Killian’s Nasal Speculum

This is one variety of nasal speculum and is used for both nasal examination and surgery.

It comes in several sizes, from small to long-bladed. A screw in the handle can be tightened to hold the blades of the speculum in the open position. This gives the speculum its self-retaining feature, very useful during septal surgery.

Unlike the Thudichum’s nasal speculum, this instrument is much easier to handle. The blades are attached to handles which can be used to open and close the speculum.

Uses

The Killian’s nasal speculum is used in:

•  Anterior rhinoscopy
• Anterior nasal packing
• Septoplasty
• Polypectomy
• Nasal foreign body, rhinolith removal
• Turbinate reduction surgeries

The speculum is particularly helpful in septoplasty. When the mucoperichondrial flap is being raised, the blades of the speculum can be used to lift the flap to provide access and vision. Later, when the mucoperiosteum has been elevated on both sides, the instrument can be positioned within the flaps with the blades on either side of the bony septum. The self-retaining feature of the instrument helps free both hands for bone removal.

More information

• In septoplasty, the mucoperichondrial flap is only raised on one side of the septal cartilage, whereas in SMR it is raised on both sides of the septum.
• Tearing the mucoperichondrial flaps in corresponding places on both sides of the septum can result in a septal perforation postoperatively.
• A septal hematoma occurs when blood collects between the septal cartilage and its mucoperichondrium.

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