Preliminary Deformational Studies on a Finite Element Model of the Nasal Septum Reveals Key Areas for Septal Realignment and Reconstruction

Table 1

Classification of septum deviation pattern based on sites of dislocation and possible surgical corrective procedures.

Type	Septum deviation pattern	Sites of dislocation	Surgical corrective procedures
I	Tilted in one piece	(i) Vomer-ethmoidal-cartilaginous (VEC) buckling; (ii) Lower edge of septum dislocated off vomerine groove; (iii) ANS attachment may be intact	(i) Submucous resection; (ii) ±Septal reset to ANS; (iii) ±Septal extension grafts for tip support
II	C-shaped	(i) Vomer-ethmoidal-cartilaginous (VEC) buckling; (ii) Lower edge of septum dislocated off vomerine groove; (iii) ANS attachment may be intact; (iv) Septal fracture in a single site	(i) Septal reset to the ANS; (ii) Submucous resection; (iii) Inclusion of spreader grafts to buttress the septal fracture; (iv) Possible septal extension grafts for vertical septal fracture
III	S-shaped	(i) Vomer-ethmoidal-cartilaginous (VEC) buckling; (ii) Lower edge of septum dislocated off vomerine groove; (iii) ANS attachment may be intact; (iv) Septal fracture possibly in two sites, forming a septal concertina	(i) Septal reset to the ANS; (ii) Submucous resection; (iii) Inclusion of spreader grafts to buttress the septal fracture; (iv) Inclusion of septal extension grafts to restore the support that is lost with septal shortening