Correction of Caudal Septal Deviation with Dorsal Septal Flap Modification and Septal Extension Graft

Correction of caudal septal deviation remains challenging due to its impact on both nasal function and structural support. This study describes a novel surgical technique combining dorsal septal flap modification with septal extension graft application for the management of caudal septal deviation.

Twenty-two patients with caudal septal deviation associated with crooked nose deformity underwent surgery using an open rhinoplasty approach. The technique consists of two stages: controlled repositioning of the deviated septum toward the midline using a dorsal septal flap sutured to a contralateral septal extension graft, followed by stabilization with bilateral spreader grafts. All patients were followed for a minimum of 14 months.

Stable midline alignment of the caudal septum was achieved in all patients based on clinical evaluation during the follow-up period, with no recurrence observed. Functional improvement and satisfactory aesthetic outcomes were reported in all cases. No major complications or need for revision surgery were observed during the available follow-up period.

This technique may represent a useful surgical option for correcting caudal septal deviation while preserving septal continuity and structural integrity, particularly in patients with associated crooked nose deformity.

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