Two-Point Fixation in Low-Septal-Resection Dorsal Preservation Rhinoplasty

Overview

In low-septal-resection preservation rhinoplasty the freed septal cartilage is usually sutured only to the anterior nasal spine. The authors reviewed 86 patients operated by a closed approach in 2022, split by whether they received one-point fixation (spine only, n = 31) or two-point fixation (spine plus a dorsal suture to the septal mucoperichondrium, n = 55). Standardised 12-month profile photographs were checked for hump recurrence and the ROE satisfaction scale was applied.

Sections of note

• Hump recurrence: 5 of 31 with one-point fixation versus 1 of 55 with two-point fixation (p < 0.05).
• ROE scores and the proportion of satisfied patients did not differ between groups (p > 0.05).
• All cases were closed-approach, low-septal-resection preservation done January-December 2022.
• Assessment was at 12 months on standardised lateral photographs.
• Level of evidence 4.

What it means for a patient

• Hump recurrence after preservation surgery is partly a fixation problem, and a simple extra suture reduced it in this series.
• Satisfaction was similar in both groups despite the recurrence difference, suggesting the recurrences were mild.
• The study is retrospective with unequal groups, so the finding needs confirmation.

Why this paper matters

It gives a concrete, measurable technical fix for the most common preservation complication. Limits: retrospective, 86 patients, one-year follow-up, single centre.

Terms

• Low septal resection (low strip): removing a strip of cartilage at the base of the septum so the whole dorsum can drop.
• Anterior nasal spine: the bony point at the front base of the septum.
• Mucoperichondrium: the mucous lining plus the membrane covering septal cartilage.
• Quadrangular cartilage: the main sheet of septal cartilage.
• ROE: Rhinoplasty Outcome Evaluation, a patient satisfaction score.