s-2006-954839
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Septal Deviation 1882: The Origins of Systematic Submucous Resection of the Nasal Septum[*]

Wolfgang Pirsig1
  • 1University of Ulm, Ulm, Germany
Further Information

Publication History

Publication Date:
28 November 2006 (online)


The submucous resection of the nasal septum, which became well known all over the world in the beginning of the 20th century through its promoters Gustav Killian (Germany) and Otto Tiger Freer (United States), has been practiced in a few isolated cases since 1847. However, its systematic use started around 1882 by Ephraim Fletscher Ingals in Chicago and by Arthur Hartmann, Robert Krieg, and Ferdinand Petersen in Germany. The development of this operation is shown against the background of the anatomic-pathological knowledge and surgical conditions prevailing around 1882 and is compared with the mostly less effective methods for the management of septal deviation at that time. Finally, three examples of crooked noses with septal deviation are presented depicted in sculpture and painting in Roman art, the Renaissance period, and the 20th century.

1 The historical part of this article is a shortened translation of an article published by the author under the title: Septumdeviation 1882: Beginn der systematischen submukösen Septumchirurgie. Laryngol Rhinol Otol 1982;61:547-551.