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
