Deviations of the nasal septum which cause dysfunction in nasal respiration require surgical correction. The degree of the deviation and the site and structural consistency of the deflected part have, in the past, influenced the success or failure of the operation.
The development of septal surgery has passed through many phases. Ingals1 was the first to suggest the accomplishment of a submucous operation by removal of a part of the triangular cartilage. Krieg2 improved the technique by resecting the entire deflected cartilage. Boenninghaus3 completed the procedure by removing the osseous septum (perpendicular plate of the ethmoid and vomer) as well as the cartilage. Surgical refinements were added by Freer,4 Killian,5 Hajek,6 Ballenger,7 Yankauer,8 and St. Clair Thomson.9 Submucous resection thus became the standard procedure for the rhinologist.
There were still many inadequacies in the technique. A satisfactory buttress had to be