Modification of Low Septal Strip Septoplasty to Reduce Hump Recurrence in Dorsal Preservation Rhinoplasty

Background: Among the problems encountered in the dorsal preservation rhinoplasty technique are residual hump and hump recurrence. In our study we performed a modification to lower strip resection and the fixation of the septum. The clinical results of these modifications on hump recurrence were investigated. Patients and methods: 231 patients who underwent dorsal preservation rhinoplasty with low septal strip septoplasty between November 2021 and February 2023 were included in the study. Closed dorsal preservation rhinoplasty was performed with low septal strip septoplasty in 31.2% (n=72) and modified low septal strip septoplasty technique in 68.8% (n=159) patients. All cases were primary rhinoplasty. Demographic data, complications, revision surgeries and follow-up periods of the patients were analyzed retrospectively. Results: The mean follow-up period of the cases was 9.68±4.02 (3-16) months. Gender and age of the cases did not differ statistically significantly between the groups (p>0.05). Complications were observed in 3.5% of the patients (n=8/231). The complications in the low septal strip septoplasty group were statistically significantly higher than in the modified low septal strip septoplasty group (p=0.012; p<0.05). The incidence of recurrent hump complications in the low septal strip septoplasty group was statistically significantly higher than in the modified low septal strip septoplasty group (p=0.029; p<0.05). Conclusions: Septum fixation is one of the most important parts of the surgery in dorsal preservation rhinoplasty and must be done properly. In this modification that we described, the risk of recurrent hump is reduced, as sufficient septum fixation is achieved.