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Research Letter
December 29, 2016

Straightening the Crooked Middle Vault With the Clocking StitchAn Anatomic Study

Author Affiliations
  • 1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
JAMA Facial Plast Surg. Published online December 29, 2016. doi:10.1001/jamafacial.2016.1647

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.

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