A simple, single stage technique to harvest optimal ethmoid bone grafts for caudal septal deflections

Int Forum Allergy Rhinol. 2015 Jul;5(7):622-5. doi: 10.1002/alr.21520. Epub 2015 Apr 16.

Abstract

Background: Curvature of the caudal septum is a challenging area to surgically address because it is a tip supporting structure. Several methods to straighten the caudal septal deviation have been described to date. One commonly described technique is the placement of a bony septal batten graft. However, the harvest and subsequent ex vivo shaping of the bone graft can be difficult and lead to fracture of the graft superstructure. Here we discuss a novel single stage endoscopic approach to harvest a preformed batten graft and apply it to correct a caudal septal curvature deformity.

Methods: Description of a novel endoscopic technique for the single stage harvest of a bone graft for the correction of a caudal septal deflection utilizing an open Jansen-Middleton septum forceps.

Results: We have successfully utilized this technique in 10 patients with a caudal septal curvature deformity with no complications. All patients had symptomatic improvement of nasal obstruction symptoms.

Conclusion: The open Jansen-Middleton septum forceps allow for a reproducible, single stage, harvest of a bone graft from the perpendicular plate or vomer when addressing a caudal septal deformity using an endoscopic septoplasty approach.

MeSH terms

  • Bone Transplantation*
  • Ethmoid Bone / transplantation*
  • Humans
  • Nasal Obstruction / diagnostic imaging
  • Nasal Obstruction / surgery*
  • Nasal Septum / abnormalities
  • Nasal Septum / diagnostic imaging
  • Nasal Septum / surgery*
  • Natural Orifice Endoscopic Surgery / instrumentation*
  • Natural Orifice Endoscopic Surgery / methods*
  • Nose Deformities, Acquired / diagnostic imaging
  • Nose Deformities, Acquired / surgery*
  • Rhinoplasty / methods*
  • Tissue and Organ Harvesting / methods*
  • Tomography, X-Ray Computed