From the Department of Otolaryngology, Division of Facial Plastic Surgery, New York Hospital-Cornell Medical Center, New York, NY (Dr Pastorek); and the Division of Rhinology and Facial Plastic & Reconstructive Surgery, Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia (Dr Becker).
Caudal septal deflection can be a challenging nasal deformity. Although there are a number of maneuvers available to manage this functional and aesthetic abnormality, each approach is effective in only a limited number of cases. For over 25 years, the senior author (N.J.P.) has employed a "modified swinging door" technique for treatment of the deviated caudal septum. Using this technique, the septal cartilage along the maxillary crest is dissected free but is not excised. Instead, the caudal septum is flipped over the nasal spine, which acts as a "doorstop" and secures the caudal septum in a straighter position. This maneuver may be useful in the armamentarium of the surgeon managing this potentially difficult technical challenge.
Pastorek NJ, Becker DG. Treating the Caudal Septal Deflection. Arch Facial Plast Surg. 2000;2(3):217-220. doi: