ORIGINAL ARTICLE RHINOPLASTY Septal Deviation Treatment Using Bone or Cartilage Grafts Fixed with Cyanoacrylate Tissue Adhesive I ˙ rfan O ¨ zyazgan 1 Received: 9 December 2016 / Accepted: 10 February 2017 Ó Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2017 Abstract Background This paper presents a method in which bone or cartilage grafts are fixed to the septal cartilage with cyanoacrylate-based tissue adhesive for the treatment of septal deviation. A prospective study was designed to show the effectiveness of the technique. Methods Cyanoacrylate-based tissue adhesive was used to fix the cartilage or bone grafts onto the septal cartilage to straighten deviated septal cartilage in 77 patients. Regarding the patients’ preoperative and postoperative nasal respiration, the following were assessed: (1) Nasal Obstruction Symptom Evaluation (NOSE) scales, (2) patient satisfaction with postoperative nasal respiration using visual analog scoring, and (3) computerized tomo- graphic images. Results The patients were followed up for 29 months on average. Patients’ respiration-related problems resulting from septal deviation were relieved in all but four patients. Clinically and radiologically, the straightened septums preserved their new forms, and it was detected with com- puterized tomography that the bone grafts had acquired permanency. In addition, the NOSE scores improved sig- nificantly compared to their preoperative levels. Conclusions In cases in which the use of bone or cartilage grafts is chosen to straighten the deviated septal cartilage, fixation of grafts with cyanoacrylate (CA) tissue adhesive is a quick, instantly effective, and reliable method. CA, which enables the subsurface of the graft to have complete contact with the septal cartilage, provides extra benefit by transferring all of the reformative forces of the grafts to the septal cartilage. Level of Evidence II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Septal deviation Á Cartilage graft Á Bone graft Á Cyanoacrylate Á Fixation Introduction Septal deviation is a difficult disorder for surgeons to treat. The memory of the deviated cartilage renders treatment difficult, and whichever method is used, the abutment provided by the septum for the tip and dorsum of the nose should also be preserved. Therefore, care should be taken not to waste or decimate the septal car- tilage [1–3]. When straightening septal deviation resulting from slight deformities, releasing the peripheral connections of the septal cartilage, and its mere repositioning may be adequate [2, 4]. In more severe deformities, the deviation can be straightened by fixing straight cartilage or bone grafts to the septal cartilage with stitches [5–12]. Although the fixation of cartilage grafts is easier, sutures are liable to cut the cartilage, and such grafts may not always be strong enough to straighten the deviation in the septal cartilage. Bone grafts provide stronger abutment. However, their This paper was presented at the 37th National Plastic, Reconstructive, and Esthetic Surgery Congress, November 4–7, 2015, Ankara, Turkey. & I ˙ rfan O ¨ zyazgan ozyazganirfan@gmail.com 1 Department of Plastic, Reconstructive and Esthetic Surgery, Faculty of Medicine, Erciyes University, 38039 Melikgazi, Kayseri, Turkey 123 Aesth Plast Surg DOI 10.1007/s00266-017-0836-9