nasal septum correction

1. The nasal septum deviation is significant, affecting nasal ventilation and sinus drainage. 2. The nasal septum is often caused by sudden nose or headache. Indication 1. The nasal septum deviation is significant, affecting nasal ventilation and sinus drainage. 2. The nasal septum is often caused by sudden nose or headache. Preoperative preparation 1. Trim the nose hair. 2. If the high deviation of the nasal septum affects the sinus drainage, the maxillary sinus puncture should be performed to improve the inflammation of the maxillary sinus before surgery. Surgical procedure 1. Position: Generally, the sitting position is used, and the surgeon sits on the opposite side of the patient. If taken in a semi-recumbent position, the surgeon is placed on the right side of the patient. 2. Incision: Hold the nose device with the left hand, expand the left front nose and hold the small round knife to the right. Make a concave curved back with a concave surface at the junction of the left skin and mucous membrane on the left side of the nasal septum, starting the upper part of the nasal septum. To the bottom, completely cut the periosteum (Figure 1). If the position of the condyle or the condyle is low, the lower end of the incision may be extended to the rear along the nasal base such as "l" shape to reduce the mucosal tension; if the deviated part of the nasal septum is earlier, the incision may be slightly moved forward. 3. Separation of the periosteum: the nasal septum is removed from the incision, the periosteum is peeled off, the white cartilage is exposed, and then the septal cartilage is adhered to the septum. The separation of the upper and lower parallel along the periosteum should be light, and the upper and lower peeling should be small. And large, from the front to the back beyond the partial distortion (Figure 2). When the cartilage is connected to the bone, if there is adhesion of connective tissue. When it is not easy to separate, it can be cut gently with a knife; in the case of sharp protrusions, it can be separated and peeled off by a stripper with upper and lower curvature. When peeling the mucous membrane above the rectangular protrusion, the downward side of the curvature can be used; when the lower side is peeled off, the upward side of the curvature can be used until the rectangular protrusion is completely exposed. 4. Cut the cartilage: Use a septal cartilage knife or a small round knife to cut the septal cartilage about 2 to 3 mm later in the mucosal incision (Fig. 3). In order to avoid cutting the mucosa on the right septum, the left hand can be inserted into the right nasal cavity to support the septal cartilage. 5. Separate the contralateral mucosa: the right periosteum is removed by the same method through the cartilage incision (Fig. 4). At this time, the right nostril can be dilated with a snivel to directly observe the submucosal dissection. After the periosteum on both sides of the nasal septum was completely separated, the nasal septum was fixed through the incision to fix the septal cartilage between the two blades of the septum fixed hook. 6. Excision of the septal cartilage: use the septal cartilage rotary knife to push the upper part of the forefoot cartilage leading edge to the upper rear, turn to the lower part of the ethmoid vertical plate, and then re-orient at the vomer and the humerus Pull forward to cut most of the septal cartilage (Figure 5). This cartilage piece should be retained until the end of the operation, in case the mucosa on both sides is torn to form a perforation for repair. 7. Cut the curved vertical plate of the ethmoid bone and the vomer: use a rongeur to clamp the vertical plate of the ethmoid and the deflected part of the vomer. Do not swing left and right to avoid damage to the sieve. The bones at the bottom of the septum can be removed with a fishtail. Care should be taken to avoid damage to blood vessels. A small cotton ball soaked with 1 adrenaline can be used to completely stop the blood and remove the blood clots and broken bone pieces in the wound, and remove the septum fixing hooks, and push the periosteum on both sides to the middle to make them fit together. Check if the deflection has been corrected. 8. The mucosa of the incision can be sutured with 1 to 2 needles for fine healing. After applying Vaseline gauze on the medial septum of one side of the incision, use two rubber finger sleeves to place the nasal cavity on both sides, and fill the gauze evenly in the finger sleeve to pressurize the hemostasis.

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