Why is the Bent Septal Cartilage Sometimes Removed, Sometime Reshaped in Septoplasty?

Dear Orador,


If a piece of cartilage is very deformed or warped, then removing it seems to keep the patient happy so the breathing problems do not return

I would only replace straight pieces of septum just in case you need that cartilage for the future (like a rhinoplasty)


Best regards,

Nima Shemirani

When it comes to addressing bent septal cartilage a lot comes down to surgeon preference. In my experience it is very difficult to predictably reshape bent cartilage so that it then lays straight. My preference is usually to remove the deviated portions of cartilage.

Cartilage has memory so scoring or otherwise modifying it to become straight often isn't very successful. Other surgeons may have different preferences, though.

The decision to remove or reshape cartilage in septoplasty depends on  where the cartilage is and how badly it is bent.  The surgeon should only remove the portions that are necessary to straighten a septum in order to maintain the strength of the septum and external nose.  Taking too much of the septum can lead to a change in the external nose or lead to a "floppy" septum and cause difficulty breathing through the nose. Each patient's septum should be critically analyzed and addressed individually.  A surgeon should not perform the same septoplasty on every patient.

When a septoplasty is performed, replacing a bent portion after straightening it or removing it completely are both appropriate. If removed it is important to leave enough back to keep the nose stable.  It is removed if it is going to be used in another area.  It can be replaced to restore the normal anatomy or to preserve it for future use. Hope this helps.