A Promising New Technique for Correcting a Deviated Nose: Partial Disarticulation of Keystone Area.

Abstract

Correction of the septum is essential for the correction of deviated nose. If no intervention is made to the septum that does not start from midline at the keystone area, either the crookedness will persist or thicker spreader grafts will need to be placed at the opposite side of the crookedness or further camouflaging will be required. The latter may cause dorsum to get wider. In the present study, partial disarticulation of keystone (PDK) method is presented for the correction of septum that does not start from the midline at the keystone area. This retrospective study included 18 patients in whom PDK method was employed to correct nasal deformity. The keystone area was repositioned by disarticulating the cartilage from the bone on the anterior part of the junction of the ethmoid bone with the septal cartilage. The patients were followed up for the duration of 12 to 33 (mean: 22.5) months. No patients developed a serious complication or required revision surgery. The PDK method can be applied to patients if dorsal septum does not start from the midline at the keystone area. This is a minimally invasive, time-saving method that has a short learning curve and decreases the possibility of further widening of dorsum.