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Updated: Aug 6, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Clinical Application and Outcomes of Endoscopic-Assisted Autologous Septal Cartilage Technique in Crooked Nose
1Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background:
Crooked nose deformity is challenging when septal deviation coexists with external malalignment. We evaluated an endoscopic-assisted approach using autologous septal cartilage to improve both function and aesthetics.
Methods:
We retrospectively reviewed 186 consecutive patients (January 2023-June 2025) who underwent endoscopic-assisted septorhinoplasty with autologous septal cartilage grafting. Rohrich types were Type I (n = 58), C-type (n = 100), and S-type (n = 28). Outcomes included digital photographic measurements (dorsum/tip deviation angles, nasolabial angle, tip projection [Goode ratio]) and 10-point VAS scores for obstruction and satisfaction. Objective nasal function testing (volume, minimal cross-sectional area, expiratory resistance) was available in 112 patients. Complications and recurrent deviation were recorded.
Results:
Median follow-up was 3.7 months (IQR 2.0-6.2; range 1.0-13.6). Nasal obstruction and patient-reported satisfaction improved significantly (both P < 0.001). Morphological parameters, including dorsum deviation, tip deviation, nasolabial angle, and tip projection, also improved significantly. In the functional subset (n = 112), objective nasal function improved significantly, including increased nasal volume and minimal cross-sectional area and decreased expiratory resistance (all P < 0.001). Recurrent deviation occurred in 4.3% (8/186); complications in 7.5%, without major adverse events. Representative cases were shown in Figures 4-6.
Conclusion:
In this retrospective single-arm series, a structured refinement of established endoscopic septal and cartilage grafting principles appears associated with measurable improvements in nasal alignment, nasal patency, and patient-reported aesthetics. In the absence of a comparator group, these findings should be interpreted as observational rather than comparative.
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 .
