Facial plast Surg 2014; 30(02): 205-213
DOI: 10.1055/s-0034-1372424
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of the Middle Vault in Endonasal Rhinoplasty

Fred G. Fedok1, 2, Frank Garritano1
  • 1Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, The Pennsylvania State University, Hershey, Pennsylvania
  • 2The McCollough Plastic Surgery Clinic, Gulf Shores, Alabama
Further Information

Publication History

Publication Date:
08 May 2014 (online)


The management of the middle vault has become a crucial consideration in esthetic and functional rhinoplasty. Central to this management is an acknowledgment of the importance of the anatomic features and functional integrity of this nasal region. The diagnosis of middle vault insufficiency and techniques to prevent and repair such collapse have been widely reported. Many of these descriptions are based on the management of the middle vault using an open rhinoplasty approach. The purpose of this article is to describe various options for the management of the middle vault using an endonasal approach that have been used by a single surgeon in a university hospital–based setting.