Investigation of the Changes in Nasal Tip Projection with L- shape Strut Graft
Journal of Otorhinolaryngology and Facial Plastic Surgery,
Vol. 9 No. 1 (2023),
2 September 2023
,
Page 1-5
https://doi.org/10.22037/orlfps.v9i1.45726
Abstract
Background: Knowing the long-term consequences or side effects induced by various types of strut and septal extension grafts following rhinoplasty are essential and aid in estimating and predicting difficulties later. The purpose of this study is to look at how the projection of the nose tip changes following rhinoplasty with the L-shape strut, a new type of septal extension.
Aim: We aimed to determine the changes in nasal projection in patients who received an L-shaped strut at 6 and 12 months’ post-operation.
Methods: Following inclusion and exclusion criteria, an L-shape strut was prepared from the patient's septal cartilage and used in the surgery. We objectively assess the results of the L-shape strut with standard images. These standard images were taken before surgery and on the day of the nasal splint off, six- and twelve-months after surgery. Then the nasal projection was calculated using Goode's ratio.
Results: Thirty patients were included. The mean Goode's ratio was 0.573 ± 0.014 shortly after surgery, all participants had a ratio between 0.55 and 0.60. After 6 and 12 months of follow-up, the measured Goode ratio of the participants was 0.556 ± 0.024 and 0.550± 0.027, respectively. Thus, the observed ratio declined by 2% during the first six months, and 1 % during the second six months. This decreasing pattern was statistically significant. After twelve months of follow-ups, Goode's ratio of all included cases was in the optimal range of 0.55 to 0.6.
Conclusion: The findings of this study demonstrate that the L-shape strut, a new type of septal extension, can help to keep the optimal Goode’s ratio after a year follow-up.
- L-shape strut; Nasal projection; Goode’s ratio; Rhinoplasty.
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References
Rohrich RJ, Hoxworth RE, Kurkjian TJ. The role of the columellar strut in rhinoplasty: indications and rationale. Plast Reconstr Surg. 2012;129(1):118e-25e.
Hwang NH, Dhong ES. Septal Extension Graft in Asian Rhinoplasty. Facial plastic surgery clinics of North America. 2018;26(3):331-41.
Mendelsohn JE, Hilger P. The AAFPRS Web site. Facial plastic surgery : FPS. 1999;15(2):149-52.
Sheen JH, Sheen AP. Aesthetic rhinoplasty. (No Title). 1987.
Gunter JP, Landecker A, Cochran CS. Frequently used grafts in rhinoplasty: nomenclature and analysis. Plastic and reconstructive surgery. 2006;118(1):14e-29e.
Rethi A. Uber die korrektiven operationen der nasen deformitaten I die hockerabtragung. Chirurgie. 1929;1:1103.
Anderson JR. New approach to rhinoplasty. A five-year reappraisal. Arch Otolaryngol. 1971;93(3):284-91.
Goodman WS, Charbonneau PA. External approach to rhinoplasty. Laryngoscope. 2015;125(7):1505-11.
Gruber RP. Open rhinoplasty. Clin Plast Surg. 1988;15(1):95-114.
Tebbetts JB. Shaping and positioning the nasal tip without structural disruption: a new, systematic approach. Plast Reconstr Surg. 1994;94(1):61-77.
Rohrich RJ, Adams WP, Jr. The boxy nasal tip: classification and management based on alar cartilage suturing techniques. Plast Reconstr Surg. 2001;107(7):1849-63; discussion 64-8.
Rohrich RJ, Ahmad J. Rhinoplasty. Plast Reconstr Surg. 2011;128(2):49e-73e.
Sheen JH. Achieving more nasal tip projection by the use of a small autogenous vomer or septal cartilage graft. A preliminary report. Plast Reconstr Surg. 1975;56(1):35-40.
Kim JS, Han KH, Choi TH, Kim NG, Lee KS, Son DG, et al. Correction of the nasal tip and columella in Koreans by a complete septal extension graft using an extensive harvesting technique. J Plast Reconstr Aesthet Surg. 2007;60(2):163-70.
Adams WP, Jr., Rohrich RJ, Hollier LH, Minoli J, Thornton LK, Gyimesi I. Anatomic basis and clinical implications for nasal tip support in open versus closed rhinoplasty. Plast Reconstr Surg. 1999;103(1):255-61; discussion 62-4.
Byrd HS, Andochick S, Copit S, Walton KG. Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg. 1997;100(4):999-1010.
Kim HI, Lee WJ, Roh TS, Suh MK. A Novel Technique of Asian Tip Plasty: Rein-Shaped Columellar Strut Graft. Aesthetic Plast Surg. 2019;43(5):1301-9.
Seyhan A, Ozden S, Ozaslan U, Sir E. A simplified use of septal extension graft to control nasal tip location. Aesthetic Plast Surg. 2007;31(5):506-11; discussion 12-3.
Kang JG, Ryu J. Nasal tip surgery using a modified septal extension graft by means of extended marginal incision. Plast Reconstr Surg. 2009;123(1):343-52.
Ciolek PJ, Hanick AL, Roskies M, Fritz MA. Osseocartilaginous Rib Graft L-Strut for Nasal Framework Reconstruction. Aesthet Surg J. 2020;40(4):NP133-NP40.
Apaydin F. Projection and Deprojection Techniques in Rhinoplasty. Clin Plast Surg. 2016;43(1):151-68.
Dhong ES, Kim YJ, Suh MK. L-shaped columellar strut in East asian nasal tip plasty. Archives of plastic surgery. 2013;40(5):616-20.
Apaydin F, Garcia RFF, Tas V. L-Strut Graft: A Very Versatile Graft in the Management of Crooked and Traumatic Noses. Facial plastic surgery & aesthetic medicine. 2021;23(2):110-7.
Baykal B, Erdim I, Guvey A, Oghan F, Kayhan FT. Caudal Septal Stabilization Suturing Technique to Treat Crooked Noses. J Craniofac Surg. 2016;27(7):1830-3.
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