Outcomes of Combined Anterior Septal Reconstruction and Dorsal Hump Reduction.

[OBJECTIVES/HYPOTHESIS] Deviations of the caudal nasal septum can impact airflow and aesthetics. The anterior septal reconstruction (ASR) technique, a modification of extracorporeal septoplasty, addresses this issue while preserving a segment of the dorsal septum. When ASR is combined with dorsal hump reductions and osteotomies, the keystone may be destabilized. This study evaluates the outcomes of this intervention.

[STUDY DESIGN] Retrospective chart review.

[METHODS] This is a retrospective study evaluating the functional and aesthetic outcomes of 58 patients who underwent ASR combined with dorsal hump reductions (with or without osteotomies). The Nasal Obstruction Symptom Evaluation (NOSE) and Standardized Cosmesis and Health Nasal Outcomes Survey Obstructive/Cosmetic (SCHNOS-O, SCHNOS-C) scores were measured and compared pre- and postoperatively. Linear regression analysis was performed to determine the impact of sex, gender, osteotomies, and trauma on outcomes.

[RESULTS] Mean improvement in NOSE, SCHNOS-O, and SCHNOS-C scores within the first 3 months after surgery were -41.8, -32.6, and -51.5 respectively (P < .05). At follow-up >9 months, these improvements were also significant for NOSE and SCHNOS-O scores and approached significance (P = .06) for SCHNOS-C scores. A subanalysis of patients who underwent osteotomies yielded functional and aesthetic improvements across all follow-up periods, all of which were significant with the exception of SCHNOS-O scores at >9 months (P = .1). In a multiple linear regression analysis, osteotomies contributed significantly to change in SCHNOS-C scores (β = -64.09, P = .001) at 3- to 9-month follow-up.

[CONCLUSIONS] The combination of ASR, hump take down, and osteotomies is safe and efficacious with implications for patients who seek correction of caudal septal deviations in conjunction with changes in external contour deformities.

[LEVEL OF EVIDENCE] 3 Laryngoscope, 2020.