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Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
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Preserving Nasal Tip Rotation and Projection in Open Septorhinoplasty.

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  • 1Department of Otolaryngology, Head and Neck Surgery, Ochsner Clinic Foundation, New Orleans, LA.

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|October 3, 2022
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Summary
This summary is machine-generated.

This study evaluated three nasal tip support techniques in open septorhinoplasty. While all reliably maintained nasal tip projection, the tongue-in-groove technique increased rotation, and the caudal septal extension graft decreased it.

Keywords:
Nasal septumnasal surgical proceduresprojectionrhinoplastyrotation

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Area of Science:

  • Facial Plastic Surgery
  • Rhinoplasty Techniques
  • Nasal Reconstruction

Background:

  • Open septorhinoplasty is a complex procedure demanding precise planning for predictable outcomes.
  • Maintaining patient's original nasal tip characteristics and ensuring long-term stability are key surgical goals.
  • Common techniques for nasal tip support include tongue-in-groove, caudal septal extension graft, and caudal septal replacement graft.

Purpose of the Study:

  • To assess the 1-year reliability of three nasal tip support techniques in open septorhinoplasty.
  • To evaluate the impact of tongue-in-groove, caudal septal extension graft, and caudal septal replacement graft on nasal tip rotation and projection.

Main Methods:

  • Retrospective case series review of 57 open septorhinoplasty cases (2015-2019) excluding those intending to alter tip rotation or projection.
  • Two blinded reviewers analyzed standardized preoperative and 1-year postoperative photographs.
  • Comparison of nasal tip rotation and projection ratios among the three surgical techniques.

Main Results:

  • No significant differences were found in mean preoperative and postoperative nasal tip rotations and projection ratios across all techniques.
  • Tongue-in-groove procedure showed a significant increase in nasal tip rotation (2.31°), while caudal septal extension graft showed a significant decrease (2.1°).
  • Caudal septal replacement graft demonstrated no significant change in nasal tip rotation; projection ratios remained stable for all techniques.

Conclusions:

  • Tongue-in-groove, caudal septal extension graft, and caudal septal replacement graft are reliable for maintaining nasal tip projection in open septorhinoplasty.
  • The tongue-in-groove technique tends to increase nasal tip rotation, whereas the caudal septal extension graft tends to decrease it.
  • Surgeons should consider these rotational effects when aiming to preserve preoperative nasal tip characteristics.