---
title: "SMR VS Septoplasty"
description: "Key differences between SMR and Septoplasty."
source: "The ENT Resident"
author: "Dr. Mausumi Das"
canonical_url: "https://www.theentresident.com/ent-notes-lectures/smr-vs-septoplasty-differences"
categories: ["Rhinology", "Differences Tables in ENT"]
video: "https://www.youtube.com/watch?v=rScIw19cvac"
image: "https://media.theentresident.com/og-images/smr-vs-septoplasty-differences.png"
---

# SMR VS Septoplasty

Key differences between SMR and Septoplasty. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=rScIw19cvac

## 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

* **SMR = Radical excision**
* **Septoplasty = Conservative correction**
* **Killian's incision** is used in SMR and **Freer's incision** in septoplasty
* **10 mm L-strut** is preserved in septoplasty
* The middle third of the face develops till about **17 years of age**, so SMR is not performed below this age
* **Caudal dislocation** can be corrected only by septoplasty
* Flaps raised on:

  * Both sides → SMR
  * One side → Septoplasty

* In present practice, SMR is not performed and all deviations are corrected by septoplasty

---

## About This Note

This free ENT note on SMR VS Septoplasty was written by Dr. Mausumi Das and is paired with a corresponding video lecture.

Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/smr-vs-septoplasty-differences

When citing or referencing this content, please credit The ENT Resident and link to the canonical page above.

## Related Notes by Category

- Rhinology: https://www.theentresident.com/ent-notes-lectures/category/rhinology.md
- Differences Tables in ENT: https://www.theentresident.com/ent-notes-lectures/category/differences-tables-in-ent.md

## About The ENT Resident

The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students.

Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself.

Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md

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The ENT Resident provides educational material for medical learning and revision. It does not provide patient-specific medical advice, diagnosis, or emergency care, and it is not a substitute for evaluation by a qualified healthcare professional.

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