The broad base columellar strut for correction of retracted columella and under rotated tip

Abstract

Objective: To describe the technique and to detect the efficacy of the broad base columellar strut in correcting retracted columella and under rotated nasal tip. Design: Retrospective chart review. Setting: University-affiliated medical center. Methods: The charts and photographs of patients suffering from columellar retraction with acute columellar-labial angle were reviewed. The columellar-labial angle and the nasal tip projection were measured and calculated from the photos and the columellar show was measured using a fine caliper. Results: The study included 17 patients, 12 females and 5 males with a mean age of 30.2 years ranging from 19 to 49 years, 14 patients had primary surgery while 3 were revision cases, Preoperative columellar-labial angle ranged from 75°to 86°with a mean 82.06 ± 4.08458 SD, while postoperatively it ranged from 92°to 105°with a mean 97.12°± 3.9825 SD. Columellar show ranged preoperatively from 0.4 to 1.7 mm with a mean 0.94 mm ± 0.38739 SD while postoperatively it ranged from 2.5 to 3.5 mm with a mean of 2.65 mm ± 0.38098 SD. Nasal tip projection preoperatively ranged from 0.45 to 0.58 and postoperatively from 0.51 to 0.59. Conclusions: The broad base columellar strut technique is simple, easy, does not cause excessive tip stiffness and reduces the need to use the plumbing graft in conjunction with the columellar strut, and should help in increasing tip rotation and columellar show reliably and may add to tip projection as required.

Columellar Strut Graft in Tip Rhinoplasty, Is It of Benefit?

“…In addition, we found that there is significant role of strut graft in maintaining nasal tip projection, which is similar with Rod J. Rohrich 6 study that strut graft does not necessarily increase the nasal tip projection. We agreed with Vuyk etal 7 study that the strut graft helps to maintain nasal tip projection as well as Amr N. Rabie 4 and Mohammad Sadeghi 8 studies. Moreover, in our study we found there are strong relationship between strut graft implantation and nasal tip projection (p-value 0.016).…”

“…In the current study, columellar strut graft was used as a dominant procedure for controlling tip projection, tip rotation with minor contribution of suture technique and cartilage resection. The age of patients participating in this study ranged from 16 to 46 with a mean of 26 years similar to the study of Amr N. Rabie 4 in which patients age ranged from 19-49 with mean of 30.2 years. While Koen Ingels 5 , Rod J. Rohric 6 studies did not mention any link to age distribution.…”

“…The current study differ from the study done by Rod J. Rohrich 6 who found that tip projection increase in 65% and decrease in 27% , 8% had no change. Moreover, Amr N. Rabie 4 study found an increase in 70% of the patients and a decrease in 11% of the patients and unchanged results in 17% of the patients. The reason for this contradiction may be that they used another techniques to enhance tip projection other than columellar strut.…”

“…We found that 65% of the patients have nasal problems and 35% have no nasal problems. There was no mention for any significant importance for nasal problems in previous studies (Koen Ingels 5 , Rod J. Rohrich 6 , Vuyk etal 7 , Amr N. Rabie 4 and Mohammad Sadeghi 8 ). This study showed no significant relationship between nasal problem and seeking rhinoplasty surgery (p-value 0.240) .…”