Background and Objective

Nasal tip projection and position in relation to dorsum and superior lip frequently suffers variations during rhinoplasty post operatory time. Depending on the technique and on individual factors those changes can be more or less severe.

The aim of the present study is to demonstrate that autologous caudal septal extensión graft predicts with more precision definitive nasal tip position and projection.

Methods

We prospectively studied 40 open rhinoplasty patients using a caudal septal extension autologus graft and we measured pre and post operatory lateral view photographs during 1 year follow-up.

Results

Nasal proportions measured using Goode Index (normal value: 0.55-0.6) get from 0.54 to 0.56 measured at 1 month (p=0.005) and in nasal disproportion patients we observed an increment from 0.51 to 0.54 (p=0.001) and after it stabilized at 0.53 (p=0.021). Tip projection increased 4.8% (1.2 mm), and in the group with nasal disproportion it increased 5.75% (1.4 mm) and maintained those values along 1 year (p=0.039). In patients with a <100° angle it increased from 95.6 to 105.6° at 1 month measurements and it maintained its stability along 1 year with measurements approximating 104.4° (statistically significant). Patients with normal naso-labial angle (100°-115°) maintained normal parameters at 1 month (111.4°) and 1 year (112.6°). In patients with an angle greater than 115° the naso-labial angle diminished from 120.1° to 112.3° at 1 month and 111.1° at 1 year (p=0.008). There was an improvement of obstructive symptoms in 37.6% of patients evaluated through NOSE scale (p=0.001). Patients satisfaction with esthetic results evaluated through ROE scale revealed an improvement of self-perception in a 63.5% (p=0.001).

Conclusions

The caudal septal extension graft significantly increased tip projection and corrected naso-labial angle. All studied parameters maintained its stability along 1 year follow-up.

In our opinion, the use of caudal septal extension autologus graft as a part of structural rhinoplasty increases significantly the nasal function and brings a high level of satisfaction with esthetic results in rhinoplasty patients.

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