title: Repair of caudal septal deviation: the fishing line technique.
abstract: Repair of caudal septal deviation using currently described methods is challenging technically. The aim of this work is to describe a novel and simple technique for the treatment of caudal septal deviations that protects the nasal tip, by fixating of cartilage to the columella.
  
  
  
  All patients with caudal septal deviation operated on between June 2008 to November 2013 in 2 major medical centers were operated using the "fishing line technique." Patient satisfaction was recorded by a standard questionnaire (16-item Sino-Nasal Outcome Test [SNOT-16]), before and after surgery. The fishing line technique was performed in 63 patients with a severe caudal septal deviation of which 14 also had rhinoplasty. A mucoperichondrial flap was elevated on either side of the damaged septal cartilage. The cartilage was excised and remodeled into a straight sheet, and then repositioned between the mucoperichondrial flaps, and fixed to the septal columella.
  
  
  
  Mean age of the study group was 36 years. Follow-up ranged from 24 to 70 months. At the last follow-up, the septum was straight in all cases, with no deviation from the nostrils to the choana. Good airway was found in 53 patients. Eight patients had partial turbinate hypertrophy with an impaired airway, and 2 had severe turbinate hypertrophy. SNOT-16 mean score improved from 27 to 10 (p < 0.001). All patients were satisfied with the aesthetic outcome.
  
  
  
  The fishing-line technique for severe caudal septum deviations is easy to perform and yields satisfactory anatomic and aesthetic results.
authors.affiliation: Nose and Sinus Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Yaniv
authors.affiliation: Nose and Sinus Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tuvia
authors.initials: T
authors.lastname: Hadar
authors.affiliation: Nose and Sinus Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Roe
authors.initials: R
authors.lastname: Hod
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Otorhinolaryngology, Asuta Medical Center, Tel Aviv, Israel.
authors.forename: Roee
authors.initials: R
authors.lastname: Lansberg
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Otorhinolaryngology, Asuta Medical Center, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Koren
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Otorhinolaryngology, Asuta Medical Center, Tel Aviv, Israel.
authors.forename: Eitan
authors.initials: E
authors.lastname: Yaniv
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D009668:Nose Diseases / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D055815:Young Adult
keywords: cartilage; nasal septum; nose; surgical procedure; sutures