Nasal growth after external septoplasty in children
I. Bejar, L. G. Farkas, A. H. Messner and W. S. Crysdale
Department of Pediatric Otolaryngology, Hospital for Sick Children, Toronto, Ontario.
OBJECTIVE: To assess the impact of external septoplasty surgery on nasal
growth in children. DESIGN: Twelve anthropometric measurements (9 linear
and 3 angular) were obtained in patients who previously underwent external
septoplasty surgery for severe nasal obstruction caused by septal deviation
anterior to the nasal spine. Surgery consisted of excision, refashioning,
and reinsertion of the quadrilateral cartilage. From these 12 measurements,
5 proportional indexes were calculated, and then all measurements and
proportions were compared with previously published norms. Follow-up
measurements were taken at least 2 years after surgery (average, 3.4
years). SETTING: The Hospital for Sick Children, Toronto, Ontario, a
tertiary care children's hospital. PARTICIPANTS: Twenty-eight patients who
underwent external septoplasty surgery between the ages of 6 and 15 years.
RESULTS: The principal measurements of the face and nose were within 1 SD
of the normative mean for the majority of those in the study group. This
was true for nasal height, nasal tip protrusion, nasal width, columella
width, columella length, upper face height, face height, face width,
inclination of the upper face, inclination of the nasal dorsum, and
inclination of the columella. Values for 4 of the 5 proportional indexes
were also overwhelmingly in the normal range. Twenty-nine percent of nasal
dorsum measurements and 57% of nasal dorsum indexes were more than 2 SDs
from the mean, indicating a predominance of short nasal dorsums.
CONCLUSIONS: External septoplasty does not affect most aspects of nasal and
facial growth, but it may negatively influence growth of the nasal dorsum.
Prospective studies are needed to clarify this issue.
