A deviated nasal septum causing nasal obstruction has a high C-shaped deviation to the right. Submucous resection (SMR) is being compared to septoplasty. The main advantage of septoplasty over classical SMR is:
- A No risk of scarring or adhesion formation
- B Preservation of the quadrilateral cartilage framework, reducing the risk of saddle nose deformity ✓
- C Shorter operative time and no general anesthesia required
- D Can be performed in children under 10 years as it does not affect growth
Explanation
In classical SMR (Killian's operation), the entire cartilaginous septum is excised between mucoperichondrial flaps, leaving only the mucosal-perichondrial bilayer for support. This carries the risk of saddle nose deformity (loss of dorsal support), flail septum, and columellar retraction due to loss of the cartilaginous skeleton. Septoplasty (Cottle's operation) preserves the dorsal and caudal L-strut of cartilage (at least 10–15 mm), only excising or reshaping the deviated portions, maintaining structural support and normal nasal profile. Septoplasty also allows repositioning, scoring, or grafting of cartilage rather than wholesale removal. Both procedures can be done under LA or GA.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.