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Facial Plast Surg 2019; 35(01): 023-030
DOI: 10.1055/s-0039-1677767
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bony Fixation of the Nasal Framework

Sebastian Haack
1   Clinic for Facial Plastic Surgery, Marienhospital Stuttgart, Stuttgart, Germany
,
Stefan Hacker
1   Clinic for Facial Plastic Surgery, Marienhospital Stuttgart, Stuttgart, Germany
,
Steven Mann
1   Clinic for Facial Plastic Surgery, Marienhospital Stuttgart, Stuttgart, Germany
,
Wolfgang Gubisch
1   Clinic for Facial Plastic Surgery, Marienhospital Stuttgart, Stuttgart, Germany
› Author Affiliations
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Publication History

Publication Date:
13 February 2019 (online)

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Abstract

The importance of a straight and stable central framework is beyond dispute. Many authors allude to technical aspects how to achieve the above-mentioned requirements. Far less is said about the contact zones of the framework and how to achieve a long-lasting and solid fixation. In the authors' patient group, they found the need to work on the septum/the central framework in approximately 84% of the cases. In 61% of the patients, the authors had to operate on the fixation point. Of course, there is a great variety of anatomical findings. So the required techniques differ immensely. The surgeon must be prepared for all kinds of different situations. Especially the dorsal fixation and the anchoring on the maxilla without having a standard anterior nasal spine can be a great challenge. In their daily routine, suture techniques (e.g., the transcutaneous transosseous cerclage suture) have become the authors' working horse for these complex fixation situations.

Keywords

septal fixation - bony framework - anterior nasal spine - TTC suture