title: A simple, single stage technique to harvest optimal ethmoid bone grafts for caudal septal deflections.
abstract: BACKGROUND
  Curvature of the caudal septum is a challenging area to surgically address because it is a tip supporting structure. Several methods to straighten the caudal septal deviation have been described to date. One commonly described technique is the placement of a bony septal batten graft. However, the harvest and subsequent ex vivo shaping of the bone graft can be difficult and lead to fracture of the graft superstructure. Here we discuss a novel single stage endoscopic approach to harvest a preformed batten graft and apply it to correct a caudal septal curvature deformity.
  
  
  METHODS
  Description of a novel endoscopic technique for the single stage harvest of a bone graft for the correction of a caudal septal deflection utilizing an open Jansen-Middleton septum forceps.
  
  
  RESULTS
  We have successfully utilized this technique in 10 patients with a caudal septal curvature deformity with no complications. All patients had symptomatic improvement of nasal obstruction symptoms.
  
  
  CONCLUSIONS
  The open Jansen-Middleton septum forceps allow for a reproducible, single stage, harvest of a bone graft from the perpendicular plate or vomer when addressing a caudal septal deformity using an endoscopic septoplasty approach.
authors.affiliation: Massachusetts Eye and Ear Infirmary, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA.
authors.forename: William C
authors.initials: WC
authors.lastname: Yao
authors.affiliation: Massachusetts Eye and Ear Infirmary, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Bleier
mesh_terms: D016025:Bone Transplantation; D005004:Ethmoid Bone / Q000637:transplantation*; D006801:Humans; D015508:Nasal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D009300:Nasal Septum / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation* / Q000379:methods*; D009667:Nose Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014057:Tomography, X-Ray Computed