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Iris Fixation via External Pentagram Suturing
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Hemitransdomal versus Dome-Binding Suture.

Fernando Casanueva1, Deniz Gerecci2, Felipe Cardemil3

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|December 27, 2017
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Summary
This summary is machine-generated.

The hemitransdomal suture (HTS) technique offers a more favorable rotational axis for the lateral crus compared to the dome-binding suture (DBS). This objective measurement supports HTS for natural nasal tip contouring.

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Area of Science:

  • Plastic Surgery
  • Anatomy
  • Surgical Techniques

Background:

  • The dome-binding suture (DBS) and hemitransdomal suture (HTS) are surgical techniques for nasal tip refinement.
  • The DBS may result in an unnatural, pinched appearance.
  • The HTS technique aims for a more natural contour and alar margin support.

Purpose of the Study:

  • To objectively measure and compare the rotational axis of the lateral crus between the DBS and HTS techniques.
  • To determine which technique, DBS or HTS, yields a more favorable lateral crus rotation using the alar surface septal angle (ASSA).

Main Methods:

  • Open rhinoplasty with cephalic trim and either DBS or HTS placement was performed on 6 cadaveric heads (12 lower lateral cartilages).
  • Alar surface septal angle (ASSA) measurements were recorded at baseline and after each suture technique.
  • A total of 36 ASSA measurements were analyzed.

Main Results:

  • The median baseline ASSA was 142 degrees.
  • The median ASSA after DBS placement was 141 degrees (no significant difference from baseline).
  • The median ASSA after HTS placement was 112 degrees (significant difference from baseline and DBS, p < 0.0001).

Conclusions:

  • The HTS technique significantly improves the rotational axis of the lateral crus compared to the DBS.
  • Objective ASSA measurements support the HTS as a superior technique for nasal tip contouring.
  • This study provides quantitative data to guide the selection of suture techniques in rhinoplasty.