Two-level septocolumellar suture technique for correction of septal caudal dislocation / Técnica de sutura septocolumelar em dois níveis para correção de desvio septal caudal

ABSTRACT INTRODUCTION: Caudal septal dislocation is a respiratory and cosmetic problem. The correction of caudal septal dislocation is a challenging issue. Although different modalities have been described for the treatment, it is still controversial. OBJECTIVES: This study aims to describe a two-level suture technique which can be used to correct and stabilize the septum in the columellar pocket. METHODS: The caudal septum was fixed to the nasal spine with suturing, and an anterior columellar pocket was formed. Two septocolumellar sutures including superior and inferior were performed to correct the dislocated caudal septum and to increase the stability of caudal septum in the columellar pocket. RESULTS: Anterior rhinoscopy showed no recurrent deviation or dislocation in our patients. CONCLUSION: Our suture technique is an effective and easy-to-use method to correct the caudal septal dislocation. It can also be used to increase the stability of corrected septum by other techniques. A two-level suture technique increases the success of correction and reduces the risk of postoperative septal caudal luxation, stabilizing the superior portion of the caudal septum, in particular. Therefore, it would reduce the rate of redo surgeries.

Resumo Introdução: O desvio septal caudal é um problema respiratório e estético, e a sua correção é tarefa desafiadora. Embora tenham sido descritas diferentes modalidades para o tratamento, esse é ainda um tópico controverso. Objetivos: O presente estudo objetivou descrever uma técnica de sutura em dois níveis, que pode ser empregada na correção e estabilização do septo na bolsa columelar. Método: O septo caudal foi fixado à espinha nasal com suturas, após a realização de uma bolsa columelar anterior. Duas suturas septocolumelares, superior e inferior, foram aplicadas para a correção do desvio septal caudal e, também, para maior estabilidade do septo caudal na bolsa columelar. Resultados: Rinoscopia anterior não resultou em recorrência do desvio ou luxação em nossos pacientes. Conclusão: Nossa técnica de sutura é um método efetivo e de fácil uso para a correção do desvio septal caudal. A técnica também pode ser utilizada para aumentar a estabilidade de septos corrigidos por outras técnicas. A técnica de sutura em dois níveis aumenta o sucesso da correção e diminui o risco de luxação septal caudal, estabilizando, em particular, a parte superior do septo caudal. Portanto, nossa técnica diminui o percentual de reoperações.

Two-level septocolumellar suture technique for correction of septal caudal dislocation.

INTRODUCTION: Caudal septal dislocation is a respiratory and cosmetic problem. The correction of caudal septal dislocation is a challenging issue. Although different modalities have been described for the treatment, it is still controversial. OBJECTIVES: This study aims to describe a two-level suture technique which can be used to correct and stabilize the septum in the columellar pocket. METHODS: The caudal septum was fixed to the nasal spine with suturing, and an anterior columellar pocket was formed. Two septocolumellar sutures including superior and inferior were performed to correct the dislocated caudal septum and to increase the stability of caudal septum in the columellar pocket. RESULTS: Anterior rhinoscopy showed no recurrent deviation or dislocation in our patients. CONCLUSION: Our suture technique is an effective and easy-to-use method to correct the caudal septal dislocation. It can also be used to increase the stability of corrected septum by other techniques. A two-level suture technique increases the success of correction and reduces the risk of postoperative septal caudal luxation, stabilizing the superior portion of the caudal septum, in particular. Therefore, it would reduce the rate of redo surgeries.

Postadenoidectomy hemorrhage: how we do it?

AIMS: Conventionally, adenoidectomy has been performed using blind curettage. Postoperative hemorrhage is the most common complication of surgery. There is no specific management algorithm in the literature. In this study, we described an endoscopic approach in the management of postadenoidectomy hemorrhage. MATERIAL AND METHODS: Between 1995 and 2014, 7946 patients undergoing adenoidectomy under general anesthesia in our clinic were retrospectively analyzed. All patients had a rest adenoid tissue located in the choanae. Endoscopic excision of the tissue was performed without using a post-nasal pack. RESULTS: All patients (100%) had a rest adenoid tissue located in the choanae. Hemorrhage was completely discontinued with endoscopic excision of the hemorrhagic tissue. CONCLUSION: Based on our study findings, we conclude that an endoscopic approach should be applied in all postoperative patients with hemorrhage who are unresponsive to conservative treatment modalities.