• Rhinoplasty;
  • septoplasty;
  • L-strut;
  • deviated nose;
  • crooked nose


Objective: A deviated nose with involvement of a severely deviated cartilaginous dorsum is a particular challenge for rhinoplasty surgeons. We applied a new approach for treating such cases, the “dorsal L-strut cutting and suture technique,” and assessed its efficacy and the surgical outcomes.

Study Design: Retrospective chart review.

Methodss: The study population consisted of 27 patients who received the “cutting and suture technique of dorsal L-strut” to control a severe cartilaginous dorsal deflection between February 2004 and September 2006. Two otolaryngologists who were not involved in surgeries assessed surgical outcomes. Preoperative and postoperative photographs were studied to evaluate outcomes, and anthropometric measurements were made. Postoperative complications were assessed.

Results: Postoperative assessments showed that 81.5% of patients had “excellent” or “good” deviation correction. Two (7.4%) patients experienced cephalic rotation of the tips and shortening of the nasal length. There were no reports of recurrence, saddling, or infection during follow-up. Pre- and postoperative anthropometric measurements showed there was no significant change in tip projection, nasal length, nasofrontal angle, or nasolabial angle.

Conclusions: The dorsal L-strut cutting and suture technique appears to be a useful method for correcting severe cephalocaudal convexity of the dorsal L-strut in deviated noses.