Background/Aim: Nasal obstruction is caused mainly by nasal septal deviation, and submucosal resection
is usually performed to treat this problem. However, if over-resected, nasal tip deprojection, deprojection
of the dorsum, or pseudo-hump formation may be seen. Spreader grafts are used to restore the nasal
septum in these cases, and different techniques have been described for this restoration; however, these
techniques may not be the best fit for such restoration. This study presents a novel and effective method
for septal reconstruction in patients with previous septal resections.
Methods: Between March 2012 and October 2014, a case series of 14 male patients with tip deprojection
and pseudo-hump formation who had undergone corrective surgery in our clinic was retrospectively
examined. Partial-split, caudal extension costal spreader grafts were used and were fixed to the dorsum of
the remnant septum cranially to prevent warping while avoiding nasal dorsum widening. Pre- and postoperative comparisons were performed, and the Nasal Obstructive Symptoms Evaluation questionnaire for
the functional results and subjective Esthetic Appearance test for the esthetic outcomes were administered.
Results: The mean age was 36.8 years (19–56 years), and the mean follow-up time was 14.6 months.
Functional outcomes and esthetic appearance led to significantly improvements in all post-operative
categories (P < 0.05) without any major complications. Common complaints were usually the same as seen
in conventional rhinoplasty procedures, such as facial swelling, nasal stuffiness, pain, and/or epistaxis.
None of the patients requested revision surgery.
Conclusion: Using partial-split, caudal extension costal spreader grafts in the reconstruction of
dorsocaudal septum in patients with previous septal resections appears to provide favorable functional and
Keywords: Partial-split, Spreader grafts, Reconstruction of dorsocaudal septum, Nasal tip deprojection,
Deprojection of dorsum