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Updated: Jul 13, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
A simplified use of septal extension graft to control nasal tip location
Ahmet Seyhan1, Sema Ozden, Ummahan Ozaslan
1Department of Plastic and Reconstructive Surgery, Celal Bayar University, Medical Faculty, 45010, Manisa, Turkey. ahmetseyhan@hotmail.com
Background:
For defining the shape and projection of the nasal tip, the bilateral and symmetric batten-type septal extension grafts proposed by Byrd and colleagues have drawbacks. The main problems are stiffness of the nasal tip and thickening of the septum in the nasal valve area.
Methods:
Since 1998, unilateral single-batten grafts, and more frequently, bilateral asymmetric batten grafts as compared with Byrd's bilateral symmetric application, have been used for 72 patients in our facility.
Results:
At the 6-month postoperative follow-up assessment, tip projection was found to be satisfactory in 61 patients. Less than desired projection occurred in three cases and overprojection in two cases. Nasal lobule deviation was evident in one patient. The loss of the columellar break point was evident in five cases.
Conclusion:
Unilateral or asymmetric bilateral batten grafts facilitate adjustment of the nasal tip intraoperatively. This technique results in a more pliable nasal tip in the horizontal plane. Construction of a three-layered cartilage in the nasal valve area is not needed, and the nasal airway is preserved. With this modification, a reliable and predictable nasal tip location is obtained with a minimum of graft usage.
