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Surgical Technique
Nov/Dec 15, 2010

Oblique Septal Crossbar Graft for Anterior Septal Angle Reconstruction

Author Affiliations

Author Affiliations: Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield (Drs Aziz and Brenner); and Department of Surgery, University of Illinois College of Medicine at Peoria (Dr Putman).

Arch Facial Plast Surg. 2010;12(6):422-426. doi:10.1001/archfacial.2010.92

Nasal septal deformity is a central feature of the crooked nose, contributing to functional and aesthetic problems. Straightening of the septum often requires resection, scoring, or incision of the septum—maneuvers that inevitably weaken the cartilaginous dorsal and caudal L-shaped struts, which together are known as the L-strut. Compromise of this L-strut predisposes to septal buckling, recurrent deviation, and saddle nose deformity. We describe our experience with the oblique septal crossbar, a structural graft that allows biomechanically sound anterior septal angle reconstruction during septorhinoplasty. The technique improves dorsal septal support and facilitates correction of the crooked nose. The open septorhinoplasty approach and swinging door maneuver are followed by placement of a diagonally oriented crossbar graft, obtained from cartilage or the perpendicular plate. The approach allows consistent midline correction and buttressing of the nasal dorsum, with no complications to date.