SMR VS Septoplasty
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SMR vs Septoplasty - Differences
SMR (Submucous Resection) and Septoplasty are both septal surgeries, but they differ significantly in their principle, extent of resection, preservation of septal framework, and complications.
| Feature | SMR | Septoplasty |
|---|---|---|
| Principle | Radical excision of the septum | Conservative correction of the deviated septum |
| Extent of Resection | Large part of septum removed, not just the deviated parts | Only deviated parts removed |
| Site of Deviation (Cottle's Line) | Deviation posterior to Cottle's line | Deviation anterior to Cottle's line |
| Preservation of Septal Framework | Not preserved | Preserved |
| L-Strut | Only a thin 2–3 mm rim of dorsal and caudal cartilage left | 10 mm dorsal and caudal L-strut preserved |
| Age of Patient | Not performed below 17 years of age | Can be performed at any age, including children |
| Incision | Killian's incision | Freer's incision |
| Flap Elevation | Mucoperichondrial flaps raised on both sides | Mucoperichondrial flap raised on one side |
| Caudal Dislocation | Cannot be corrected | Can be corrected |
| Complications | More common | Less common |
| Revision Surgery | Not possible | Possible |
| Combination with Rhinoplasty | Not possible | Possible (Septorhinoplasty) |
What is Cottle's Line? What is it's clinical significance?
What is L-Strut?
What is Caudal Dislocation?
Why are complications more common in SMR than in Septoplasty?
What is Columellar Retraction?
Why is revision surgery not possible after SMR?
Viva Pearls
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SMR = Radical excision
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Septoplasty = Conservative correction
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Killian's incision is used in SMR and Freer's incision in septoplasty
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10 mm L-strut is preserved in septoplasty
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The middle third of the face develops till about 17 years of age, so SMR is not performed below this age
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Caudal dislocation can be corrected only by septoplasty
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Flaps raised on:
- Both sides → SMR
- One side → Septoplasty
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In present practice, SMR is not performed and all deviations are corrected by septoplasty
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