120 Years of Dorsal Preservation in Rhinoplasty

Ng, Chew Lip; D’Souza, Alwyn

doi:10.1055/s-0041-1723826

Cited by 6 publications

(4 citation statements)

References 39 publications

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“…Rhinoplasty, such as preservation rhinoplasty (PR), demands the precise stripping of nasal cartilage from soft tissues. Protection of nasal cartilage needs attention for the maintenance of the keystone area and dorsal aesthetic lines [34]. Pre-surgical imaging is helpful in delineating anatomical information (e.g., position of nasal cartilage and surrounding soft tissues).…”

Section: Discussionmentioning

confidence: 99%

Usefulness of T2-Weighted Images with Deep-Learning-Based Reconstruction in Nasal Cartilage

Gao,

Liu,

et al. 2023

Diagnostics

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Objective: This study aims to evaluate the feasibility of visualizing nasal cartilage using deep-learning-based reconstruction (DLR) fast spin-echo (FSE) imaging in comparison to three-dimensional fast spoiled gradient-echo (3D FSPGR) images. Materials and Methods: This retrospective study included 190 set images of 38 participants, including axial T1- and T2-weighted FSE images using DLR (T1WIDL and T2WIDL, belong to FSEDL) and without using DLR (T1WIO and T2WIO, belong to FSEO) and 3D FSPGR images. Subjective evaluation (overall image quality, noise, contrast, artifacts, and identification of anatomical structures) was independently conducted by two radiologists. Objective evaluation including signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was conducted using manual region-of-interest (ROI)-based analysis. Coefficient of variation (CV) and Bland–Altman plots were used to demonstrate the intra-rater repeatability of measurements for cartilage thickness on five different images. Results: Both qualitative and quantitative results confirmed superior FSEDL to 3D FSPGR images (both p < 0.05), improving the diagnosis confidence of the observers. Lower lateral cartilage (LLC), upper lateral cartilage (ULC), and septal cartilage (SP) were relatively well delineated on the T2WIDL, while 3D FSPGR showed poorly on the septal cartilage. For the repeatability of cartilage thickness measurements, T2WIDL showed the highest intra-observer (%CV = 8.7% for SP, 9.5% for ULC, and 9.7% for LLC) agreements. In addition, the acquisition time for T1WIDL and T2WIDL was respectively reduced by 14.2% to 29% compared to 3D FSPGR (both p < 0.05). Conclusions: Two-dimensional equivalent-thin-slice T1- and T2-weighted images using DLR showed better image quality and shorter scan time than 3D FSPGR and conventional construction images in nasal cartilages. The anatomical details were preserved without losing clinical performance on diagnosis and prognosis, especially for pre-rhinoplasty planning.

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Section: Discussionmentioning

confidence: 99%

Usefulness of T2-Weighted Images with Deep-Learning-Based Reconstruction in Nasal Cartilage

Gao,

Liu,

et al. 2023

Diagnostics

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“…3 PR has undergone significant improvements in recent years as doctors develop new approaches. 4 The pushdown technique with high strip was first described by Goodale in 1899. 5 In 1914, Lothrop described the letdown technique with high strip.…”

Section: Dorsal Preservation Techniques Have Been Developedmentioning

confidence: 99%

Effect of Dorsal Preservation Techniques on Septum Strength: An Experimental Animal Study

Erol,

Berber,

Soto-Galindo

et al. 2024

Facial Plast Surg

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This experimental animal model study investigates the impact of different methods employed in Preservation Rhinoplasty (PR) on the strength of the nasal roof, focusing on three techniques: high strip, low strip, and intermediate strip. Using 15 lamb heads as surgical models, the study addresses key questions related to the strengths of each PR techniques, the influence of septal cartilage harvesting on septum strength, and the effectiveness of spreader grafts for stability. The research involves detailed dissection steps and measurements at various nasal points, evaluating the resistance at each stage. Results indicate that the low strip technique demonstrates the most significant reduction in strength. Furthermore, the combination of PR techniques with structural grafts, specifically spreader grafts, is assessed, revealing the classical rectangular spreader graft to be more effective in stabilizing the dorsum. Despite the limitation of using the lamb heads as models, this study offers valuable insights into the effects of PR on nasal septum strength and provides a foundation for further research on the biomechanics of preservation techniques.

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“…Although his article was published at a later date, Cottle was also one of the most important pioneers of the dorsal preservation technique 3 . Despite this long history, however, it was only in recent years that Saban et al popularized the dorsal preservation technique 4,5 . The idea of an intact dorsum attracted even surgeons who were highly experienced in structural rhinoplasty.…”

Section: Introductionmentioning

confidence: 99%

“…3 Despite this long history, however, it was only in recent years that Saban et al popularized the dorsal preservation technique. 4,5 The idea of an intact dorsum attracted even surgeons who were highly experienced in structural rhinoplasty. In a short time, preservation techniques began to be used frequently, and many new definitions and technical modifications were described.…”

mentioning

confidence: 99%

Fixation of the Cartilaginous Vault with Barbed Suture in Closed-Approach High-Septal-Resection Dorsal Preservation Rhinoplasty

Erdal

Genç

Manav³

et al. 2022

Facial Plast Surg

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Background: Fixation of the cartilaginous vault is an important maneuver in preservation rhinoplasty to reduce hump recurrences. This paper presents a cartilaginous vault fixation technique with a barbed suture. Methods: Forty-six patients who underwent closed-approach high-septal-resection dorsal preservation rhinoplasty between August 2019 and March 2020 were included in this retrospective study. According to the cartilaginous vault fixation sutures applied, the patients were divided into two main groups as follows: (i) barbed suture and (ii) conventional suture. Standardized postoperative 1-month lateral view photographs were scanned for the presence of any degree of hump recurrence. The Rhinoplasty Outcome Evaluation (ROE) scale was applied at 12 months. Results: Hump recurrence was detected in one patient in the barbed suture group (n = 21) and one patient in the conventional suture group (n = 25; p > 0.05). For the ROE scores and number of satisfied patients, no statistically significant difference was found between the barbed and conventional suture fixation techniques (p > 0.05). Conclusions: Fixation with barbed suture showed similar results to conventional suture fixation. Barbed sutures can be used for cartilaginous vault fixation, taking advantage of the ease of placement in closed rhinoplasty.

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120 Years of Dorsal Preservation in Rhinoplasty

Cited by 6 publications

References 39 publications

Usefulness of T2-Weighted Images with Deep-Learning-Based Reconstruction in Nasal Cartilage

Usefulness of T2-Weighted Images with Deep-Learning-Based Reconstruction in Nasal Cartilage

Effect of Dorsal Preservation Techniques on Septum Strength: An Experimental Animal Study

Fixation of the Cartilaginous Vault with Barbed Suture in Closed-Approach High-Septal-Resection Dorsal Preservation Rhinoplasty

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