High septal osteotomy in rhinoplasty for the deviated nose

John J. Jameson, Adam D. Perry, Edmond F. Ritter, Harold I. Friedman, S. Anthony Wolfe

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


When attempting to straighten a patient's healed, deviated bony nasal dorsum, deviation of the central structure (high dorsal septum and medial nasal bones) must be addressed following the completion of medial and lateral osteotomies. When hump resection is not performed, blunt fracture (digitally or with forceps) of the deviated central structure is not a reliable method of mobilization, often leading to postoperative nasal drift. An intranasal osteotomy technique to mobilize the central structure of the nose is described, called "high septal osteotomy." Review of 25 cases suggests high septal osteotomy, supplemented as needed by resection of overlapping septal elements, can be performed safely and efficaciously, permitting stable midline reduction of the nasal pyramid. The technique is not advocated when hump resection is performed, as it is unnecessary and could destabilize the dorsum. Even aggressive maneuvers to mobilize the bony dorsum may fail if not performed properly with meticulous attention to completion of all osteotomies.

Original languageEnglish (US)
Pages (from-to)40-45
Number of pages6
JournalAnnals of plastic surgery
Issue number1
StatePublished - Jan 2006


  • Nasal bones
  • Nasal septum
  • Osteotomy
  • Rhinoplasty
  • Septoplasty

ASJC Scopus subject areas

  • Surgery


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