Availability of Extended Columellar Strut Integrated with Dorsal Graft in The Patients with Loosing Nasal Septal Support

Kwak, Seo Young; Rha, Ki Sang; Kim, Yong Min

Abstract

BACKGROUND AND OBJECTIVES
Aesthetic and functional reconstruction of nose whose nasal septal support is deteriorated is challenging problem. The goal with this study was to evaluate our experience with 3 patients who underwent rhinoplasty with extended columellar strut integrated with dorsal graft.
METHODS
Open rhinoplasty approach using the transcolumellar and marginal incision was used. After elevation of skin envelop, bilateral subperichondrial tunnels are made along the dorsal aspect of the septum and deformed septal cartilage and perpendicular plate were removed. Costal cartilage was harvested and carved into two pieces which were boat-shaped dorsal graft and 'upper and lower left quadrants'-shaped columellar strut. Cephalic end of dorsal graft was placed in subperiosteal pocket of nasal bone and ventral end of columellar strut graft was fixed on nasal spine with non-absorbable suture. Finally, two grafts were integrated in the shape of tongue-in-groove at the nasal tip area. Onlay tip graft was placed over the alar dome if necessary. The results and complications were evaluated postoperatively.
RESULTS
All patients were satisfied with functional and aesthetic results. There was no severe complication or requirement of revision surgery with this technique.
Conclusion
The extended columellar strut integrated with dorsal graft is a reliable method to provide stable nasal tip projection and functional concern. The successful use of the graft requires precise diagnosis and surgical technique.