Facial Plast Surg 2006; 22(4): 289-297
DOI: 10.1055/s-2006-954847
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Complications in Septoplasty

Gerhard Rettinger1 , Hanspeter Kirsche1
  • 1ENT-Department University Ulm, Ulm, Germany
Further Information

Publication History

Publication Date:
28 November 2006 (online)

ABSTRACT

The most frequent complications of septoplasty are deformities, infections, and perforations. The effects of each of these complications, however, can be very different. Dislocations and deformities of the septum may result not only in an impaired airway but also in visible deformities of the entire nasal base and dorsum. A patient who underwent septoplasty can be “stigmatized.” Infections may lead not only to septal abscess but also to endocranial complications such as meningitis or septicemia with endocarditis. Permanent perforations of the nasal septum can result in significant symptoms if they are located in the anterior part of the nose. Surgical closure is the treatment of choice, with a high success rate if the patients are selected properly. Besides these three major types of complications there are many others, from smell disturbances to blindness. Causes, prevention, and correction of selected complications are presented and data of the recent literature reported.

REFERENCES

  • 1 Schwab J A, Pirsig W. Complications of septal surgery.  Facial Plast Surg. 1997;  13 3-14
  • 2 Gruber R P, Nahai F, Bogdan M A, Friedman G D. Changing the convexity and concavity of nasal cartilages and cartilage grafts with horizontal mattress sutures: part I. Experimental results.  Plast Reconstr Surg. 2005;  115 589-594
  • 3 Gruber R P, Nahai F, Bogdan M A, Friedman G D. Changing the convexity and concavity of nasal cartilages and cartilage grafts with horizontal mattress sutures: part II. Clinical results.  Plast Reconstr Surg. 2005;  115 595-606 discussion 607-608
  • 4 Gubisch W. Extracorporeal septoplasty for the markedly deviated septum.  Arch Facial Plast Surg. 2005;  7 218-226
  • 5 Gubisch W. 20 years' experience with extracorporal septoplasty.  Laryngorhinootologie. 2002;  81 22-30
  • 6 Lee B J, Chung Y S, Jang Y J. Overcorrected septum as a complication of septoplasty.  Am J Rhinol. 2004;  18 393-396
  • 7 Muhammad I A, Nabil-ur R. Complications of the surgery for deviated nasal septum.  J Coll Physicians Surg Pak. 2003;  13 565-568
  • 8 Bateman N D, Woolford T J. Informed consent for septal surgery: the evidence-base.  J Laryngol Otol. 2003;  117 186-189
  • 9 Bewarder F, Pirsig W. Long-term results of submucous septal resection.  Laryngol Rhinol Oto (Stuttg). 1978;  57 922-931
  • 10 Kim D W, Egan K K, O'Grady K, Toriumi D M. Biomechanical strength of human nasal septal lining: comparison of the constituent layers.  Laryngoscope. 2005;  115 1451-1453
  • 11 Vaiman M, Eviatar E, Segal S. The use of fibrin glue as hemostatic in endonasal operations: a prospective, randomized study.  Rhinology. 2002;  40 185-188
  • 12 Rettinger G, Masing H, Heinl W. Management of septal perforations by rotationplasty of the septal mucosa [in German].  HNO. 1986;  34 461-466
  • 13 Schultz-Coulon H J. Experiences with the bridge-flap technique for the repair of large nasal septal perforations.  Rhinology. 1994;  32 25-33
  • 14 Makitie A, Aaltonen L M, Hytonen M, Malmberg H. Postoperative infection following nasal septoplasty.  Acta Otolaryngol Suppl. 2000;  543 165-166
  • 15 Lemmens W, Lemkens P. Septal suturing following nasal septoplasty, a valid alternative for nasal packing?.  Acta Otorhinolaryngol Belg. 2001;  55 215-221
  • 16 Boenisch M, Trenite G J. Fibrin glue for operative correction of septal deviations.  HNO. 2004;  52 963-967
  • 17 Weber R K, Hay U. Is packing of the nose up-to-date?.  Laryngorhinootologie. 2003;  82 650-654
  • 18 Leonard D W, Thompson D H. Unusual septoplasty complication: Streptococcus viridans endocarditis.  Ear Nose Throat J. 1998;  77 827 830-831
  • 19 Kaygusuz I, Kizirgil A, Karlidag T et al.. Bacteriemia in septoplasty and septorhinoplasty surgery.  Rhinology. 2003;  41 76-79
  • 20 Durr J, Lindemann J, Keck T. Sense of smell before and after functional esthetic rhinoplasty.  HNO. 2002;  50 626-629
  • 21 Philpott C M, Banerjee A R. Is there a role for more day-case septal surgery?.  J Laryngol Otol. 2005;  119 280-283
  • 22 Briner H R, Simmen D, Jones N. Impaired sense of smell in patients with nasal surgery.  Clin Otolaryngol Allied Sci. 2003;  28 417-419
  • 23 Pfaar O, Huttenbrink K B, Hummel T. Assessment of olfactory function after septoplasty: a longitudinal study.  Rhinology. 2004;  42 195-199
  • 24 Damm M, Vent J, Schmidt M et al.. Intranasal volume and olfactory function.  Chem Senses. 2002;  27 831-839
  • 25 Hwang P H, McLaughlin R B, Lanza D C, Kennedy D W. Endoscopic septoplasty: indications, technique, and results.  Otolaryngol Head Neck Surg. 1999;  120 678-682
  • 26 Dolan R W. Endoscopic septoplasty.  Facial Plast Surg. 2004;  20 217-221
  • 27 Lopez M A, Westine J G, Toriumi D M. The role of powered instrumentation in rhinoplasty and septoplasty.  J Long Term Eff Med Implants. 2005;  15 283-288
  • 28 Kocak A, Gurlek A, Kutlu R, Celbis O, Aydn N E. An unusual complication of septorhinoplasty: massive subarachnoid hemorrhage.  Ann Plast Surg. 2004;  53 492-495
  • 29 Onerci T M, Ayhan K, Ogretmenoglu O. Two consecutive cases of cerebrospinal fluid rhinorrhea after septoplasty operation.  Am J Otolaryngol. 2004;  25 354-356
  • 30 McMains K C, Gross C W, Kountakis S E. Endoscopic management of cerebrospinal fluid rhinorrhea.  Laryngoscope. 2004;  114 1833-1837
  • 31 Rettinger G, Christ P, Meythaler F H. Blindness caused by central artery occlusion following nasal septum correction.  HNO. 1990;  38 105-109
  • 32 Uslu H, Uslu C, Varoglu E, Demirci M, Seven B. Effects of septoplasty and septal deviation on nasal mucociliary clearance.  Int J Clin Pract. 2004;  58 1108-1111
  • 33 Stewart M G, Smith T L, Weaver E M et al.. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study.  Otolaryngol Head Neck Surg. 2004;  130 283-290
  • 34 Siegel N S, Gliklich R E, Taghizadeh F, Chang Y. Outcomes of septoplasty.  Otolaryngol Head Neck Surg. 2000;  122 228-232
  • 35 Pirila T, Tikanto J. Unilateral and bilateral effects of nasal septum surgery demonstrated with acoustic rhinometry, rhinomanometry, and subjective assessment.  Am J Rhinol. 2001;  15 127-133

 Professor Dr. med
Gerhard RettingerM.D. 

Head of ENT-Department University Ulm

Frauensteige 12, 89075 Ulm, Germany