Complex deviation of the nasal septum is one of the most challenging situations for the nasal surgeon. Standard septoplasty fails to obtain a good outcome when multiple planes of deviation are present. We describe three different techniques for extracorporeal nasal septum reconstruction suitable for any possible situation of the septal framework. Normal nasal patency and a good aesthetic result were achieved in every case. No important complications or sequelae appeared in any of the patients. Complete external reconstruction of the septal framework is the technique of choice in complex deviations of the nasal septum.
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