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Updated: Jan 17, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
The Effect of the Membranous Tongue-in-Groove Technique on Projection and Rotation in Patients Undergoing Closed
Ömer Çelikal1, Mehmet Melih Çiçek2, Görkem Dündar3
1Department of Otorhinolaryngology, Medicana Çamlıca Hospital, İstanbul, Turkey. dromercelikal@gmail.com.
Objective:
The rotation and projection of the nasal tip are fundamental factors in determining surgical success. The tongue-in-groove (TIG) technique is performed by securing the medial crura to the septum to control nasal tip rotation and projection. Unlike the traditional TIG technique, the membranous TIG variation involves creating a pocket between the two layers of the membranous septum and placing the caudal septum into this pocket. The aim of this study is to evaluate the long-term effects of the membranous TIG technique on nasal tip rotation and projection in patients undergoing closed rhinoplasty.
Methods:
Fifty-two patients who underwent closed rhinoplasty using the membranous tongue-in-groove technique between January 2021 and February 2024 were retrospectively analyzed. Preoperative, postoperative operating table, short-term, and long-term postoperative photographs were evaluated. The nasolabial angle and nasal tip projection ratio were recorded.
Results:
All patients included in the study were female. The age range was between 19 and 37 years, with a median age of 25. The mean preoperative, postoperative operating table, short-term, and long-term rotation values were 100.58±10.64, 116.19±7.67, 113.73±7.50, and 108.49±8.41, respectively (p<0.001). The mean preoperative, postoperative operating table, short-term, and long-term goode ratios were 0.61±0.05, 0.77±0.05, 0.68±0.05, and 0.64±0.05, respectively (p<0.001). Rotation loss was more pronounced in the long term, whereas projection loss more pronounced in the short term.
Conclusion:
The membranous TIG technique is an effective method for stabilizing nasal tip rotation and projection. Additional supportive techniques should be explored to maintain long term LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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