The patient is a twenty five year old man. He has chronic nasal obstruction. He was seen by a local ENT who did a septoplasty in the office. The patient continues to have nasal obstruction after the procedure.
On examination, he was noted to have anterior septum deviation. This type of septum deviation is very difficulty to treat as it requires reconstruction of the whole septum. The previous surgery was the wrong surgery for this type of deviation. Because he had surgery before and there is missing septum, he has to have ear cartilage harvest as part of the reconstruction of a new septum. He had a successful re-surgery.
So, not all septums are the same. Not all ENT surgeons are skilled in recognizing & treating anterior septum.