Resistance Measurements with Dynamometer in Foundation Dorsal Preservation Rhinoplasty Techniques

Some recommendations have been reported about nasal hump recurrence and its possible reasons or mechanisms after dorsal preservation rhinoplasty. In this study, we aimed to measure how additional maneuvers affect recoil on the dorsum with the help of a dynamometer during the dorsal preservation rhinoplasty operation.

Twelve patients who underwent closed approach dorsal preservation rhinoplasty at the Ege University Hospital ENT department between September and December 2022 were included in this prospective study. During the dorsal preservation rhinoplasty operation in all patients, the pressure values caused by the recoil of the dorsum on the probe of the dynamometer placed on the rhinion were measured and recorded in 4 steps. (1: Push down (PD), 2: Let down (LD), 3: Lateral keystone dissection, 4: Rasping) RESULTS: Of the 12 patients included in the study, 6 (50%) were female and 6 (50%) were male. The mean age was found to be between 29.9 ± 6.5 (minimum 22-maximum 42). Mean follow-up time was 36.6 ±15.3 (minimum 15 -maximum 60). 3 patients (25%) had a straight nose, 7 patients (58.3%) had a tension nose and 2 patients (16.7%) had a kyphotic nose. The scores of all four stages measured were statistically significant (p < 0.001). In the comparison of the stages against each other, there were significant differences between PD-LD, LD-LKA dissection, and LKA dissectionrasping (p < 0.001). The scores of all four stages measured were statistically significant (p<0.001). In the comparison of the stages against each other, there were significant differences between PD-LD, LD-LKA dissection, and LKA dissection-rasping (p < 0.001). In the comparative analysis of nose types with each other, the difference between straight nose and kyphotic nose was found to be significant (p < 0.05). There was no significant difference between tension nose and other nose types (p > 0.05). There were differences in pressure values according to nose types (Straight, Tension, Kyphotic) and all nose types were found to be statistically significantly affected by additional maneuvers.

The effect of maneuvers performed on areas defined as resistance points in dorsal preservastion rhinoplasty have been evaluated with objective measurement methods. In selected cases, noses with severely angled and kyphotic humps require additional maneuvers, including resection of the bony cap, to flatten the nasal dorsum and the cartilaginous roof.

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