Septoplasty is an important part of nasal surgery. Aproach for caudal dislocations will be discussed

videos about functional and nasal valve surgery will be presented in this session

This study examines the indications, safety, and long-term outcomes of septoplasty performed in pediatric patients. Emphasis is placed on preserving nasal growth centers while correcting functional obstruction and septal deformity. The aim is to establish evidence-based guidelines for timing, technique, and postoperative follow-up in children undergoing septal surgery.

Septal extension grafts (SEGs) are structural grafts placed along the septal cartilage to stabilize and define nasal tip projection, rotation, and shape. Originally described by Toriumi nearly three decades ago as a caudal septal extension graft primarily for correcting columellar retraction, the technique was later modified by Byrd et al. to address nasal tip control, offering three distinct graft variations. Byrd’s version introduced superior projection at a 45° angle, which unfortunately positioned the graft’s axis vertically against the forces acting on the nasal tip, unlike Toriumi’s more force-aligned concept.

In endonasal rhinoplasty, Margulis and Harel (2007) introduced the “horizontal columellar strut,” a conceptually similar SEG applied through a closed approach. However, both external and endonasal SEG techniques continued to evolve. In my practice, I found that repositioning the graft from a horizontal (cephalocaudal) to a vertical (inferosuperior) orientation increased its mechanical stability and simplified fixation to the caudal septum.

SEGs provide superior control of nasal tip dynamics compared to traditional columellar struts, which lack firm anchorage to the septum and thus offer limited long-term support. However, drawbacks such as reduced nasal tip flexibility and potential asymmetry from unilateral grafting exist. These limitations can be mitigated through bilateral grafting or by thinning the distal portion of the graft to preserve elasticity.

My surgical approach avoids a one-size-fits-all philosophy. I adapt my technique intraoperatively based on septal shape and asymmetry. For instance, in cases of caudal septal concavity, I carve a graft to match the curve. If symmetry is still an issue, bilateral grafts are employed. Rather than relying on excessive tension from medial crura to increase projection, I often use cap grafts or ANSA banner-type SEGs (as per Perez et al.) to achieve a natural yet stable nasal tip.

Orbital and optic nerve decompression: when and how?  

speech about Diagnosis and management of nasal septal perforation

Functional problems and correction of these problems are one of the main reasons for patients seeking corrective surgery. This panel especially addresses these issues and speakers will present their solutions to functional problems