Hirai Tomohisa, Ueda Tsutomu, Ishino Takashi, Hamamoto Takao, Takeno Sachio, Sera Takehiro
Otolaryngology, Hiroshima Prefectural Hospital, Hiroshima, JPN.
Otolaryngology - Head and Neck Surgery, Hiroshima University, Hiroshima, JPN.
Cureus. 2025 Jan 27;17(1):e78104. doi: 10.7759/cureus.78104. eCollection 2025 Jan.
Surgery for caudal septal deviations is challenging due to cartilage shape memory, the need for adequate nasal tip and dorsal septal support, and long-term healing effects. Here, we report a new surgical method for caudal septal deviations called the minimally invasive cutting and suture technique (MICST). Although similar to the cutting and suture technique, MICST preserves the tissue around the posterior septal angle by maintaining the continuity of the nasal septum cartilage from the keystone area to the anterior nasal spine. The direction of the cutting line is parallel to the dorsal line of the nose, allowing it to release excess pressure from both dorsal and caudal deviations.
A total of 45 patients underwent MICST between September 2022 and August 2023. We analyzed data collected preoperatively and 3 months postoperatively to compare the cross-sectional area ratios of the convex side (narrower) and the concave side (wider), known as the N/W ratio and nasal tip height (using computed tomography), visual analog scale, and operative time with those of 45 patients who underwent the standard cutting and suture technique (CST) between September 2020 and July 2022.
Significant differences were not observed in preoperative and postoperative N/W ratio, and visual analog scale scores between the MICST and CST groups. The proportion of cases in which the nasal tip decreased by ≥3 mm was higher in the CST group, and the operative time was shorter in the MICST group.
The improvement of nasal obstruction using MICST is equivalent to that of CST. Compared to conventional methods, MICST results in the more conservative treatment of the nasal septal cartilage, carries a smaller risk of external nasal deformity, allows correction of dorsal deviation, and does not require a batten graft. The procedure is straightforward and can be performed in a short time.
由于鼻中隔软骨的形状记忆特性、鼻尖和鼻中隔背侧支撑的需求以及长期愈合效果，尾侧鼻中隔偏曲的手术具有挑战性。在此，我们报告一种治疗尾侧鼻中隔偏曲的新手术方法，即微创切割缝合技术（MICST）。尽管与切割缝合技术相似，但MICST通过保持鼻中隔软骨从关键区域到前鼻棘的连续性，保留了鼻中隔后角周围的组织。切割线的方向与鼻背线平行，从而能够从背侧和尾侧偏曲处释放多余压力。
2022年9月至2023年8月期间，共有45例患者接受了MICST。我们分析了术前和术后3个月收集的数据，以比较凸侧（较窄）和凹侧（较宽）的横截面积比（即N/W比）、鼻尖高度（使用计算机断层扫描）、视觉模拟评分以及手术时间，并与2020年9月至2022年7月期间接受标准切割缝合技术（CST）的45例患者进行对比。
MICST组和CST组在术前和术后的N/W比以及视觉模拟评分方面未观察到显著差异。CST组中鼻尖下降≥3 mm的病例比例更高，而MICST组的手术时间更短。
使用MICST改善鼻塞的效果与CST相当。与传统方法相比，MICST对鼻中隔软骨的处理更为保守，鼻外部畸形风险更小，能够矫正背侧偏曲，且无需使用支撑移植物。该手术操作简单，可在短时间内完成。
