Use of Cartilage Grafts for Internal Septal Support of the Crooked Nose

Abstract

The repair of a crooked nose relies on the successful straightening of the crooked septum. Failure to align the septum properly can compromise the final result. The versatility and effectiveness of using an open approach to repair the septal deformity are examined. The technique involves an extensive degloving of the septum, with a release of all extrinsic tethering attachments. This is followed by a direct repair of the intrinsic angulations of the septum, with cartilage splint grafts being applied to support and straighten the septum, and cartilage spreader grafts used to camouflage deviations and elevate segments of upper lateral cartilage collapse. Thirty-two patients were managed with this approach. The exposure is excellent, and the procedure is not difficult to perform because the steps are logical and anatomically based. The enhanced precision of repair results in greater predictability and an improved final result.