الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 97 |  |  |
| | | from | 97 | | |
Abstract
Caudal or anterior nasal septum deviations cause much complaint, both obstructive as well as cosmetic to the nasal tip. Caudal nasal deviation, manifested by a “crooked tip”, asymmetric nostrils, and a deviated columella, is one of the most challenging deformities encountered in septoplasty. Even small anterior deviations cause important nasal obstruction because they are located exactly in the narrowest portion of the nasal cavity (the nasal valve). Metzenbaum (7) is credited as being the first to address the challenges of the caudal septal deviation. He described “swinging door” technique. Many have used modifications of this technique in the last 80 years. Other authors have developed different ways to correct these deviations. Having so many different techniques that have been tested and proved, reflect the great difficulty in correcting these anterior deviations. If this is a simple correction, there would be only one single universal technique accepted. This study was planned to include 25 patients with caudal end dislocation of the nasal septum. These patients were classified into two groups, group A consisted of 13 patients in whom dislocated caudal end was corrected by (tongue in groove) technique, and group B consisted of 12 patients in whom dislocated caudal end was corrected by (cartilage resection) technique. Preoperatively, all patients were subjected to full history talking, clinical examination, preoperative filling of the NOSE questionnaire and preoperative photographs in order to show the deformity before procedure. Postoperatively, all patients were subjected to postoperative follow up during which clinical examination was performed to evaluate the aesthetic and functional outcomes of the performed procedure, postoperative filling of the NOSE questionnaire by the patient at least 3 months postoperatively, and photographs were taken at least 6 months after the surgery in order to show the cosmetic improvement after the surgery. Preoperative and postoperative evaluation was performed using photographs and the Nasal Obstruction Symptoms Evaluation scale. Both groups showed improvement in airway function postoperatively but group A showed significant improvement in the postoperative NOSE score greater than group B using paired t-test. A P value of less than 0.05 is considered statically significant. In group B 40.0% of the patients (who undergone cartilage resection) have residual postoperative caudal dislocation or sublaxation while in group A (who undergone tongue in groove) there was no residual postoperative caudal dislocation or sublaxation. Examination of postoperative photographs revealed improved tip anatomy. All patients of group A have postoperative firm sensation of the tip while none of group B patients had.