Use of Perpendicular Plate of Ethmoid Split Technique in Rhinoplasty and Septoplasty.

[SUMMARY] In recent years, the perpendicular plate of ethmoid (PPE) has become a prominent choice for bone-grafting materials. This study introduces the PPE split technique for efficient removal of the bony septum or the harvesting of partial PPE for septal batten grafts in rhinoplasty and septoplasty, particularly suited for cases with a thick PPE. In this study, this technique was used to minimize septal defects and prevent complications while achieving harvested bony grafts of the desired effective thickness. In this retrospective study, 36 patients underwent surgery using the PPE split technique (22 septoplasties and 14 rhinoplasties). The procedure involved detaching the PPE from the septal cartilage and performing a vertical plane osteotomy with a no. 10 scalpel blade to remove bony spurs or prepare batten grafts. Paranasal sinus computed tomography revealed that the average anteroinferior PPE thickness was 3.46 mm. This technique was used for bony batten graft harvesting (26 cases), bony spur removal, and septum reshaping (10 cases). Successful PPE harvesting was achieved in all cases except for 3, which experienced graft breakage. This study demonstrates the viability and effectiveness of the PPE split technique as a supplementary maneuver in septoplasty and rhinoplasty procedures. Its diverse applications include reshaping, correcting deviated septum, harvesting bony batten grafts, and providing support for an aesthetically pleasing nasal profile.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, IV.