[The repair of extensive deformities of the ventrocaudal septum segment in children].

In children severe deformities of the nasal septum requiring surgical repair are often limited to the caudal portion of the septal cartilage only. Such deformities can be rarely corrected sufficiently by Cottle's method, because the usually severely deformed caudal part of the septum cannot be straightened by mobilization only and because additional incisions within this section will weaken its supporting function for the nasal tip. For that reason we prefer another surgical technique in such cases: the deviated portion is resected and replaced by a free cartilaginous graft taken from the remaining portion of the septal cartilage; the resected portion is straightened by crushing and re-implanted between the mucoperichondrial flaps. This method, which we call "reconstructive septoplasty", does not injure the important ossification area between the perpendicular plate and the cartilage, because in children the septal cartilage is relatively much larger than in adults. Until now this method has proved a success in 18 children (4-12 years old). Postoperative follow-up (more than 3 years in 4 cases) showed only in one case a slight saddling of the dorsum of the nose after one year.