New Incision Method for Effective Execution of Endonasal Septoplasty

Introduction: Endonasal septoplasty is almost no effect on the tip support mechanism. However, it has the difficulties in exfoliation of muciperichondrial flap and narrow view of the surgical area.¹ Therefore, Author have devised incision method that can easily exfoliate and effectively expose the nasal septum that the existing approach method and I am making report of the comparison of my method with the existing methods.

Methods: Firstly, incision was made between a and a`(dense area) on the median line of the existing modified Killian incision with interval of approximately 5mm. The incision was extended to the both ends(loose area) in radial direction that can be reached with clear surgical view. Then, simple suture with vicryl 5-0 was made at 2 locations(a, a`) after having collected the septum by leaving L-strut following exfoliation of mucoperichondrial flap(Fig. 1, 2). Endonasal septoplasty under the conditions that are the same as the existing 3 types of incision methods was performed 10 times and the average duration of surgery using my method was compared with the other 3 methods in order to determine the usefulness of my method at the time of endonasal septoplasty.

Results: My incision method took the shortest time among the methods compared with average time of 9 minutes and 43 seconds in collecting the maximum quantity of septum while leaving the L-strut(Table 1).

Conclusion: By exfoliating the dense tissues in a relatively small area of 5mm, it was possible to accurately perform septoplasty as it was possible to secure relative wider surgical view by easily exfoliating the loose tissues. In addition, suturing could be easily completed through simple suture with vicryl 5-0 only at a and a' following collection of the septum. For these reasons, my incision method recommended as an effective approach to be implemented in endonasal septoplasty since it requires the shortest time for surgery in comparison to the existing incision methods.

Table. 1. Comparison of 4 types of incision methods

	Transfixation	Killian	Modified Killian	Author`s incision
Time taken for the surgery*	15 minutes and 55 seconds	11minutes and 57seconds	10minutes and 10seconds	9minutes and 43seconds

* Rounded off to the unit of second

Fig. 1. Representative incision methods and my method of endonasal septoplasty

Fig. 2. Mucoperichondrial flap of nasal septum