Costal Cartilage Lateral Crural Strut Graft for Correction of External Nasal Valve Dysfunction in Primary and Revision Rhinoplasty

Abstract

Objective: To evaluate and compare the costal cartilage lateral crural strut graft’s (LCSG) ability to support a weak lateral crus in patients with external nasal valve dysfunction (EVD) undergoing primary versus revision functional rhinoplasty. Methods: This is a prospective cohort study of 26 patients (mean [SD]: 40.23 [6.75] years of age; 10 [38%] females) with clinically diagnosed EVD, who underwent primary versus revision functional rhinoplasty with the use of a costal cartilage LCSG (10 [38%] primary functional rhinoplasty patients and the 16 [62%] revision patients). Preoperative and 12-month postoperative subjective and objective functional measurements along with statistical analysis were performed. Results: While all baseline demographic and preoperative functional measurement scores were similar between the 2 groups, the primary cohort’s preoperative scores were higher overall. Follow-up was a mean of 14.58 months. The primary group demonstrated a greater difference in score improvement postoperatively in all categories. All patients had significantly improved visual analog scale (VAS), Nasal Obstruction Symptom Evaluation Scale, 22-Item Sinonasal Outcome Test, and nasal peak inspiratory flow (NPIF) scores. When comparing the overall score outcome and surgical efficacy of the LCSG, both groups had near equal final score outcomes with the exception of VASL and NPIF. Conclusion: The LCSG is a viable and versatile option in the management of EVD for both primary and revision rhinoplasty patients.

A Unique Case of Modifying an Old Extended Spreader Costal Graft into a Supportive Structure in a Nasal Alar Reconstructive Surgery – A Case Report

“…In our case, we adhered to the recommended postoperative management, which later showed improvements in graft survivability and no infection 13-16 . Thirdly, costal cartilage has good stability for maintaining lateral crus structures and might also improve external nasal valve dysfunction (EVD) by increasing the cross-sectional area, which is great for aesthetic improvement 17 .…”

Surgical Treatment of Dynamic Nasal Collapse

“…9 24 37 The LCSG technique has been shown to improve nasal peak inspiratory flow, Sinonasal Outcomes Test 22 (SNOT-22) scores, NOSE scores, and patient-reported cosmesis scores. 38 39 Similarly, the miniature LCSG technique has demonstrated improvement in SCHNOS scores and tip cosmesis. 40…”

“…9,24,37 The LCSG technique has been shown to improve nasal peak inspiratory flow, Sinonasal Outcomes Test 22 (SNOT-22) scores, NOSE scores, and patient-reported cosmesis scores. 38,39 Similarly, the miniature LCSG technique has demonstrated improvement in SCHNOS scores and tip cosmesis. 40 Following hydrodissection with local anesthetic, the vestibular skin is undermined from the lateral crus and dissected from the cephalic border of the lateral crus towards the caudal border.…”

“…30 Blinded aesthetic analysis has also determined the AARG creates structural support along the alar rim Facial Plastic Surgery Vol. 38 No. 4/2022 © 2022.…”