Skip to main content Accessibility help

A new technique of revision septoplasty using semi-penetrating straight and circular incisions of the nasal septum

  • L Wei (a1), L Wang (a1), W Lu (a1), T Jiang (a1), Z Liu (a1), M Wang (a1), X Wu (a2) and Z Wang (a1)...



This study aimed to investigate endoscopic revision septoplasty with semi-penetrating straight and circular incisions in patients for whom septoplasty was unsuccessful.


Patients in this study (n = 14) had a deviation of the nasal septum after septoplasty. Pre-operative and post-operative assessments were performed using a visual analogue scale and nasal endoscope. Semi-penetrating straight and circular incisions in front of the caudal septum and at the margin of the nasal septal cartilage–bone defect, respectively, were made. The mucoperichondrium and mucoperiosteum were bilaterally dissected until interlinkage with the cartilage–bone defect was achieved. Mucous membranes within the circular incision as well as the right mucoperichondrium and mucoperiosteal flaps were protected by pushing them to the right. This exposed the osteocartilaginous framework and allowed correction of the residual deviation. The patients were followed up for 30–71 months.


For nasal obstruction and headaches, a significant improvement was noted in post-operative compared to pre-operative visual analogue scale scores. No patients had septal deviations, saddle nose, false hump nose or contracture of the nasal columella.


The technique allowed exposure of the septal osteocartilaginous framework and a broad operational vision, which enabled successful correction of various deformities of the nasal septum.


Corresponding author

Author for correspondence: Dr Zhiqiang Wang, Otolaryngology Department, Affiliated Zhongshan Hospital of Dalian University, 6# Jiefang Street, Zhongshan District, Dalian 116001, China E-mail: Fax: +86 411 628 93555


Hide All

Dr Z Wang takes responsibility for the integrity of the content of the paper



Hide All
1Samad, I, Stevens, HE, Maloney, A. The efficacy of nasal septal surgery. J Otolaryngol 1992;21:8891
2Bohlin, L, Dahlqvist, A. Nasal airway resistance and complications following functional septoplasty: a ten-year follow-up study. Rhinology 1994;32:195–7
3Illum, P. Septoplasty and compensatory inferior turbinate hypertrophy: long-term results after randomized turbinoplasty. Eur Arch Otorhinolaryngol 1997;254(suppl 1):8992
4Siegel, NS, Gliklich, RE, Taghizadeh, F, Chang, Y. Outcomes of septoplasty. Otolaryngol Head Neck Surg 2000;122:228–32
5Dinis, PB, Haider, H. Septoplasty: long-term evaluation of results. Am J Otolaryngol 2002;23:8590
6Uppal, S, Mistry, H, Nadig, S, Back, G, Coatesworth, A. Evaluation of patient benefit from nasal septal surgery for nasal obstruction. Auris Nasus Larynx 2005;32:129–37
7Harrison, L, Jones, NS. Intranasal contact points as a cause of facial pain or headache: a systematic review. Clin Otolaryngol 2013;38:822
8Rudmik, L, Mace, J, Ferguson, BJ, Smith, TL. Concurrent septoplasty during endoscopic sinus surgery for chronic rhinosinusitis: does it confound outcomes assessment? Laryngoscope 2011;121:2679–83
9Manoukian, PD, Wyatt, JR, Leopold, DA, Bass, EB. Recent trends in utilization of procedures in otolaryngology-head and neck surgery. Laryngoscope 1997;107:472–7
10You, X, Gao, Q, Liu, Z, Cui, Y. The value of nasal endoscopy in the resection of upper and posterior nasal septum deviation [in Chinese]. Lin Chuang Er Bi Yan Hou Ke Za Zhi 1999;13:392–3
11Gillman, GS, Egloff, AM, Rivera-Serrano, CM. Revision septoplasty: a prospective disease-specific outcome study. Laryngoscope 2014;124:1290–5
12Xiao, HJ, Kong, WJ, Wang, GP, Yang, CZ, Le, JX. Revision of submucous resection of nasal septum [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2006;41:184–6
13Sillers, MJ, Cox, AJ 3rd, Kulbersh, B. Revision septoplasty. Otolaryngol Clin North Am 2009;42:261–78
14Becker, SS, Dobratz, EJ, Stowell, N, Barker, D, Park, SS. Revision septoplasty: review of sources of persistent nasal obstruction. Am J Rhinol 2008;22:440–4
15Grymer, LF, Hilberg, O, Elbrønd, O, Pedersen, OF. Acoustic rhinometry: evaluation of the nasal cavity with septal deviations, before and after septoplasty. Laryngoscope 1989;99:1180–7
16Metzenbaum, M. Replacement of the lower end of the dislocated septal cartilage versus submucous resection of the dislocated end of the septal cartilage. Arch Otolaryngol 1929;9:282–6
17Pastorek, NJ, Becker, DG. Treating the caudal septal deflection. Arch Facial Plast Surg 2000;2:217–20
18Pham, AM, Tollefson, TT. Correction of caudal septal deviation: use of a caudal septal extension graft. Ear Nose Throat J 2007;86:142–4
19Giacomini, P, Lanciani, R, Di Girolamo, S, Ferraro, S, Ottaviani, F. Caudal septal deviation correction by interlocked graft technique. Ann Plast Surg 2010;65:280–4
20Constantine, FC, Ahmad, J, Geissler, P, Rohrich, RJ. Simplifying the management of caudal septal deviation in rhinoplasty. Plast Reconstr Surg 2014;134:379e–88e
21Stupak, HD. Book review: functional reconstructive nasal surgery. Ann Otol Rhinol Laryngol 2016;125:522


Related content

Powered by UNSILO

A new technique of revision septoplasty using semi-penetrating straight and circular incisions of the nasal septum

  • L Wei (a1), L Wang (a1), W Lu (a1), T Jiang (a1), Z Liu (a1), M Wang (a1), X Wu (a2) and Z Wang (a1)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.