This study investigated changes in size of the bony nasal vault after closed septal osteotomy and turbinotomy. Maximal internal diameter of the bony vault was measured bilaterally in 7 cadavers, and casts of the vault made with a silicone compound. Maximal internal diameter was determined by observing the largest diameter rubber tube (3/16 – 9/16") admissible through the vestibule. Casts were sectioned and vault diameter measured serially. Repeated measurements and casting were performed after immediate closed septal osteotomy/turbinotomy.

Results

Closed septal osteotomy/turbinotomy enlarged the more constricted side in all 7 cases (Mann-Whitney–U, p< 0.05). Mean increase was 70% in maximum diameter (from 3/16" to 5/16"). The non-constricted side was not reduced in diameter despite septal displacement, attributable to turbinate reduction on the non-constricted side with closed turbinotomy. Examination and measurements of the casts showed diameter changes confined primarily to the inferior turbinate level, turbinate displacement toward the maxillary wall, and change in turbinate size and position independent of changes in its mucous membrane width.

Conclusions

Closed septal osteotomy/turbinotomy is a simple, non-invasive technique which enlarges the nasal vault in a cadaver model. The bony septum was medianized and the turbinate lateralized, with significant enlargement of the bony vault.