%0 Journal Article
%T Comparative clinical study with a novel technique for stabilization of the nasal tip projection and rotation: fixation of the septum and the strut graft through the septal cartilage autoextension.
%A Bilgili AM
%A Çerçi Özkan A
%J Eur Arch Otorhinolaryngol
%V 277
%N 12
%D Dec 2020
%M 32705359
%F 3.236
%R 10.1007/s00405-020-06225-y
%X <B>OBJECTIVE: </B>It is important to reinforce nasal tip support for long-term satisfactory results. Two workhorses of tip support are strut grafting and the tongue-in-groove technique. Tongue-in-groove causes retraction and stiffness; the strut causes loss of rotation and projection of tip. We introduced a novel technique that avoids these consequences.<BR><B>METHODS: </B>Between February 2018-February 2019, 40 female underwent primary rhinoplasty. Mean age: 27 years (18-41 years).<BR><B>RESULTS: </B>1-2 years. In first group (20 patients), caudal septum was resected and strut was not fixated to caudal septum. In second group (20 patients), tongue-like extension (septal autoextension) was preserved at caudal septum and sutured to strut. Preoperative, peroperative, and postoperative images were compared.<BR><B>RESULTS: </B>Tip projection ratio calculations, nasolabial angle measurements were evaluated by statistical analyses. The change in projection ratios between peroperative period and 1-year postoperative period of strut-only group was higher than septal autoextension group (p = 0.001). This result indicates that nasal tip projection loss in strut-only group was higher compared to septal autoextension group. The change in nasolabial angle measurements from peroperative period to 1-year postoperative period differed significantly between two groups (p = 0.001). Significant difference was observed between 1-year postoperative nasolabial angle measurements of two groups (p = 0.006); septal autoextension group measurements were higher than strut-only group. These results showed that fixation of strut graft to the septal autoextension provides better preservation of the nasolabial angle and stabilization of nasal tip projection. CONCLUSıON: Fixation of septum and strut graft through septal autoextension provides satisfactory stabilization of tip projection and rotation without stiffness or rigidity.