Predictive Evaluation of Septal Cartilage-bone Complex for Rhinoplasty Using Cone Beam Computed Tomography

Area of Science:

• Plastic Surgery
• Otolaryngology
• Medical Imaging

Background:

• Septal extension grafting (SEG) is a common technique for correcting short noses in Asian individuals.
• When septal cartilage is insufficient, septal bone can be incorporated into the graft.
• This study investigates the efficacy of SEG using a septal cartilage-septal bone complex (SCBC).

Purpose of the Study:

• To evaluate the clinical outcomes of SEG utilizing an SCBC.
• To assess the utility of preoperative cone beam computed tomography (CBCT) in predicting septal bone suitability for grafting.

Main Methods:

• A retrospective review of 27 Korean women undergoing or considered for SEG with SCBC was performed.
• Preoperative CBCT scans measured Hounsfield Unit (HU) values of septal bone components (perpendicular plate of the ethmoid and vomer).
• Clinical results and patient satisfaction were evaluated post-surgery.

Main Results:

• Nineteen patients underwent SEG with SCBC, showing significant improvements in nasal length and tip projection.
• CBCT Hounsfield Unit (HU) ratios helped differentiate suitable bone (PPE: 6.8±2.1, vomer: 5.7±1.8) from unsuitable bone (too thick/stiff or fragile).
• Eight patients did not receive SCBC due to unsuitable septal bone quality identified preoperatively.

Conclusions:

• SEG with SCBC is an effective method for correcting Asian short noses.
• Preoperative CBCT-derived HU ratios are valuable for predicting septal bone quality and guiding surgical decisions.
• Larger studies are warranted to validate these findings and refine surgical planning.