Septoplasty Part 1 - Definition, Goldman Criteria, Indications & Contraindications
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👃 Septoplasty - Definition, Indications & Contraindications
This post covers:
- Definition of septoplasty
- Aim of septoplasty
- Goldman criteria for septoplasty
- Indications of septoplasty
- Contraindications of septoplasty
📝 Definition of Septoplasty
Septoplasty is a conservative surgical procedure used to correct a deviated nasal septum by correction of only the deviated portions of the septal cartilage and/or bone, while preserving adequate septal support.
What is Submucous Resection of Septum (SMR)?
What are the differences between SMR and Septoplasty?
🎯 Aims of Septoplasty
- Preserve as much septal support as possible
- Resect only minimal portions of the septal cartilage
- Mobilize the septum to the midline
What is the Goldman Criteria for Septoplasty?
✅ Indications of Septoplasty
Indications are divided into:
1️⃣ Septal causes
DNS presenting with:
a. Nasal obstruction (one or both sides)
b. Recurrent epistaxis due to septal spur
c. Headache
- Sinusitis
- Sluder's neuralgia
- Vacuum headache
d. Sleep apnea / hypopnea syndrome
How does Septal spur cause recurrent epistaxis?
What is Sluder's neuralgia? Which nerve is involved in Sluder's neuralgia?
What are the features of Sluder's neuralgia?
What is Vacuum Headache?
2️⃣ Non-septal causes
-
Harvesting cartilage graft for other surgeries
-
As part of septorhinoplasty
-
To improve endoscopic access for other surgeries
- Endoscopic dacryocystorhinostomy (Endo-DCR)
- Endoscopic sinus surgery (access to middle meatus and frontal recess)
- Endoscopic hypophysectomy (access to pituitary fossa)
- Vidian neurectomy
What is Vidian Neurectomy?
❌ Contraindications of Septoplasty
- Active Infection of Nose & Paranasal Sinuses
- Uncontrolled diabetes mellitus
- Hypertension
- Cardiac problems
- Uncontrolled bleeding diathesis
⭐ These conditions should be treated and brought under control before septoplasty.
⭐ Exam Pearls
- Septoplasty → Conservative septal surgery
- SMR → Radical septal surgery
- Goldman criteria → 7 criteria
- Every DNS is not an indication → Only symptomatic DNS
- Most common indication → Nasal obstruction
- Septal spur → Recurrent epistaxis
- Active infection → Not an absolute contraindication
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