Managing the nasal septum (NS) position is crucial in septorhinoplasty. The analysis
and the preparation of the anterior nasal spine and the quadrangular cartilage as
well as the strategy defined to efficiently stabilize the septum will dictate considerably
the success of the result. Moreover, what we see in the surgical table can suffer
modifications during the healing process because of poor fixation or the cheese-wire
effect of the cartilage. We will present a logical sequence and tools to achieve a
proper and stable position of the NS and the nasal pyramid. The sublaminar (supraperichondral)
dissection of the quadrangular cartilage as an option to the subperichondral one and
the use of cable and mirror sutures to three-dimensionally positioning and stabilizing
the NS will be described.
Keywords
cable sutures - mirror sutures - sublaminar dissection - supraperichondral dissection
- anterior nasal spine