DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20191442

Metzenbaum’s procedure: a forgotten technique in septal surgery

K. Satish Kumar, Deepalakshmi Tanthry

Abstract


Background: Deviation of the caudal end of the nasal septum is one of the significant challenges encountered in septal surgery. Deviated caudal septum changes lobular and columellar relationships and has a significant effect on tip position and symmetry. Metzenbaum was the first to describe the technique for the mobilisation of the caudal end in a swinging door fashion. Our study aims to highlight the procedure and its advantages.

Methods: This prospective study was conducted in Department of ENT and Head and Neck Surgery, Adichuchanagiri Institute of Medical Sciences, BG Nagara, between January 2018 to January 2019. 30 patients above 18 years of age, presenting with isolated deviation of the caudal end of the nasal septum were included in the study. A detailed clinical and photodocumentation was done and the results were analysed as follows.  

Results: The postoperative surgical results were evaluated using a 4 point scale. 26 (86.7%) patients gave a score of 1 on the 4 point scale suggesting that they were completely satisfied with the results. Whereas 3 (10%) patients gave a score of 2 on our 4 pt scale. 1 (3.3%) patient felt that there was only a minimal improvement after the surgery hence gave a score of 3 on the 4 point scale.

Conclusions: We conclude that Metzenbaum’s technique is very effective in treating caudal septal deviations. Reviving the Metzenbaum’s procedure will help reduce the failure rate in surgeries for correction of caudal septal deviation.


Keywords


Metzenbaum, Caudal end deviation, Septoplasty

Full Text:

PDF

References


Baumann I. Septoplasty Update. Laryngorhinotalgie. 2010;89(6):373–84.

Sedwick JD, Lopez AB, Gajewski BJ, Simons R, Caudal septoplasty for the treatment of septal deviation; Aesthetic and functional correction of nasal base. Arch Facial Plast Surg. 2005;7(3):158–62.

Lawson W, Westreich R. Correction of caudal deflections of the nasal septum with a modified Goldman technique; how we do it. ENT J. 2007;86(10):617-20.

Hossam MJ, Foda K, Caudal septum replacement graft, Arch Facial Plast Surg. 2008;10(3):20-5.

Wexler MR, Surgical repair of the caudal end of the septum. Laryngoscope. 1977;87(3):304-9.

Metzenbaum M. Dislocation of the lower end of the nasal septal cartilage. Arch Otolaryngol Head Neck Surg. 1936;24(1):78- 88.

Koch CA, Friedman O. Modified back to back autologous conchal cartilage graft for caudal septal construction. Arch Facial Plast Surg. 2011;13(1):20-5.

Garcia LB, Oleveira P, Vidigal TA, Suguri VM, Santos RP, Gregorio LC. Caudal septoplasty; Efficacy of a surgical technique – Prelimnary report, Braz J Otorhinolaryngol. 2011;77(2):178-84.