Finite Element Analysis of the Septal Cartilage L-Strut

Menapace, Deanna C.; Carlson, Kent; Dragomir-Daescu, Dan; Matsumoto, Jane M.; Hamilton, Grant

doi:10.1089/fpsam.2019.0012

Cited by 12 publications

(13 citation statements)

References 30 publications

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“…They reported that avoiding sharp angles and making a curved incision at the corners had reduced stress at the corners and along the anterior septal angle. 4 Lee et al used computer-aided modeling to create Lstrut cartilage models, and a simulation was performed to analyze the deformation models. 5 They defined that the Kpoint and nasal spine/PSA were the most potent points and that the wide L-strut (at least 1 cm) would provide a more stable septum.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of mucoperichondrium on the nasal septum was assessed in four different situations and the measurements were recorded respectively at six levels: at the keystone area they were 5.07, 4.6(À9%), 3.54(À23%), 3.22(À9%) Newton (N); at the mid vault, 4.18, 3.9(À6%), 3.09(À20%), 3.05(À1%) N; at the supratip region 3.96, 2.56(À35%), 2.05(À19%), 2.06 (À2%) N; at the ASA/Tip region 3.53, 2.08(À41%), 2(À4%), 1.81(À9%) N; at the infratip region 5.41, 3.16(À42%), 2.92 (À6%), 2.86(À4%) N; at the Columella/PSA region 12.7, 11.89 (À6%), 11.12(À6%), and 10.63(À4%) N (►Fig. 4).…”

Section: Mucoperichondrium Effect (Steps 0-3)mentioning

confidence: 99%

“…2 Many computer modeling studies have been conducted to estimate the strength of the cartilaginous septum and L-strut. [3][4][5][6] During septal procedures, one of the most neglected issues is the role of mucoperichondrium in determining the support for the nasal septum. While some surgeons elevate the mucoperichondrium bilaterally, 7,8 some try to keep an unelevated portion thinking that it will add support to the cartilaginous pyramid.…”

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Biomechanics of Septal L-Strut on Lamb Head Models

2022

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It is very crucial to know the biomechanics of the septal cartilage and adjacent structures during septoplasty. The aim of this study was to investigate the strength changes of different L-strut models after mucoperichondrium elevation, application of septal extension grafts and spreader grafts on an experimental lamb model. Ten lamb heads were dissected according to a dissection protocol and septal resistances were measured with the newton meter at six zones. Three different L-strut types were designed, and all the L-strut models were created at different widths of 15mm, 10mm, and 5mm. In addition, effects of two different types of septal extension grafts and spreader grafts were compared. After mucoperichondrium elevation and harvesting the septum cartilage, there was a significant decrease in the septum resistance (p <0.05). As the width of the L-strut decreased, the septum strength decreased significantly (p <0.05). There was no significant difference between three chondrotomy types at different widths (p >0.05). There was no significant difference between the overlapping SEG and end-to-end SEG in terms of septum resistance (p >0.05). This was the first study to measure septal resistance in lamb heads. The mucoperichondrium and L-strut width were important structures for maintaining septal resistance. Chondrotomy style was not crucial, but as the width of the L-strut increased, the septal resistance increased. The septal extension grafts regardless of suturing style and the spreader grafts added strength to the caudal septum.

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Section: Discussionmentioning

confidence: 99%

Section: Mucoperichondrium Effect (Steps 0-3)mentioning

confidence: 99%

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confidence: 99%

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Biomechanics of Septal L-Strut on Lamb Head Models

2022

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“…Nonetheless, due to the promotion of the concept of medical and industrial intersection, it has also been applied in the medicinal field to interpret the interaction between the complex tissues of the human body with respect to biomechanics. 21 Previously, in otorhinolaryngology and plastic surgery, some researchers used finite element technology to analyze the stability of L-strut under various conditions, 22,23 but no precedent was observed in the perpendicular plate of ethmoid. Herein, used finite element technology to explore the optimum position to cut the perpendicular plate of ethmoid, guide the clinical operation, minimize the occurrence of complications, and improve the safety of surgery.…”

Section: Discussionmentioning

confidence: 99%

Use of nasal septal bone to straighten septal L‐Strut in correction of east Asian short nose: A retrospective study

Shu

Xie

et al. 2023

J of Cosmetic Dermatology

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Background:The perpendicular plate of ethmoid (PPE) was used to correct short noses in rhinoplasty in Asians, but the safe harvest of the plate and the assessment of its clinical application has been perplexing to plastic surgeons. Aims:To explore how to safely cut the perpendicular plate of ethmoid bone and evaluate its application effect.Patients/Methods: A finite element model was established to guide the clinical operation. A total of 30 patients with short noses were selected. Among them, 15 patients used autologous septal cartilage to lengthen the nasal tip, and 15 patients used the PPE to strengthen the L-shape nasal septum. The differences in the esthetic parameters of the nose, complications, and patients' satisfaction were compared between the two groups.Results: Significant differences were noted in the nasal dorsal length (p = 0.001), Goode's ratio (p = 0.001), and nasofrontal angle (p = 0.003) after rhinoplasty, and no significant differences were noted in any of the esthetic parameters between the two groups. The symptoms of nasal obstruction in the experimental group were significantly lighter than those in the control group (p = 0.04). There was no statistically significant difference in the doctors' assessment of outcomes between the two groups (p = 0.48). Conclusion:The safest region to harvest the PPE is in the middle and lower third.Rhinoplasty improves the esthetics of the patient's nose. The PPE used to strengthen the L-shape nasal septum structure has a smaller probability of nasal septal deviation with the time in Asian short noses.

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“…Menapace et al performed a cadaveric analysis of various chondrotomy designs compared with maximum principal stress tolerated. 10 They found that a double cornered chondrotomy, in which a Ccurve is created at the transition between the caudal and dorsal struts and at the bony-cartilaginous junction, resulted in a 44% reduction in maximum principal stress compared with a traditional L-strut. Further, they showed that there was no statistically significant reduction in volumetric and surface area of the harvested cartilage with this technique.…”

Section: Septoplasty Pearlsmentioning

confidence: 99%

Nuances of Septal Deviation Repair

Abrol

2022

Facial Plast Surg

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Septoplasty is one of the most common procedures performed by facial plastic surgeons. Surgical decision-making surrounding septal deviation repair centers around the location of deviation and need for dorsal and/or caudal septal correction. Endonasal approaches are often adequate and external approaches are utilized for significant L-strut involvement. For severe deformities, extracorporeal septoplasty and anterior septal reconstruction can be utilized. We present an overview of septal deviation repair with technical nuances and advanced reconstruction techniques.

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Finite Element Analysis of the Septal Cartilage L-Strut

Cited by 12 publications

References 30 publications

Biomechanics of Septal L-Strut on Lamb Head Models

Biomechanics of Septal L-Strut on Lamb Head Models

Use of nasal septal bone to straighten septal L‐Strut in correction of east Asian short nose: A retrospective study

Nuances of Septal Deviation Repair

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