More endoscopic sinus surgery videos at: www.arizonasinus.com Endoscopic septoplasty may be performed alone or in conjunction with endoscopic sinus surgery. This procedure is performed to correct a deviated nasal septum which is obstructing nasal airflow or preventing surgical access to the sinus outflow tracts. Advantages include excellent visualization of septal cartilage and bone and the ability to perform limited and targeted resection of deviated anatomy. The disadvantage of this approach is the associated learning curve. Surgeon's facile with endoscopic sinus instrumentation often become proficient after several cases. Key instrumentation includes: the 30 or 0 degree endoscope, suction Freer elevator, sickle knife or angled Beaver blade, Blakesley forceps and the side-biting antrum punch. Diagnostic nasal endoscopy is performed first. Functional endoscopic sinus surgery is completed on the right side (not shown here). Next, lidocaine with epinephrine is injected into the septum for vasoconstriction and anesthetic effect. The sharp suction Freer elevator is used to make a vertical incision in the right caudal septum. The dull suction Freer elevator is used to elevate an ipsilateral mucoperichondrial flap. The elevator is then used to incise the cartilage approximately 5 mm posterior to the mucosal incision. The contralateral mucoperichondrial flap is then elevated. Cartilage and bone are resected as needed to open the nasal airway and allow access to the middle meatus for functional endoscopic sinus surgery. Care is taken to preserve caudal and dorsal cartilaginous struts so that post-operative saddle nose deformity and tip ptosis are avoided. At the conclusion of the procedure, the mucoperichondrial flaps are then reapproximated and closed with a chromic quilting suture. Video Provided by www.ArizonaSinus.com