Management of Reconstruction of the Columella in Open Rhinoplasty Procedure: Using b-Shaped Columellar Strut Graft

Abstract

Objective:The columellar strut graft (CSG) can help to correct nasal tip (NT) deformities in rhinoplasty. The value of using the CSG technique as a routine procedure in rhinoplasty is still being debated. The reason for this ambivalence is the increased rotation effect of a CSG on the NT. In this article, “b” (small letter “B”) shaped CSG was prepared differently from the traditional CSG, and two different designs of CSGs were compared in terms of nasolabial angles.Method:A total of 99 patients who were operated on using CSG between September 2018 and March 2020 were included in this study. We analyzed preoperative and postoperative lateral views of photographs and case histories of 99 patients. Traditional shape and b-shaped CSGs were used for 33 (33.3%) and 66 (66.6%) of the total patients, respectively. The groups of traditional shaped and b-shaped CSGs were compared with statistical analysis.Results:When postoperative nasolabial angles were evaluated, it was found that 36.4% and 7.6% of the nasolabial angles were above the optimal range in the traditional strut graft group and b-shaped CSG group, respectively. Wide-nasolabialangles were observed to be more common in cases with traditional strut grafts than in cases with b-Shaped CSG. The b-shaped CSG provided gain optimal projection without extended rotation. The difference between the two groups was statistically significant (p=0.00).Conclusion:The overall conclusion derived from this research is that an optimally shaped columella can be obtained using a b-shaped CSG without overrotation of the NT.

Keywords

• columella reconstruction
• columellar strut graft
• open rhinoplasty