Caudal Septal Reconstruction for Severe Deviation: A Modification to Respect the Valve Area

Septal deviations are common causes of disordered nasal breathing. The caudal septum is of special interest as it contributes to shape and support for nasal breathing and aesthetics. Caudal end septoplasty involves correction of deviation while maintaining adequate support and tip projection. Here, the caudal septum’s contribution to the internal nasal valve area is highlighted and an explanation is given why this critical area is corrected to improve nasal breathing. In this report, we share our experience with a modification of the caudal end transplant using autologous posterior bony-cartilaginous septum in which the resection of the donor septum occurs posterocephalic to the internal valve area and a specific suture technique is employed to secure the transplanted septum to the dorsal strut and nasal spine.