Endonasal Tongue in Groove Septoplasty

Caudal or anterior nasal septum deviations, despite not being the most common type of septal deviation, cause much complaint as well as cosmetic deformity to the nasal tip. Deflections of the caudal end of the nasal septum are often not addressed at the time of septoplasty by simple submucosal resection of midportion of bony and/or cartilaginous septum for fear of disrupting the caudal strut making its ability to treat the functional and aesthetic complications of many septal deviations limited. No single method of correction has been shown to be effective in all cases. Most caudal septal reconstruction maneuvers are more easily accessible by way of an external approach. One of the most popular techniques is the “tongue-in-groove” which has been reported to improve projection and rotation.

The aim of this study: To test the effectiveness of using the tongue in groove technique endonasally to correct nasal septum caudal deviations. Materials and methods: the study included 137 patients with nasal obstruction for not less than one year due to caudal septal deviation with or without inferior nasal turbinates hypertrophy including revision cases. Patients with medical and/or surgical sinonasal pathologies were excluded. The patients were then submitted to surgery using endonasal “tongue-in-groove” correction technique. Results: Our results show that there was no cosmetic change in relation to nasal tip support after the proposed surgical correction. Conclusion: The results from this study indicate subjectively, through patient satisfaction and pre and post-operative photographing that using endonasal “tongue-in-groove” technique for correction of caudal septal deviation seems to be efficient.