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Updated: Apr 30, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Management of the middle vault in endonasal rhinoplasty
Fred G Fedok1, Frank Garritano1
1Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, The Pennsylvania State University, Hershey, Pennsylvania.
Abstract:
The management of the middle vault has become a crucial consideration in esthetic and functional rhinoplasty. Central to this management is an acknowledgment of the importance of the anatomic features and functional integrity of this nasal region. The diagnosis of middle vault insufficiency and techniques to prevent and repair such collapse have been widely reported. Many of these descriptions are based on the management of the middle vault using an open rhinoplasty approach. The purpose of this article is to describe various options for the management of the middle vault using an endonasal approach that have been used by a single surgeon in a university hospital-based setting.
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