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Updated: Jun 23, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Published on: June 20, 2018

A double-layered, stepped spreader graft for the deviated nose.

Ahmet Seyhan¹, Sema Ozden, Melike Gungor

¹Department of Plastic and Reconstructive Surgery, Celal Bayar University, Manisa 45010, Turkey. ahmetseyhan@hotmail.com

Annals of Plastic Surgery

|May 23, 2009

Summary

A novel stepped spreader graft technique effectively reconstructs shorter nasal walls in deviated noses, achieving stable, symmetrical results. This method enhances dorsal stability and improves aesthetic outcomes in rhinoplasty patients.

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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

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Published on: June 20, 2018

Scalable, Flexible, and Cost-Effective Seedling Grafting

Scalable, Flexible, and Cost-Effective Seedling Grafting

Published on: January 6, 2023

Area of Science:

Plastic Surgery
Otolaryngology
Rhinoplasty Techniques

Background:

Deviated noses often present challenges with shorter nasal walls after hump resection and lateral wall transposition.
Standard techniques may not adequately address inadequate height of the shorter nasal wall, leading to asymmetry.
Preserving the shorter nasal wall during beveled hump resection is crucial but sometimes insufficient.

Purpose of the Study:

To introduce and evaluate a double-layered, stepped spreader graft technique for reconstructing shorter lateral nasal walls in deviated noses.
To achieve symmetrical lateral nasal walls and a stable nasal dorsum post-rhinoplasty.
To improve aesthetic dorsal lines in patients with nasal deviations.

Main Methods:

A double-layered, stepped spreader graft was utilized on the shorter nasal wall.
The graft composite involved a smaller cartilage piece affixed to a standard spreader graft for added height.
Grafts were primarily harvested from septal cartilage, with one case using auricular cartilage.

Main Results:

The technique was applied in 6 cases (4 primary, 2 secondary rhinoplasties).
All patients achieved acceptable symmetrical dorsal aesthetic lines post-surgery.
No significant recurrent nasal deviation was observed postoperatively.

Conclusions:

The stepped spreader graft is a valuable option for nasal wall height reconstruction in deviated noses.
This technique provides enhanced dorsal stability and resistance to relapse.
It allows for simultaneous reconstruction of dorsal aesthetic lines.