Dorsal septal deviations are traditionally corrected with unilateral spreader grafts or camouflage grafting, with mixed results. An alternative is the clocking or septal rotation suture, an asymmetric horizontal mattress suture between upper lateral cartilage (ULC) and septal cartilage.1 Both extracorporeal septoplasty2 and anterior septal reconstruction (ASR) have been used to treat combined dorsal and caudal septal deviations 1.3 Herein we describe, to our knowledge, the first anatomic study of the clocking suture to straighten the midvault, and furthermore, we describe the effect of septoplasty and ASR on the degree of rotation achieved.
Keeler JA, Moubayed SP, Most SP. Straightening the Crooked Middle Vault With the Clocking StitchAn Anatomic Study. JAMA Facial Plast Surg. 2017;19(3):240–241. doi:10.1001/jamafacial.2016.1647