The Effect of the Columellar Strut Graft on Nasal Tip Position in Primary Rhinoplasty

Rohrich, Rod J.; Kurkjian, T. Jonathan; Hoxworth, Ronald E.; Stephan, Phillip J.; Mojallal, Ali

doi:10.1097/prs.0b013e318262f3a9

Cited by 98 publications

(73 citation statements)

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“…1 However columellar struts have some limitations, they are subject to both resorption and displacement, 2 and as they are not attached to the caudal septum post operative tip drooping may occur. 6 In their study to know the effect of columellar strut on final tip position Rhorich et al 7 analyzed the tip projection, columellar-labial angle and nasofrontal angle in 100 rhinoplasty patients, the columellar-labial angle was increased in only 46% and unchanged in 20%, while it decreased in 34%. They also found that tip projection decreased in 65%, increased in 27%, and was unchanged in 8% of subjects.…”

Section: Discussionmentioning

confidence: 99%

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

Rabie

Begermy

2016

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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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.

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Section: Discussionmentioning

confidence: 99%

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

Rabie

Begermy

2016

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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“…According to Rhorich study including 100 rhinoplasty patients with retracted columella, although 67 % of the patients could reach NLA increasing, still 23 % finally experienced statistically significant NLA reduction [13].…”

Section: Discussionmentioning

confidence: 99%

Caudal extension graft versus columellar strut with plumping graft for acute nasolabial angle correction in rhinoplasty surgery

Atighechi

Sajadinejad

Baradaranfar

et al. 2014

Eur Arch Otorhinolaryngol

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Nasal tip support is an important factor to be considered in rhinoplasty surgery. There are several techniques for improving tip support. Caudal extension graft (CEG) and columellar strut with plumping graft (CSPG) are two methods in rhinoplasty surgery. The final goal of this experimental study is to find the most effective method for tip correction among patients with tip ptosis. In this study, we compare two different methods which are used for the tip correction among patients who suffer from acute nasolabial angle (NLA) and columellar retraction. We performed a randomized clinical trial to compare correction ratio of NLA and columellar show obtained via CEG and CSPG methods. Standardized photographs were taken before the surgery and 12 months after the surgery to compare results between two groups. The mean post-operation NLA was 112.55° in CEG and 104.17° in CSPG (p value < 0.001). Correction ratio of NLA was 22.26° in CEG and 13.77° in CSPG (p value < 0.001). The difference in the mean and the correction ratio of NLA were statistically significant in two groups. The mean post-operation columellar show was 3.75 mm in CEG and 3.44 mm in CSPG (p value < 0.083). The correction ratio of columellar show was 1.76 mm in CEG and 1.20 mm in CSPG (p value < 0.007). The difference in the correction ratio of the two groups was statistically significant. Our study reveals that both techniques properly improve NLA and columellar show, however, CEG is a more stable method in patients with tip ptosis.

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“…The columellar strut has been a mainstay to maintain tip support in rhinoplasty surgery. [4][5][6][7] Some have suggested that columellar struts or tip reconstruction may not be necessary if tip support mechanisms are not disrupted. 19 We have found that this is true only in very rare cases.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] While many find this technique quite reliable, pitfalls include clicking of the strut on the nasal spine and poor control of (or excess) columellar show. [6][7][8] Furthermore, this technique requires autologous cartilage harvest, usually from the septum, although rib or ear may be used. While many of these challenges can be overcome with proper technique and are surgeon-and technique-dependent, we find the primary drawback of columellar strut grafting is its reliability to precisely set tip projection and rotation.…”

mentioning

confidence: 99%

Tongue-in-Groove Technique for Rhinoplasty: Technical Refinements and Considerations

Spataro

Most

2018

Facial plast Surg

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A key concept in successful rhinoplasty surgery is maintaining or increasing tip support, and addressing tip projection and rotation. The tongue-in-groove (TIG) technique is a method to achieve this goal using sutures to create a strong connection between the septum and medial crura to change tip rotation and projection. Criticisms of this method include that it may cause stiffness of the nasal tip and columellar retraction. TIG is routinely used by the authors during anterior septal reconstructions (a modified extracorporeal septoplasty technique), as well as in primary and revision aesthetic and functional rhinoplasties. Through this review, technical aspects of the TIG technique are discussed, as well as how pitfalls of the technique can be avoided, as illustrated by several rhinoplasty patient examples.

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The Effect of the Columellar Strut Graft on Nasal Tip Position in Primary Rhinoplasty

Abstract: Use of the columellar strut cartilage graft does not necessarily imply an increase in tip projection, but rather serves as a means of unifying the nasal tip and helping to control final tip position.

Cited by 98 publications

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

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

Caudal extension graft versus columellar strut with plumping graft for acute nasolabial angle correction in rhinoplasty surgery

Tongue-in-Groove Technique for Rhinoplasty: Technical Refinements and Considerations

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