{"id":1714,"date":"2022-12-21T06:35:46","date_gmt":"2022-12-21T06:35:46","guid":{"rendered":"https:\/\/drshehabbeg.com\/?p=1714"},"modified":"2025-04-22T10:28:46","modified_gmt":"2025-04-22T10:28:46","slug":"treatment-of-deviated-nose","status":"publish","type":"post","link":"https:\/\/drshehabbeg.com\/index.php\/2022\/12\/21\/treatment-of-deviated-nose\/","title":{"rendered":"TREATMENT OF DEVIATED NOSE"},"content":{"rendered":"<p>TREATMENT OF DEVIATED NOSE <b style=\"color: var(--wd-title-color); font-family: var(--wd-title-font); font-size: 18px; font-style: var(--wd-title-font-style); text-transform: var(--wd-title-transform); background-color: var(--wd-main-bgcolor);\">Prof. D<\/b><b style=\"color: var(--wd-title-color); font-family: var(--wd-title-font); font-size: 18px; font-style: var(--wd-title-font-style); text-transform: var(--wd-title-transform); background-color: var(--wd-main-bgcolor);\">r.<\/b><b style=\"color: var(--wd-title-color); font-family: var(--wd-title-font); font-size: 18px; font-style: var(--wd-title-font-style); text-transform: var(--wd-title-transform); background-color: var(--wd-main-bgcolor);\"> Mirza S<\/b><b style=\"color: var(--wd-title-color); font-family: var(--wd-title-font); font-size: 18px; font-style: var(--wd-title-font-style); text-transform: var(--wd-title-transform); background-color: var(--wd-main-bgcolor);\">hehab<\/b><b style=\"color: var(--wd-title-color); font-family: var(--wd-title-font); font-size: 18px; font-style: var(--wd-title-font-style); text-transform: var(--wd-title-transform); background-color: var(--wd-main-bgcolor);\"> Afzal Beg<\/b><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture1.jpg\" sizes=\"(max-width: 842px) 100vw, 842px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture1.jpg 842w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture1-300x183.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture1-768x470.jpg 768w\" alt=\"TREATMENT OF DEVIATED NOSE\" width=\"842\" height=\"515\" \/><br \/>\n<img decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture2.jpg\" sizes=\"(max-width: 799px) 100vw, 799px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture2.jpg 799w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture2-300x192.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture2-768x492.jpg 768w\" alt=\"\" width=\"799\" height=\"512\" \/><\/p>\n<h3 style=\"text-align: center;\"><b>ANATOMY<\/b><\/h3>\n<p><img decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture3.jpg\" sizes=\"(max-width: 639px) 100vw, 639px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture3.jpg 639w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture3-300x224.jpg 300w\" alt=\"\" width=\"639\" height=\"478\" \/><\/p>\n<h2>DEVIATED NOSE<\/h2>\n<ul>\n<li>Physical disorder of the nose involving a displacement of the nose off center(external deviation)<\/li>\n<li>Causes;\n<ul>\n<li>Deviated septum<\/li>\n<li>ULC-deforming forces<\/li>\n<li>Asymmetrical nasal bones<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4><b>AETIOLOGY<\/b><\/h4>\n<ol>\n<li style=\"list-style-type: none;\">\n<ol>\n<li>Trauma<\/li>\n<li>Developmental errors<\/li>\n<li>Racial factors<\/li>\n<li>Hereditary factors<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<h4>TRAUMA<\/h4>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>A lateral blow on the nose may cause displacement of septal cartilage from the vomerine groove and maxillary crest<\/li>\n<li>A crushing blow from the front may cause buckling , twisting ,fractures and crushing of nasal septum<\/li>\n<li>Trauma during delivery<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4><b>DEVELOPMENTAL ERRORS<\/b><\/h4>\n<p>Here&#8217;s the sentence rewritten in active voice:<\/p>\n<p><strong>&#8220;The tectoseptal process forms the nasal septum as it descends to meet the two halves of the developing palate in the midline.&#8221;<\/strong><\/p>\n<ul>\n<li><\/li>\n<\/ul>\n<p style=\"text-align: center;\">Unequal growth between palate and base of skull may cause buckling of nasal septum<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture6.jpg\" sizes=\"(max-width: 787px) 100vw, 787px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture6.jpg 787w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture6-300x267.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture6-768x684.jpg 768w\" alt=\"\" width=\"787\" height=\"701\" \/><\/p>\n<h3><b>SEPTAL DEVIATION TYPES<\/b><\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7.jpg\" sizes=\"(max-width: 1218px) 100vw, 1218px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7.jpg 1218w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7-300x247.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7-1024x844.jpg 1024w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7-768x633.jpg 768w\" alt=\"\" width=\"1218\" height=\"1004\" \/><\/p>\n<h4><b>EFFECTS OF DNS<\/b><\/h4>\n<ul>\n<li>Compensatory hypertrophy of turbinates of opposite side<\/li>\n<li>External deformity<\/li>\n<li>Impairment of drainage to sinus<\/li>\n<li>Secondary atrophic rhinitis<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture8-232x300.jpg\" sizes=\"(max-width: 232px) 100vw, 232px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture8-232x300.jpg 232w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture8.jpg 639w\" alt=\"\" width=\"232\" height=\"300\" \/><\/p>\n<p><b>CLINICAL FEATURES<\/b><\/p>\n<ul>\n<li style=\"text-align: left;\">Nasal obstruction<\/li>\n<li style=\"text-align: left;\">Headache<\/li>\n<li style=\"text-align: left;\">Sinusitis<\/li>\n<li style=\"text-align: left;\">Epistaxis<\/li>\n<li style=\"text-align: left;\">Anosmia<\/li>\n<li style=\"text-align: left;\">External deformity<\/li>\n<li style=\"text-align: left;\">Middle ear infection<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture9-194x300.jpg\" sizes=\"(max-width: 194px) 100vw, 194px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture9-194x300.jpg 194w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture9.jpg 454w\" alt=\"\" width=\"194\" height=\"300\" \/><\/p>\n<h4><\/h4>\n<h4><b>COTTLE TEST<\/b><\/h4>\n<ul>\n<li>Used in nasal obstruction due to abnormality of nasal valve<\/li>\n<li>If the nasal airway improves on test side, the test is positive<\/li>\n<li>Indicates abnormality of internal nasal valve<\/li>\n<\/ul>\n<h4><b>TREATMENT OPTIONS<\/b><\/h4>\n<ul>\n<li>Submucous resection<\/li>\n<li>Septoplasty\n<ul>\n<li>Septum repositioning<\/li>\n<li>Septal resection<\/li>\n<li>Septal scoring<\/li>\n<li>Spreader graft\/Batten grafts<\/li>\n<li>Supporting sutures<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10.jpg\" sizes=\"(max-width: 770px) 100vw, 770px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10.jpg 770w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10-289x300.jpg 289w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10-768x798.jpg 768w\" alt=\"\" width=\"770\" height=\"800\" \/><\/p>\n<h3 style=\"text-align: center;\"><b>SUBMUCOUS RESECTION OPERATION<\/b><\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture11.jpg\" sizes=\"(max-width: 579px) 100vw, 579px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture11.jpg 579w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture11-300x218.jpg 300w\" alt=\"\" width=\"579\" height=\"420\" \/><\/p>\n<h4><\/h4>\n<h4><b>Anaesthesia <\/b><\/h4>\n<p>local anaesthesia or general anaesthesia<\/p>\n<h4><b>Positioning<\/b><\/h4>\n<p>reclining position with head end of the table raised<\/p>\n<h4><b>Infiltration<\/b><\/h4>\n<p>subperichondrial infiltration with xylocaine with adrenaline<\/p>\n<p style=\"text-align: center;\">Elevation of the mucoperichondrial and mucoperiosteal flaps on either side of the septal framework<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture15.jpg\" sizes=\"(max-width: 457px) 100vw, 457px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture15.jpg 457w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture15-300x220.jpg 300w\" alt=\"\" width=\"457\" height=\"335\" \/><br \/>\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture14.jpg\" sizes=\"(max-width: 377px) 100vw, 377px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture14.jpg 377w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture14-300x255.jpg 300w\" alt=\"\" width=\"377\" height=\"321\" \/><\/p>\n<h3 style=\"text-align: center;\"><b>SUBMUCOUS RESECTION INCISION<\/b><\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-274x300.jpg\" sizes=\"(max-width: 274px) 100vw, 274px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-274x300.jpg 274w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-934x1024.jpg 934w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-768x842.jpg 768w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12.jpg 973w\" alt=\"\" width=\"274\" height=\"300\" \/><\/p>\n<p style=\"text-align: center;\"><strong>Dislocation of bony cartilaginous junction<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture16.jpg\" sizes=\"(max-width: 479px) 100vw, 479px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture16.jpg 479w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture16-225x300.jpg 225w\" alt=\"\" width=\"479\" height=\"640\" \/><\/p>\n<ul>\n<li>Removing the deflected parts of bony and cartilaginous septum, leaving a 1cm l-strut dorsally and caudally<\/li>\n<li>Repositioning the flaps<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture17.jpg\" sizes=\"(max-width: 798px) 100vw, 798px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture17.jpg 798w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture17-300x241.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture17-768x618.jpg 768w\" alt=\"\" width=\"798\" height=\"642\" \/><\/p>\n<h4><b>SEPTOPLASTY<\/b><\/h4>\n<ul>\n<li>Performed under general anaesthesia in supine position<\/li>\n<li>Septal framework is corrected\/resected and repositioned<\/li>\n<li>Mucoperichondrial or mucoperiosteal flap is generally raised only in one side of the septum retaining the attachment and blood supply of the other<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture18.jpg\" sizes=\"(max-width: 352px) 100vw, 352px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture18.jpg 352w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture18-300x282.jpg 300w\" alt=\"\" width=\"352\" height=\"331\" \/><br \/>\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture19.jpg\" sizes=\"(max-width: 795px) 100vw, 795px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture19.jpg 795w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture19-300x217.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture19-768x555.jpg 768w\" alt=\"\" width=\"795\" height=\"575\" \/><\/p>\n<h4><b>SEPTOPLASTY\u00a0 INCISIONS<\/b><\/h4>\n<ul>\n<li>Transcolumellar stairstep with intranasal marginal incisions: standard for open rhinoplasty<\/li>\n<li>Cartilage-splitting incision: often used in<\/li>\n<li>Intercartilaginous incision: often used in combination with marginal incision to \u201cdeliver\u201d cartilage in closed rhinoplasty<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture25-300x222.jpg\" sizes=\"(max-width: 300px) 100vw, 300px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture25-300x222.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture25.jpg 510w\" alt=\"\" width=\"300\" height=\"222\" \/><br \/>\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture24.jpg\" alt=\"\" width=\"268\" height=\"198\" \/><\/p>\n<h4><\/h4>\n<h4><\/h4>\n<h4><b>EXPOSURE<\/b><\/h4>\n<ul>\n<li>Obtain wide exposure of the deviated structures<\/li>\n<li>Release all of the mucoperichondrial attachments of the deviated septum<\/li>\n<li>Release deforming forces, including the LLCs and ULCs from each other, and the ULCs from the septum<\/li>\n<\/ul>\n<h3 style=\"text-align: center;\"><b>IDENTIFICATION OF PROBLEM<\/b><\/h3>\n<ul>\n<li>If deviation is caused by asymmetry of the ULCs, the septal deviation can be corrected by the release of the ULCs from the LLCs<\/li>\n<\/ul>\n<ul>\n<li>If the deviation is result of septal deviation, the septum must be straightened<\/li>\n<\/ul>\n<ul>\n<li>The caudal septum must be anatomically reduced onto the nasal spine<\/li>\n<\/ul>\n<h4><\/h4>\n<h4><b>SEPTAL RESECTION<\/b><\/h4>\n<ul>\n<li>Resection of the posterocaudal segment of the septum<\/li>\n<li>A minimum of 1 cm septal L strut (dorsal and caudal septum) must be preserved to prevent collapse of dorsum<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture-297x300.jpg\" sizes=\"(max-width: 297px) 100vw, 297px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture-297x300.jpg 297w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture.jpg 706w\" alt=\"\" width=\"297\" height=\"300\" \/><br \/>\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture2-1-211x300.jpg\" sizes=\"(max-width: 211px) 100vw, 211px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture2-1-211x300.jpg 211w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture2-1.jpg 612w\" alt=\"\" width=\"211\" height=\"300\" \/><\/p>\n<h4><\/h4>\n<h4><b>SEPTAL TILT<\/b><\/h4>\n<p>The surgeon removes the posteriocaudal portion of the septum, leaving an L-strut septum anteriorly and caudally<\/p>\n<ul>\n<li><strong>The surgeon repositions the septum after removing a small segment of the overlapping cartilage and fixates it in the midline with a figure-of-eight suture.&#8221;<\/strong><\/li>\n<\/ul>\n<h4 style=\"text-align: center;\"><b>SWINGING DOOR TECHNIQUE<\/b><\/h4>\n<p>1.Excess septum above the maxillary crest is resected to permit repositioning in the midline<\/p>\n<p>2.Caudal septum is be secured to the anterior nasal spine<\/p>\n<article class=\"text-token-text-primary w-full\" dir=\"auto\" data-testid=\"conversation-turn-35\" data-scroll-anchor=\"true\">\n<div class=\"text-base my-auto mx-auto py-5 [--thread-content-margin:--spacing(4)] @[37rem]:[--thread-content-margin:--spacing(6)] @[70rem]:[--thread-content-margin:--spacing(12)] px-(--thread-content-margin)\">\n<div class=\"[--thread-content-max-width:32rem] @[34rem]:[--thread-content-max-width:40rem] @[64rem]:[--thread-content-max-width:48rem] mx-auto flex max-w-(--thread-content-max-width) flex-1 text-base gap-4 md:gap-5 lg:gap-6 group\/turn-messages focus-visible:outline-hidden\" tabindex=\"-1\">\n<div class=\"group\/conversation-turn relative flex w-full min-w-0 flex-col agent-turn\">\n<div class=\"relative flex-col gap-1 md:gap-3\">\n<div class=\"flex max-w-full flex-col grow\">\n<div class=\"min-h-8 text-message relative flex w-full flex-col items-end gap-2 text-start break-words whitespace-normal [.text-message+&amp;]:mt-5\" dir=\"auto\" data-message-author-role=\"assistant\" data-message-id=\"a741b4b6-c35a-44ae-8da5-cbeaeb7d804b\" data-message-model-slug=\"gpt-4o\">\n<div class=\"flex w-full flex-col gap-1 empty:hidden first:pt-[3px]\">\n<div class=\"markdown prose dark:prose-invert w-full break-words dark\">\n<p class=\"\" data-start=\"48\" data-end=\"170\"><strong data-start=\"48\" data-end=\"170\" data-is-last-node=\"\">&#8220;Alternatively, the surgeon can swing the excess septal length over to the contralateral side of the maxillary crest.&#8221;<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/article>\n<p>which serves as a &#8220;doorstop&#8221; to straighten the septum<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture3-1.jpg\" sizes=\"(max-width: 957px) 100vw, 957px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture3-1.jpg 957w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture3-1-300x96.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture3-1-768x245.jpg 768w\" alt=\"\" width=\"957\" height=\"305\" \/><\/p>\n<p style=\"text-align: center;\">The caudal septum can be stabilized in the midline by its insertion into a small pocket created between the medial crura (arrowhead) in a &#8220;tongue-in-groove&#8221; fashion<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture4.jpg\" sizes=\"(max-width: 1049px) 100vw, 1049px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture4.jpg 1049w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture4-300x114.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture4-1024x389.jpg 1024w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture4-768x292.jpg 768w\" alt=\"\" width=\"1049\" height=\"399\" \/><br \/>\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture5.jpg\" sizes=\"(max-width: 573px) 100vw, 573px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture5.jpg 573w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture5-300x164.jpg 300w\" alt=\"\" width=\"573\" height=\"314\" \/><\/p>\n<h3><\/h3>\n<h3><b>WEDGE EXCISION AND SHAVING<\/b><\/h3>\n<p>Small wedges of cartilage can be excised from the convex side of the deviation<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture6-1.jpg\" sizes=\"(max-width: 458px) 100vw, 458px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture6-1.jpg 458w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture6-1-300x243.jpg 300w\" alt=\"\" width=\"458\" height=\"371\" \/><\/p>\n<h3><\/h3>\n<h3><b>SCORING AND CROSS-HATCHING<\/b><\/h3>\n<p>Cartilage scoring on the concave side to destroy the cartilage memory and straighten the septum<\/p>\n<h3 style=\"text-align: center;\"><b>CORRECTION OF C&#8211;SHAPED SEPTAL DEVIATIONS<\/b><\/h3>\n<ul>\n<li>Resection of the posteriocaudal portion of the septum, partial<br \/>\ndisjunction of the perpendicular plate of the ethmoid and quadrangle cartilage and the scoring of the l-shaped frame in a cephalocaudal(a) and anteroposterior(b) direction on the concave surface<\/li>\n<li>An anterior nasal spine osteotomy may also be used to correct deviation at this level<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7-1.jpg\" sizes=\"(max-width: 713px) 100vw, 713px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7-1.jpg 713w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture7-1-300x183.jpg 300w\" alt=\"\" width=\"713\" height=\"436\" \/><br \/>\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture8-1.jpg\" sizes=\"(max-width: 725px) 100vw, 725px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture8-1.jpg 725w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture8-1-300x164.jpg 300w\" alt=\"\" width=\"725\" height=\"397\" \/><\/p>\n<p>Creation of a new l-strut using bilateral extended spreader grafts that articulate with a caudal septal replacement graft.<\/p>\n<h5 style=\"text-align: center;\"><b>SEPTAL BATTEN GRAFT<\/b><\/h5>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture9-1.jpg\" sizes=\"(max-width: 782px) 100vw, 782px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture9-1.jpg 782w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture9-1-300x174.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture9-1-768x445.jpg 768w\" alt=\"\" width=\"782\" height=\"453\" \/><\/p>\n<p style=\"text-align: center;\"><b>SPREADER GRAFT<\/b><\/p>\n<p style=\"text-align: center;\">\u00a0High septal deviation: shaving the convex side of the deviation with addition of cartilage dorsal spreader grafts +\/- scoring<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10-1.jpg\" sizes=\"(max-width: 812px) 100vw, 812px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10-1.jpg 812w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10-1-300x142.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture10-1-768x362.jpg 768w\" alt=\"\" width=\"812\" height=\"383\" \/><\/p>\n<ul>\n<li>\n<article class=\"text-token-text-primary w-full\" dir=\"auto\" data-testid=\"conversation-turn-33\" data-scroll-anchor=\"true\">\n<div class=\"text-base my-auto mx-auto py-5 [--thread-content-margin:--spacing(4)] @[37rem]:[--thread-content-margin:--spacing(6)] @[70rem]:[--thread-content-margin:--spacing(12)] px-(--thread-content-margin)\">\n<div class=\"[--thread-content-max-width:32rem] @[34rem]:[--thread-content-max-width:40rem] @[64rem]:[--thread-content-max-width:48rem] mx-auto flex max-w-(--thread-content-max-width) flex-1 text-base gap-4 md:gap-5 lg:gap-6 group\/turn-messages focus-visible:outline-hidden\" tabindex=\"-1\">\n<div class=\"group\/conversation-turn relative flex w-full min-w-0 flex-col agent-turn\">\n<div class=\"relative flex-col gap-1 md:gap-3\">\n<div class=\"flex max-w-full flex-col grow\">\n<div class=\"min-h-8 text-message relative flex w-full flex-col items-end gap-2 text-start break-words whitespace-normal [.text-message+&amp;]:mt-5\" dir=\"auto\" data-message-author-role=\"assistant\" data-message-id=\"bcd1e61e-a1ad-45b4-a006-7aaa2a06e2d5\" data-message-model-slug=\"gpt-4o\">\n<div class=\"flex w-full flex-col gap-1 empty:hidden first:pt-[3px]\">\n<div class=\"markdown prose dark:prose-invert w-full break-words dark\">\n<p class=\"\" data-start=\"55\" data-end=\"218\"><strong data-start=\"55\" data-end=\"218\" data-is-last-node=\"\">&#8220;The surgeon can make a series of full-thickness cuts (through only 50%) in the deviated portion of the dorsal septum to correct a persisted dorsal deviation.&#8221;<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"flex justify-start\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/article>\n<div class=\"pointer-events-none h-px w-px\" aria-hidden=\"true\" data-edge=\"true\">\n<article class=\"text-token-text-primary w-full\" dir=\"auto\" data-testid=\"conversation-turn-33\" data-scroll-anchor=\"true\">\n<div class=\"text-base my-auto mx-auto py-5 [--thread-content-margin:--spacing(4)] @[37rem]:[--thread-content-margin:--spacing(6)] @[70rem]:[--thread-content-margin:--spacing(12)] px-(--thread-content-margin)\">\n<div class=\"[--thread-content-max-width:32rem] @[34rem]:[--thread-content-max-width:40rem] @[64rem]:[--thread-content-max-width:48rem] mx-auto flex max-w-(--thread-content-max-width) flex-1 text-base gap-4 md:gap-5 lg:gap-6 group\/turn-messages focus-visible:outline-hidden\" tabindex=\"-1\">\n<div class=\"group\/conversation-turn relative flex w-full min-w-0 flex-col agent-turn\">\n<div class=\"relative flex-col gap-1 md:gap-3\">\n<div class=\"flex max-w-full flex-col grow\">\n<div class=\"min-h-8 text-message relative flex w-full flex-col items-end gap-2 text-start break-words whitespace-normal [.text-message+&amp;]:mt-5\" dir=\"auto\" data-message-author-role=\"assistant\" data-message-id=\"bcd1e61e-a1ad-45b4-a006-7aaa2a06e2d5\" data-message-model-slug=\"gpt-4o\">\n<div class=\"flex w-full flex-col gap-1 empty:hidden first:pt-[3px]\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/article>\n<\/div>\n<\/li>\n<li>&#8220;The surgeon should place bilateral cartilage spreader grafts for support and better definition of the dorsal aesthetic line if full-thickness cuts are needed.&#8221;<\/li>\n<\/ul>\n<p><b>EXTRACORPOREAL SEPTOPLASTY<\/b><\/p>\n<ul>\n<li>Whole septum is removed, L-strut is constructed and placed back<\/li>\n<li>The neo-septum is fixated to the upper lateral cartilages and keystone region dorsally and the lateral cartilages and nasal spine caudally<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture11-1.jpg\" sizes=\"(max-width: 553px) 100vw, 553px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture11-1.jpg 553w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture11-1-300x186.jpg 300w\" alt=\"\" width=\"553\" height=\"343\" \/><\/p>\n<p><b>ADDITIONAL PROCEDURE FOR TURBINATES<\/b><\/p>\n<ul>\n<li>Straightening of the septum narrows the nasal airway in patients with pre-existing inferior turbinate hypertrophy<\/li>\n<li>Options:\n<ul>\n<li>Out fracture of turbinate<\/li>\n<li>Submucous resection<\/li>\n<li>Destruction via cauterization<\/li>\n<li>Steroid injection<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><b>ADDRESSING THE NASAL BONE DEVIATION<\/b><\/p>\n<ul>\n<li>Asymmetrical oblique rasping of the nasal bones<\/li>\n<li>Osteotomies\n<ul>\n<li>If the nasal bones are symmetrical, lateral osteotomies alone will be sufficient<\/li>\n<li>The surgeon may need to perform medial osteotomies if the nasal bones are asymmetrical.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p style=\"text-align: center;\"><b>OSTEOTOMIES<\/b><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-1.jpg\" sizes=\"(max-width: 1084px) 100vw, 1084px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-1.jpg 1084w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-1-300x133.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-1-1024x454.jpg 1024w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture12-1-768x341.jpg 768w\" alt=\"\" width=\"1084\" height=\"481\" \/><\/p>\n<p style=\"text-align: center;\"><b>ANTERIOR NASAL PACKING<\/b><\/p>\n<p style=\"text-align: center;\"><b>STERISTRIP APPLICATION<\/b><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture13.jpg\" sizes=\"(max-width: 1034px) 100vw, 1034px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture13.jpg 1034w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture13-300x203.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture13-1024x692.jpg 1024w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture13-768x519.jpg 768w\" alt=\"\" width=\"1034\" height=\"699\" \/><br \/>\n<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture14-1.jpg\" sizes=\"(max-width: 644px) 100vw, 644px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture14-1.jpg 644w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture14-1-300x176.jpg 300w\" alt=\"\" width=\"644\" height=\"378\" \/><\/p>\n<p style=\"text-align: center;\"><b>COMPLICATIONS OF SEPTAL SURGERY<\/b><\/p>\n<ol>\n<li>Haemorrhage<\/li>\n<li>Septal hematoma\/ infection\/ abscess \/perforation<\/li>\n<li>Saddle nose \/ supratip depression\/ Columellar retraction<\/li>\n<li>Collapsed septum<\/li>\n<li>Persistent deviation<\/li>\n<li>Nasal synechia<\/li>\n<li>C.S.F. rhinorrhoea<\/li>\n<li>Infection<\/li>\n<li>Toxic shock syndrome<\/li>\n<\/ol>\n<p><b>POSTOP CARE<\/b><\/p>\n<ul>\n<li>Head elevation<\/li>\n<li>Nasal normal saline drops starting in the evening of procedure day<\/li>\n<li>Removal of nasal pack in 24-48 hours<\/li>\n<li>Avoidance of strenuous activities, contact sports bending head, coughing and constipation in early post op period<\/li>\n<li>Follow up in one week for ROS and steristrips, 2 weeks , 6 weeks and then in 3 months<\/li>\n<\/ul>\n<p style=\"text-align: center;\"><b>DEVIATED NOSE TREATMENT ALGORITHM<\/b><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture15-1.jpg\" sizes=\"(max-width: 820px) 100vw, 820px\" srcset=\"https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture15-1.jpg 820w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture15-1-300x245.jpg 300w, https:\/\/drshehabbeg.com\/wp-content\/uploads\/2022\/12\/Picture15-1-768x628.jpg 768w\" alt=\"\" width=\"820\" height=\"670\" \/><\/p>\n<h3>TREATMENT OF DEVIATED NOSE<\/h3>\n<h5>Contact Us<br \/>\nEmail ID: ahtcspk@yahoo.com<br \/>\nContact no: 0323 2847513<\/h5>\n<p>Facebook Pages<\/p>\n<p><a href=\"https:\/\/www.facebook.com\/Karachi-Plastic-Surgery-105404788979850\">https:\/\/<\/a><a href=\"https:\/\/www.facebook.com\/Karachi-Plastic-Surgery-105404788979850\">www.facebook.com\/Karachi-Plastic-Surgery-105404788979850<\/a><br \/>\n<a href=\"https:\/\/www.facebook.com\/Dr-Shehab-Beg-Plastic-Surgeon-104382309083393\/\">https:\/\/www.facebook.com\/Dr-Shehab-Beg-Plastic-Surgeon-104382309083393<\/a><a href=\"https:\/\/www.facebook.com\/Dr-Shehab-Beg-Plastic-Surgeon-104382309083393\/\">\/<\/a><br \/>\n<a href=\"https:\/\/www.facebook.com\/Advanced-Hair-Transplant-Plastic-Surgery-102536472604336\">https:\/\/<\/a><a href=\"https:\/\/www.facebook.com\/Advanced-Hair-Transplant-Plastic-Surgery-102536472604336\">www.facebook.com\/Advanced-Hair-Transplant-Plastic-Surgery-102536472604336<\/a><\/p>\n<h6>Website<br \/>\n<a href=\"https:\/\/drshehabbeg.com\/\">https:\/\/drshehabbeg.com<\/a>\u00a0 | <a href=\"https:\/\/www.ahtcs.com\/\">https:\/\/www.ahtcs.com<\/a>\u00a0 | <a href=\"https:\/\/www.karachiplasticsurgery.com\/\">https:\/\/www.karachiplasticsurgery.com<\/a><\/h6>\n","protected":false},"excerpt":{"rendered":"<p>TREATMENT OF DEVIATED NOSE Prof. Dr. Mirza Shehab Afzal Beg ANATOMY DEVIATED NOSE Physical disorder of the nose involving a<\/p>\n","protected":false},"author":1,"featured_media":1717,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9,1],"tags":[],"class_list":["post-1714","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-surgery-procedures","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>TREATMENT OF DEVIATED NOSE | drshehabbeg.com<\/title>\n<meta name=\"description\" content=\"&quot;Treatment of Deviated Nose by Prof. Dr. Shehab Beg, Best Nose Surgeon in Karachi \u2013 Expert Care for Nose Correction 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