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Surgical Pearls
AAFPRS Advances in Rhinoplasty Featured Article
May 5, 2017

A New Nasal Septum Splint

Author Affiliations
  • 1Mobley MD Facial Plastic & Reconstructive Surgery, Salt Lake City, Utah
  • 2Division of Otolaryngology–Head and Neck Surgery, University of Utah, Salt Lake City
JAMA Facial Plast Surg. Published online May 5, 2017. doi:10.1001/jamafacial.2017.0732

Nasal septum splints can be a valuable tool in nasal septal surgery. Whether dealing with a severely crooked septum or perhaps using an extracorporeal septoplasty technique, nasal splints can be critical for the internal stabilization of a highly reconstructed nasal septum.1

Rhinologic surgeons are certainly familiar with many of the commonly available commercial splints. Doyle splints offer the proposed advantage of maintaining patent airways, although actual experience with these splints may lead to various levels of patent nasal airflow because debris can easily accumulate in the open silastic channels. Bivalve splints provide the advantage of easy insertion because the splints can “collapse” on themselves as they pass through the nasal vestibular inlet. However, most commonly available bivalve splints have prefabricated perforation, or holes, in them. Seemingly, these holes are for the easy passage of suture through the splints. However, in cases in which the surgeon may prefer to leave the splints in place for more than 14 days; it is quite common for the swollen septal mucous membranes to evaginate through these holes. This makes the removal of the splints challenging and often bloody because the congested septal membranes can tear and bleed as the splints are removed. Furthermore, both Doyle and bivalve splints are not designed to sit extremely caudally (anteriorly) along the septum.

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