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Erschienen in: Aesthetic Plastic Surgery 2/2014

01.04.2014 | Original Article

The Effects of Nasal Base Stabilization Techniques on Nasal Tip Rigidity

verfasst von: Filiz Aydogan, Eren Tastan, Emine Aydin, Hatice Karadas Emir, Arzu Tuzuner, Sule Demirci, Erdal Samim

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 2/2014

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Abstract

Background

The aim of this study was to compare the degree of nasal tip rigidity from different techniques for increasing nasal tip projection.

Methods

Retrospective records of patients who had undergone rhinoplasty were reviewed at the tertiary referral center. 81 patients who had undergone suturing of the medial crura to the extension graft or to the long septum were selected. In group A, fixation was performed at the same level compared to before surgery. In group B, tip grafting was performed to gain 3 mm or more in projection after fixation as done in group A. In group C, the same tip projection was provided by advancing the medial crura on the caudal septum or extension graft. Patients were evaluated with a visual analog scale, based on the rigidity of the nasal tip (0 = very flexible, 10 = very rigid).

Results

When the preoperative and postoperative VAS scores of all groups were compared, postoperative scores were significantly higher than the preoperative scores (p < 0.001). The postoperative scores of group C were higher than those of the other groups. These differences were statistically significant (p < 0.001). There was no statistically significant difference between groups A and B with regard to the postoperative scores (p = 0.389). However, in group C, the increase between preoperative and postoperative scores was significantly higher than in the other groups (p < 0.001).

Conclusion

Advancing the medial crura on the caudal septum and suturing to gain 3 mm or more of tip projection may result in a more rigid nasal tip. Patients should be informed preoperatively of this potential result.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Sen C, Iscen D (2006) Caudal septal advancement for nasal tip projection and support in rhinoplasty. Aesthet Plast Surg 30:135–140CrossRef Sen C, Iscen D (2006) Caudal septal advancement for nasal tip projection and support in rhinoplasty. Aesthet Plast Surg 30:135–140CrossRef
2.
Zurück zum Zitat Dobratz EJ, Tran V, Hilger PA (2010) Comparison of techniques used to support the nasal tip and their long-term effects on tip position. Arch Facial Plast Surg 12:172–179PubMedCrossRef Dobratz EJ, Tran V, Hilger PA (2010) Comparison of techniques used to support the nasal tip and their long-term effects on tip position. Arch Facial Plast Surg 12:172–179PubMedCrossRef
3.
Zurück zum Zitat Han SK, Lee DG, Kim JB et al (2004) An anatomic study of nasal tip supporting structures. Ann Plast Surg 52:134–139PubMedCrossRef Han SK, Lee DG, Kim JB et al (2004) An anatomic study of nasal tip supporting structures. Ann Plast Surg 52:134–139PubMedCrossRef
4.
Zurück zum Zitat Toriumi DM, Checcone MA (2009) New concepts in nasal tip contouring. Facial Plast Surg Clin North Am 17:55–90PubMedCrossRef Toriumi DM, Checcone MA (2009) New concepts in nasal tip contouring. Facial Plast Surg Clin North Am 17:55–90PubMedCrossRef
5.
Zurück zum Zitat Kridel RW, Scott BA, Foda HM (1999) The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1:246–256PubMedCrossRef Kridel RW, Scott BA, Foda HM (1999) The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1:246–256PubMedCrossRef
6.
Zurück zum Zitat Guyuron B, Varghai A (2003) Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 111:1533–1539PubMedCrossRef Guyuron B, Varghai A (2003) Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 111:1533–1539PubMedCrossRef
7.
Zurück zum Zitat Tebbetts JB (2008) Primary rhinoplasty, redefining the logic and techniques, 2nd edn. Elsevier, Toronto Tebbetts JB (2008) Primary rhinoplasty, redefining the logic and techniques, 2nd edn. Elsevier, Toronto
8.
Zurück zum Zitat Bruschi S, Bocchiotti MA, Verga M, Kefalas N, Fraccalvieri M (2006) Closed rhinoplasty with marginal incision: our experience and results. Aesthet Plast Surg 30:155–158CrossRef Bruschi S, Bocchiotti MA, Verga M, Kefalas N, Fraccalvieri M (2006) Closed rhinoplasty with marginal incision: our experience and results. Aesthet Plast Surg 30:155–158CrossRef
9.
Zurück zum Zitat Lavinsky-Wolff M, Dolci JE, Camargo HL Jr, Manzini M, Petersen S, Romanczuk S, Pizzoni R, Polanczyk CA (2013) Vertical dome division: a quality-of-life outcome study. Otolaryngol Head Neck Surg 148:758–763PubMedCrossRef Lavinsky-Wolff M, Dolci JE, Camargo HL Jr, Manzini M, Petersen S, Romanczuk S, Pizzoni R, Polanczyk CA (2013) Vertical dome division: a quality-of-life outcome study. Otolaryngol Head Neck Surg 148:758–763PubMedCrossRef
10.
Zurück zum Zitat Klinger M, Caviggioli F, Forcellini D, Bandi V, Maione L, Vinci V, Pagliari AV, Klinger F, Mazzola RF (2012) Primary nasal tip surgery: a conservative approach. Aesthet Plast Surg 36:485–490CrossRef Klinger M, Caviggioli F, Forcellini D, Bandi V, Maione L, Vinci V, Pagliari AV, Klinger F, Mazzola RF (2012) Primary nasal tip surgery: a conservative approach. Aesthet Plast Surg 36:485–490CrossRef
11.
Zurück zum Zitat Lohuis PJ, Faraj-Hakim S, Knobbe A, Duivesteijn W, Bran GM (2012) Split hump technique for reduction of the overprojected nasal dorsum: a statistical analysis on subjective body image in relation to nasal appearance and nasal patency in 97 patients undergoing aesthetic rhinoplasty. Arch Facial Plast Surg 14:346–353PubMedCrossRef Lohuis PJ, Faraj-Hakim S, Knobbe A, Duivesteijn W, Bran GM (2012) Split hump technique for reduction of the overprojected nasal dorsum: a statistical analysis on subjective body image in relation to nasal appearance and nasal patency in 97 patients undergoing aesthetic rhinoplasty. Arch Facial Plast Surg 14:346–353PubMedCrossRef
12.
Zurück zum Zitat Dyer WK 2nd (2004) Nasal tip support and its surgical modification. Facial Plast Surg Clin North Am 12:1–13PubMedCrossRef Dyer WK 2nd (2004) Nasal tip support and its surgical modification. Facial Plast Surg Clin North Am 12:1–13PubMedCrossRef
13.
Zurück zum Zitat Ordóñez-Ordóñez LE, Navarro-García US, Angulo-Martínez ES (2010) Nasal septum to columella attachment: a major tip support? Otolaryngol Head Neck Surg 143:60–65PubMedCrossRef Ordóñez-Ordóñez LE, Navarro-García US, Angulo-Martínez ES (2010) Nasal septum to columella attachment: a major tip support? Otolaryngol Head Neck Surg 143:60–65PubMedCrossRef
14.
Zurück zum Zitat Tardy ME (1997) Rhinoplasty: the art and the science. WB Saunders, Philadelphia Tardy ME (1997) Rhinoplasty: the art and the science. WB Saunders, Philadelphia
15.
Zurück zum Zitat Sadeghi M, Saedi B, Arvin Sazegar A, Amiri M (2009) The role of columellar struts to gain and maintain tip projection and rotation: a randomized blinded trial. Am J Rhinol Allergy 23:e47–e50PubMedCrossRef Sadeghi M, Saedi B, Arvin Sazegar A, Amiri M (2009) The role of columellar struts to gain and maintain tip projection and rotation: a randomized blinded trial. Am J Rhinol Allergy 23:e47–e50PubMedCrossRef
16.
Zurück zum Zitat Kang JG, Ryu J (2009) Nasal tip surgery using a modified septal extension graft by means of extended marginal incision. Plast Reconstr Surg 123:343–352PubMedCrossRef Kang JG, Ryu J (2009) Nasal tip surgery using a modified septal extension graft by means of extended marginal incision. Plast Reconstr Surg 123:343–352PubMedCrossRef
17.
18.
Zurück zum Zitat Guyuron B (2012) Rhinoplasty, 1st edn. Elsevier, Beijing Guyuron B (2012) Rhinoplasty, 1st edn. Elsevier, Beijing
19.
Zurück zum Zitat Ha RY, Byrd HS (2003) Septal extension grafts revisited: 6-year experience in controlling nasal tip projection and shape. Plast Reconstr Surg 112:1929–1935PubMedCrossRef Ha RY, Byrd HS (2003) Septal extension grafts revisited: 6-year experience in controlling nasal tip projection and shape. Plast Reconstr Surg 112:1929–1935PubMedCrossRef
20.
Zurück zum Zitat Byrd HS, Andochick S, Copit S, Walton KG (1997) Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 100:999–1010PubMedCrossRef Byrd HS, Andochick S, Copit S, Walton KG (1997) Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 100:999–1010PubMedCrossRef
21.
Zurück zum Zitat Cingi C, Songu M, Bal C (2011) Outcomes research in rhinoplasty: body image and quality of life. Am J Rhinol Allergy 25:263–267PubMedCrossRef Cingi C, Songu M, Bal C (2011) Outcomes research in rhinoplasty: body image and quality of life. Am J Rhinol Allergy 25:263–267PubMedCrossRef
22.
Zurück zum Zitat Cingi C, Eskiizmir G (2013) Deviated nose attenuates the degree of patient satisfaction and quality of life in rhinoplasty: a prospective controlled study. Clin Otolaryngol 38:136–141PubMedCrossRef Cingi C, Eskiizmir G (2013) Deviated nose attenuates the degree of patient satisfaction and quality of life in rhinoplasty: a prospective controlled study. Clin Otolaryngol 38:136–141PubMedCrossRef
23.
Zurück zum Zitat Meningaud JP, Lantieri L, Bertrand JC (2008) Rhinoplasty: an outcome research. Plast Reconstr Surg 121:251–257PubMedCrossRef Meningaud JP, Lantieri L, Bertrand JC (2008) Rhinoplasty: an outcome research. Plast Reconstr Surg 121:251–257PubMedCrossRef
24.
Zurück zum Zitat Arima LM, Velasco LC, Tiago RS (2011) Crooked nose: outcome evaluations in rhinoplasty. Braz J Otorhinolaryngol 77:510–515PubMedCrossRef Arima LM, Velasco LC, Tiago RS (2011) Crooked nose: outcome evaluations in rhinoplasty. Braz J Otorhinolaryngol 77:510–515PubMedCrossRef
25.
Zurück zum Zitat Sinno H, Izadpanah A, Thibaudeau S, Christodoulou G, Tahiri Y, Slavin SA, Lin SJ (2012) The impact of living with a functional and aesthetic nasal deformity after primary rhinoplasty: a utility outcomes score assessment. Ann Plast Surg 69:431–434PubMedCrossRef Sinno H, Izadpanah A, Thibaudeau S, Christodoulou G, Tahiri Y, Slavin SA, Lin SJ (2012) The impact of living with a functional and aesthetic nasal deformity after primary rhinoplasty: a utility outcomes score assessment. Ann Plast Surg 69:431–434PubMedCrossRef
Metadaten
Titel
The Effects of Nasal Base Stabilization Techniques on Nasal Tip Rigidity
verfasst von
Filiz Aydogan
Eren Tastan
Emine Aydin
Hatice Karadas Emir
Arzu Tuzuner
Sule Demirci
Erdal Samim
Publikationsdatum
01.04.2014
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 2/2014
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-014-0295-5

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