Effects of various submucous resection techniques of septal cartilage on nasal tip projection

Background: There is little research which determines whether septoplasty affects nasal projection. Objectives: To assess the effect of various septoplasty (submucous resection, SMR) techniques on nasal tip projection in a fresh cadaver model. Methods: The nasal tip projection was measured on 6 fresh cadaver heads and compared postoperatively after a sequence of submucous septoplasty maneuvers. Five different septoplasty techniques were performed in the same sequence on each cadaver. After each technique, measurements were performed. Results: Removal of a central square piece of quadrangular cartilage resulted in a loss of projection in 3 in 6 (50%) heads, with average loss of 7.76%. Removal of additional cartilage along the bony cartilaginous junction resulted in no loss of projection. Removing more septum along the floor resulted caused a change loss in nasal projection in 1 in 6 (17%) cadavers. Removing the remaining septum, except for the L-strut resulted in a loss of projection in 2 in 6 (33%) heads with an average percent change in tip projection of 9.08%. Swinging door technique resulted in a loss of projection in 1 cadaver (17%), with loss of 6.25%. All 6 cadavers experienced loss of nasal projection. When all maneuvers were taken in total, there was a statically significant average decrease in projection of 8.93% (range, 5.00-13.04%, p = 0.008). Conclusion: Primary septoplasty carries a risk of nasal tip projection, with certain maneuvers carrying higher risk. (C) 2011 ARS-AAOA, LLC.