The Nasal Septum

Septoplasty is one of the most common otolaryngologic surgeries performed. Unfortunately, intricacies and nuances of septoplasty are currently underestimated by many, leading to preventable complications including persistent deviations and septal perforations. Best practices include choosing the optimal starting incision, freeing up bilateral mucoperichondrial flaps for caudal deflections, avoiding mucosal tears by meticulous dissection, reskeletonizing the flaps with straightened or crushed cartilage prior to closure, mattressing the flaps together after cartilage and bony removal with absorbable suture on curved needles, repairing any tear in the mucoperichondrial flaps, and avoiding intranasal packing or hard nasal splints.