Using the Septal Shift Technique to Correct Crooked Nose Deformity

Plast Reconstr Surg. 2022 Aug 1;150(2):300e-306e. doi: 10.1097/PRS.0000000000009371. Epub 2022 Jun 6.

Abstract

Background: Crooked nose deformity is defined as any degree of deviation of the anatomical structures involving the nasal bone, the upper and lower lateral cartilages, and the septum from the midsagittal plane of the face, in any direction.

Methods: This study introduces a new technique to correct crooked nose deformity. Twenty-six with I-shaped, C- and reverse C-shaped, and S-shaped crooked nose deformity underwent open approach rhinoplasty. After performing in-out fracture osteotomy, L-strut septoplasty was preferred. Initially, the L-strut was sutured through the hole that opened to the maxillary spine and then passed to the dorsal section. In the dorsal part of the L-strut, a spreader graft with the appropriate thickness and length was sutured opposite to the deviated side, only at the keystone area. The L-strut was then incised vertically to form a cranial and caudal segment. The caudal portion was sutured by shifting to the other side of the spreader, beginning at the caudal end of the cranial portion. The upper lateral cartilages were sutured to the newly formed L-strut. Finally, tip-plasty was performed, and the procedure was terminated.

Results: The septal shift technique is an effective method for treating crooked nose deformity.

Conclusion: The septal shift technique is a new technique without complications used in the author's routine practice as an effective method for treating crooked nose deformity.

Clinical question/level of evidence: Therapeutic, IV.

MeSH terms

  • Cartilage / surgery
  • Humans
  • Nasal Bone / surgery
  • Nasal Septum / surgery
  • Nose / surgery
  • Nose Deformities, Acquired* / surgery
  • Osteotomy / methods
  • Rhinoplasty* / methods