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Open rhinoplasty using a columellar strut: effects of the graft on nasal tip projection and rotation

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

Despite the discordance in the literature concerning the effect of columellar strut grafts on nasal tip rotation, this method is often used when an increase in nasolabial angle or nasal tip projection is desired.

Objectives

We aimed to elucidate the change in nasolabial angles and nasal tip projections after exclusive columellar strut graft implantations and in addition to other surgical steps. Furthermore, differences in these parameters between patients with conchal and septal columellar strut grafts were investigated.

Methods

A monocentric retrospective cohort study of 173 open septorhinoplasties with columellar strut graft technique, between 2006 and 2016, was conducted. The pre- and postoperative nasal tip projection, nasolabial and nasofrontal angle and interalar distance were determined and the Goode-ratio was calculated.

Results

In cases where uprotation was not specifically desired, neither nasolabial angles nor tip projections changed significantly, irrespective of whether a columellar strut graft was used alone or with additional surgical steps. If an uprotation through surgery was desired, a significant mean increase in nasolabial angle of 4.4° was achieved. Furthermore, conchal instead of septal columellar strut grafts showed significantly better results.

Conclusion

In our study, a columellar strut graft—without any additional surgical step—does only have an improving impact on nasal tip rotations and projections, if specifically intended to by the surgeon. In other words, if the strut graft was not chosen for an uprotational intention, it did not relevantly impact on the nasolabial angle or nasal tip projection. However, in patients where an uprotation is desired, the columellar strut graft still represents a meaningful tool. Since conchal instead of septal columellar strut grafts showed better results, we suggest using them for these patients.

Level of evidence

2b.

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Abbreviations

CSG:

Columellar strut graft

NLA:

Nasolabial angle

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Funding

No funding was received for this article.

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Author notes

  1. S. Bucher and S. Kunz contributed equally.

Authors and Affiliations

  1. University of Zurich, Zurich, Switzerland

    S. Bucher, S. Kunz, M. Deggeller, D. Holzmann & M. B. Soyka

  2. Department for Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zürich, Switzerland

    S. Bucher, S. Kunz, M. Deggeller, D. Holzmann & M. B. Soyka

Authors
  1. S. Bucher
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  2. S. Kunz
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  3. M. Deggeller
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  4. D. Holzmann
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  5. M. B. Soyka
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Contributions

SB has done the statistical testing, performed result analyses and has written the manuscript; SK has planned the study, collected data and performed result analyses, MD drafted the manuscript, DH has planned the study and drafted the manuscript, MBS has planned and supervised the study and drafted the manuscript.

Corresponding author

Correspondence to M. B. Soyka.

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Conflict of interest

The authors declare no conflict of interest concerning the contents of this study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution or practice at which the studies were conducted. Cantonal Ethics Committee Zurich, No.: 2016-01228.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Bucher, S., Kunz, S., Deggeller, M. et al. Open rhinoplasty using a columellar strut: effects of the graft on nasal tip projection and rotation. Eur Arch Otorhinolaryngol 277, 1371–1377 (2020). https://doi.org/10.1007/s00405-020-05836-9

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  • DOI: https://doi.org/10.1007/s00405-020-05836-9

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