Strut graft is an important, commonly used method to increase nasal tip projection and rotation. This study discuss its benefit by prospective analysis of a group of patients in which strut graft was used and compare it with a control group using digitalized photographs. The aim of this study is to evaluate the benefit of columellar strut graft and its effect on nasal projection and rotation using digital images. Thirty two patients were treated with external rhinoplasty. Using their photographs, we analyzed the projection and rotation of the nose before and after operation. The patients were classified into two groups: group A included 18 patients who have strut and group B included 14 patients without strut. The analysis of the photos of the two groups was done with a computer program. By using Goode method, nasal tip projection decreases from 0.63 to 0.62 for patients using the strut, while in patients without strut nasal tip projection decreases from 0.64 to 0.61. Nasal tip rotation slightly increased in patients with strut graft from 99 to 99.5 degrees, while in those without the graft, nasal tip rotation markedly increased from 95 to 103 degrees. In conclusion, external rhinoplasty decreases nasal tip projection and the use of strut graft is unnecessary in increasing nasal tip projection but it helps in preserving the projection and slightly increasing nasal tip rotation.
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