Journal of Rhinology 2013;20(2):102-108.
Published online November 30, 2013.
Availability of Extended Columellar Strut Integrated with Dorsal Graft in The Patients with Loosing Nasal Septal Support
Seo Young Kwak, Ki Sang Rha, Yong Min Kim
Department of Otorhinolaryngology Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea. entkym@cnu.ac.kr
비중격 지지가 소실된 코에서 연장비주지주와 결합된 비배이식을 이용한 외비성형술의 유용성
곽서영, 나기상, 김용민
충남대학교 의학전문대학원 이비인후과학교실
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.
Key Words: Rhinoplasty;Nasal Septum;Reconstruction;Nasal Obstruction


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