“Dual-Knot Fixation” Technique for Better Stabilization of the Extended Columellar Strut Graft with the Anterior Nasal Spine

Cable and Mirror Sutures and the Nasal Septum Sublaminar Dissection

“…The oblique mirror sutures have two main objectives: (1) to avoid inclinations, tilting of the septal wall, forcing it to remain in the midline through bilateral symmetrical forces (but considering the need of a compensation asymmetric one) (►Fig. 8 and ►Video 4); (2) to prevent displacements of the septum position, especially important to avoid hump recurrences in low-strip approach techniques, by creating a rhinion-ANS oblique vector pulling the rhinion down creating an opposing force to the relapsing spring effect (mimick-ing the same effect of the counter vertical force at the Tetris flap).…”

“…The dual knot fixation by C. Ozkan consists in stabilizing an extended columellar graft to the ANS with two knots above the spine before passing through the graft and making a small notch in the ECG, and thus avoiding sliding and tilting. (1). In their book R.K. Daniel and P.…”

“…The dual knot fixation by Çerçi Özkan consists in stabilizing an ECG to the ANS with two knots above the spine before passing through the graft and making a small notch in the ECG, and thus avoiding sliding and tilting. 1 Daniel and Pálházi, in their book, described a way of fixating a SEG to the ANS by making two drill holes in the spine and passing a bidirectional suture through them. 2 Toriumi uses a swinging door maneuver which consists in the trimming of a small portion of the most inferior part of the caudal septum and making a 5-mm notch in the middle of the ANS, when the posterior septal angle is subluxated, for caudal septum deviation.…”