Powered endoscopic septoplasty for septal deviation and isolated spurs

Septoplasty is commonly performed for nasal airway obstruction or rhinologic headache due to contact irritation, often in conjunction with other nasal procedures, including cosmetic rhinoplasty and endoscopic sinus surgery.Traditionally, it is performed before these procedures via a "headlight" technique. This article describes the use of the microdebrider in 29 cases of endoscopic septoplasty. Many of the procedures were performed in conjunction with functional endoscopic sinus surgery; however, several were performed as an isolated procedure or with inferior turbinoplasty. The technique is described in detail. All 29 patients had significant improvement in their symptoms, and no patient developed a perforation or postoperative hematoma. Conversion to a traditional septoplasty was required in 1 case because of the severity of the deviation. Power-assisted endoscopic septoplasty is a useful adjunct in cases involving isolated septal spurs or moderate septal deviations. Patients with severe nasal obstruction due to caudal deflection of the septum off the nasal spine are better served with traditional headlight septoplasty.