Surgical Technique
November 2006

An Alternative Method of Middle Vault Reconstruction

Author Affiliations

Author Affiliations: Department of Otorhinolaryngology, Mayo Clinic College of Medicine, Rochester, Minn (Drs Gassner and Friedman), and Departments of Otolaryngology, Millard Filmore Gates Circle Hospital (Drs Sherris) and University at Buffalo (Drs Sherris and Kern), Buffalo, NY. Dr Gassner is now a Fellow in Facial Plastic and Reconstructive Surgery at the Larrabee Center, Virginia Mason Hospital, and the University of Washington, Seattle.

Correspondence: Holger G. Gassner, MD, Division of Facial Plastic Surgery, Department of Otolaryngology, Head and Neck Surgery, University of Washington, 600 Broadway, Suite 680, Seattle, WA 98122 (


Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Facial Plast Surg. 2006;8(6):432-435. doi:10.1001/archfaci.8.6.432

Surgery of the nasal valves is a challenging aspect of rhinoplasty surgery. The middle nasal vault assumes an important role in certain aspects of nasal valve collapse. Techniques that address pathologies of the middle vault include the placement of spreader grafts and the butterfly graft. We present an alternative technique of middle vault reconstruction that allows simultaneous repair of nasal valve collapse and creation of a smooth dorsal profile. The surgical technique is described in detail and representative cases are discussed.