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Correcting the Crooked Nose: The Septal Shift Technique
Claire Oliver, Michael Subichin
Summa Health
2025-01-10
Presenter: Claire Oliver
Affidavit:
This is the original work of the resident.
Director Name: Ananth Murthy, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Crooked nose deformity is a vexing problem for the rhinoplasty surgeon. Deviation of the nasal pyramid from the midsaggital plane has both aesthetic and functional implications for the patient. These may be congenital, acquired, or secondary deformities and may have widely variable morphology affecting all structures of the nasal complex. Since the inception of nasal surgery many techniques have been employed for correction of the septal contribution to the deformity with variable success. While each crooked nose presents unique challenges, one principle of correction remains the same: The cartilage memory must be eradicated. Not doing so poses the risk of recurrent deviation. We present an emerging technique to straighten the crooked nose which addresses tissue memory and the misshapen cartilage: the septal shift technique.
Methods: In this technique, a septoplasty is first performed. The caudal L strut is secured to the anterior nasal spine for reinforcement. The L strut is then transected transversely, creating separate cephalad and caudal segments. Excess length from deviation may then be overlapped for reduction and straightening. Patients underwent either primary or secondary septorhinoplasty for traumatic or chronic crooked nose deformity with nasal airway obstruction. Patient age, presentation, intraoperative details, follow up, and pre- and post-operative photos were reviewed.
Results: All three patients in our series achieved complete correction of their crooked nose deformities at a minimum follow up of one year. No complications were encountered.
Conclusion: The septal shift is an effective method of correcting this deformity and abolishing cartilaginous memory.
