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Ignacio Béjar, MD; Leslie G. Farkas, MD, CSc, DSc, FRCSC; Anna H. Messner, MD; William S. Crysdale, MD, FRCSC

Arch Otolaryngol Head Neck Surg. 1996;122(8):816-821.

Abstract
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.

Arch Otolaryngol Head Neck Surg. 1996;122:816-821

Author Affiliations
From the Departments of Pediatric Otolaryngology (Drs Béjar and Crysdale) and Plastic Surgery (Dr Farkas), Hospital for Sick Children, Toronto, Ontario; and Division of Otolaryngology/Head & Neck Surgery, Lucile Salter Packard Children's Hospital, Stanford (Calif) University (Dr Messner).

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