Control of Nasal Tip Position: Quantitative Assessment of Columellar Strut versus Caudal Septal Extension Graft
- 1 November 2019
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Plastic and Reconstructive Surgery
- Vol. 144 (5), 772e-780e
- https://doi.org/10.1097/prs.0000000000006178
Abstract
Background: Control and maintenance of nasal tip position are critical in rhinoplasty. Two frequent methods of exerting tip control are columellar strut and caudal septal extension graft. However, no quantitative data exist comparing the two methods over time. The purpose of this study was to analyze maintenance of tip projection and rotation following either columellar strut or septal extension graft. Methods: A retrospective cohort study of patients undergoing rhinoplasty was reviewed. Three-dimensional photogrammetric evaluation of patients with either columellar strut or septal extension graft to increase tip projection was performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, the Goode ratio, and tip rotation. Results were stratified based on technique and compared statistically. Results: One hundred six patients were included. Overall, 66 percent were female, with an average age of 34.5 years. A columellar strut was used in 42 percent of cases (n = 45), and a septal extension graft was used in 57 percent (n = 61). Analysis showed greater maintenance of tip rotation over time with the septal extension graft compared with the columellar strut [-1.01 percent change (p = not significant versus -5.08 percent change (p = 0.009)]. Tip projection, nasal length, and the Goode ratio decreased over time for both groups, but the differences were not statistically different. Conclusions: Nasal tip projection and rotation appear to decrease from the immediate postoperative position. In this study, both septal extension graft and columellar strut exhibit similar changes in tip projection with time; however, septal extension graft is better able to preserve tip rotation compared with the columellar strut.Keywords
This publication has 22 references indexed in Scilit:
- An Introduction to the Septal Extension GraftArchives of Plastic Surgery, 2014
- The Effect of the Columellar Strut Graft on Nasal Tip Position in Primary RhinoplastyPlastic and Reconstructive Surgery, 2012
- The Role of the Columellar Strut in RhinoplastyPlastic and Reconstructive Surgery, 2012
- Supporting Strength of Septal Extension GraftsThe Journal of Craniofacial Surgery, 2011
- Nasal Tip Surgery Using a Modified Septal Extension Graft by Means of Extended Marginal IncisionPlastic and Reconstructive Surgery, 2009
- Frequently Used Grafts in Rhinoplasty: Nomenclature and AnalysisPlastic and Reconstructive Surgery, 2006
- New Concepts in Nasal Tip ContouringArchives of Facial Plastic Surgery, 2006
- Septal Extension Grafts Revisited:Plastic and Reconstructive Surgery, 2003
- Nasal Tip Projection: Quantitative Changes Following RhinoplastyJAMA Otolaryngology–Head & Neck Surgery, 1991
- A Reasoned Approach to Nasal Base SurgeryJAMA Otolaryngology–Head & Neck Surgery, 1984