CHAPTER 83 In a septoplasty, a submucous resection (SMR) is performed to correct a deviated septum of the nose. A rhinoplasty is the reconstruction of the bony and cartilaginous parts of the nose. A brief description of the septoplasty (SMR) procedure follows: 1. A Vienna nasal speculum is inserted into the naris for visualization. 2. A Bard-Parker scalpel handle #7 with a #15 blade is used to incise into the septum. 3. A Freer elevator is used for blunt dissection to separate and elevate tissue layers. 4. A Freer knife is used to incise the cartilage. 5. A Cottle septum elevator is used to elevate the mucous membrane. 6. A Becker scissors may be used to trim the deviated cartilage. 7. A Kerrison rongeur is used to remove any bony, thickened structures. 8. A Converse guarded osteotome with mallet is used to trim bony spurs. 9. Frazier suction tips of various sizes with tubing are used to remove drainage so as to aid in visualization. A brief description of the rhinoplasty procedure follows: 1. A Bard-Parker scalpel handle #3 with a #15 blade may be used to make an incision in the tip of the nose. 2. Joseph hooks are placed to retract the skin. 3. A McKenty elevator may be used to elevate the skin from underlying structures. 4. A Cottle septum elevator is used to free up the periosteum and perichondrium. 5. A Ballenger chisel with a mallet is used to break the nasal bones. 6. A curved Metzenbaum dissecting scissors may be used to trim the upper lateral cartilage. 7. A Converse osteotome with a mallet may be used to shape the bony dorsal hump. 8. An Aufricht rasp may be used to smooth the hump. 9. A Cottle dorsal angular scissors may be used to remove a cartilaginous hump. 10. A Becker septum scissors may be used to remove the septal cartilage. 11. A Cottle osteotome with a mallet is used to remove bony spurs.
Septoplasty (SMR) and Rhinoplasty
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