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Updated: Sep 21, 2025

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Key stone plasty and asymmetric hump resection in crooked nose deformity
Hüseyin Balikci1, Alper Yenigun2, Ismail Celik2
1Meltem Gökay Plaza, Atatürk Blv. No:23/41, 07070 Konyaaltı/Antalya, Turkey.
Objective:
The aim of this study is to propose a new approach in crooked nose deformity with key-stone plasty and asymmetric hump resection.
Method:
Twelve patients with crooked nose deformities were operated using the open rhinoplasty technique. Our method, unlike other methods, has two different steps. Following asymmetric hump resection, cartilaginous and osseous septum were cut separated at the key stone area or more caudally and fix the septum with sutures again by allowing them to slide over each other in a way that directs the septum to the midline. If there is an inability to reveal the septum, we apply a longer spreader graft to the cartilage septum side.
Results:
The mean ages were 27.4 years. The mean follow-up time of the patients was 19.1 months. No complications were observed due to this technique. This technique was effective in the treatment of all our patients with crooked nose deformities.
Conclusion:
A novel surgical approach with key-stone plasty and asymmetric hump resection method was proposed in crooked nose deformity with a video animation.

