Dr. Nassif: Now we’re starting the septoplasty. The septoplasty is correction of the deviated septum where any part of the septum made out of either cartilage or bone is obstructing the airway. A deviated septum affects breathing and the more deviated it is the more nasal obstruction you’re going to have. This situation, it’s really obstructing her left airway. The septum is the partition that divides the left and the right airway.
I’m going back to the junction where the bone meets the cartilage. Now we’re going to have specimen. So now we’re removing the vomer which is part of the septum which is obstructing her airway. So here’s what we just removed. So we’re removing part of what we call the septo-bone. The back part of the septum is composed of bone and the front part of the septum is composed of cartilage.
With Luisa’s septoplasty, this was an extremely difficult deviated septum to repair because it was really crooked at the end of it; it was really deviated over to the right. So here’s the septum where this should be straight it’s curving now over to the right towards me. That’s the front end of the septum so we have to somehow figure out a good way to straighten that. What I’m doing now is I’m putting a stitch along the bottom part of the deviated septum to see if that will help us get that straightened out. This is still very crooked. We’re going to see if I can get this closed because her septum is extremely crooked. It’s bending basically.
After I did all my work on the inside of the nose I still noticed that it was still crooked up in the top part of the nose. We’ll use this here to straighten it out. So I had to use something called a septo-batten graft. So this is a septo-batten graft. I’m using this to help straighten out that crooked septum. We’re going to see how it turns out. And what a septo-batten graft does, it adds stability to the curved part of the nose and I have to sometimes move it from left to right; you know the upper part of the dorsum of the septum or the lower part. I have to move this little batten graft around, sometimes add two or three of them to get the septum straight. So you really want to make sure the septum is straight because if the septum is deviated the tip of the nose will also be deviated.
Today I saw Luisa, she’s about seven weeks following a closed rhinoplasty, septoplasty, and turbinoplasty. We performed multiple procedures on her to take down her hump, make the middle part of her nose more symmetric, and fix her deviated septum to help open up her airway. The surgery went very smooth it was exactly what I expected. At this point she’s very early in her healing phase but she’s fine, everything looks great and she’s healing beautifully.