Septal Cartilage/Ethmoid Bone Composite Graft: A New and Improved Method for the Correction Underdeveloped Nasal Septum in Patients with Short Noses

Lee, Soo Hyang; Koo, Mun Geun; Kang, Eun Taek

doi:10.1007/s00266-016-0741-7

Cited by 24 publications

(24 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, most of the significant correlations were associated with these particular aspects. FACE-Q nose and nostrils scales showed significant correlations to the 3D alar width, columella angle, and columellar-labial angle parameters for both patient cohorts, which clinically represent wider nasal base, short nose, and tip up-rotation with the nostrils shown on frontal view 15,29,[36][37][38] . However, it only presented low correlation coefficients, suggesting that the tested measure tools are only marginally connected and other potential explanatory factors were involved in this outcome measurement process.…”

Section: Discussionmentioning

confidence: 88%

“…Unlike anatomical norms for Caucasian noses, Asians exhibit a flatter dorsum, a wider alar width, and a short nose in which there is much upward tilt of the nasal tip along with an increased nostril exposure 15,29,34,35 . Accordingly, Asians frequently request surgery to correct their typical, but not fully acceptable nose [36][37][38] . Moreover, surgical maneuvers have been performed to attenuate these specific nasal changes following skeletofacial reconstruction, including the overcorrected alar cinch suture 41 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Patient- and 3D morphometry-based nose outcomes after skeletofacial reconstruction

Denadai

Chou

Seo

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Patient satisfaction with the shape and appearance of their nose after orthognathic surgery-based skeletofacial reconstruction is an important, but often overlooked, outcome. We assessed the nose-related outcomes through a recently developed patient-reported outcome instrument and a widely adopted 3D computer-based objective outcome instrument, to verify any correlation in the results produced by these tools. We collected FACE-Q nose appearance reports (2 scales) and 3D nasal morphometry (10 parameters) from patients with class III skeletal pattern and congenital cleft lip palate deformity (n = 23) or developmental dentofacial deformity (n = 23) after (>12 months) skeletofacial reconstruction. The cleft and dentofacial cohorts demonstrated significantly (p < 0.001) poorer satisfaction scores with regard to the FACE-Q nostrils scale than the normal age-, gender-, and ethnicity-matched subjects (n = 107), without any significant difference in FACE-Q nose scale. The cleft cohort had significantly (p < 0.001) smaller nasal length, nasal tip projection, and columellar angle and greater nasal protrusion, alar width, and columellar-labial angle values than the dentofacial and normal cohorts; however, there were no significant differences between the dentofacial versus normal cohorts. The FACE-Q nose and nostrils scales were significantly (p < 0.001; r = −0.26-0.27) correlated to the results of the 3D morphometric analysis, with regard to nasal length, alar width, columella angle, and columellar-labial angle parameters. This study revealed differences in satisfaction with the appearance of the nose according to the type of underlying deformity, and demonstrated a significant correlation (low correlation coefficients) between the patient-reports and 3D image-based outcome measure tools, which has implications for multidisciplinary-centered research, auditing, and clinical care. Facial deformities associated with abnormal maxillo-mandibular relationships, such as congenital cleft lip and palate and developmental dentofacial deformities, significantly affect oral function and facial aesthetics 1,2. Skeletofacial reconstruction using orthognathic surgery principle is a successful treatment modality for these abnormalities 3-5. However, a number of post-surgical facial modifications are the primary causes of concern among the patients, particularly changes in the nasal morphology 6. A growing number of studies have addressed this issue by adopting three-dimensional (3D) nasal measurements 6-15 , but the effects of skeletofacial reconstruction are beyond these imaging-guided outcome metrics 1,4,5. The patient satisfaction with the appearance of their nose is an important, albeit often overlooked, outcome parameter after orthognathic surgery. Therefore, including a patient's self-perception by employing patient-reported outcome (PRO) techniques may help clinicians to understand the health-related concerns of the patient 16,17. Literature reviews 4,5 have revealed that a plethora of PRO instruments have been utilized to primaril...

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Patient- and 3D morphometry-based nose outcomes after skeletofacial reconstruction

Denadai

Chou

Seo

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Previous techniques harvested septal cartilage and bone together to increase the amount of material, while we harvest them separately and reinforce them using doubled cartilage. 14 The gap between the nasal septal angle and the sandwich SEG is supported by the lower lateral cartilage by fixing the lower lateral cartilage to the hole of sandwich SEG, so that the gap between them becomes fibrous and maintains firmness over time.…”

Section: Discussionmentioning

confidence: 99%

“…The septal cartilage, vomer, and perpendicular plate of the ethmoid bone were carefully harvested by septoplasty technique. For strong SEG, we made a cartilage-bone complex and to distinguish it from other SEG techniques 14 using linked septal cartilage and bone, we call this technique the ''sandwich technique'' because the bone is inserted between 2 layers of cartilage (Figure 1). At first, we made a cartilage-bone complex that was sutured by 5-0 Nylon using the vomer and perpendicular plate of the ethmoid bone between 2 layers of cartilage ( Figure 2).…”

Section: Surgical Technique and Managementmentioning

confidence: 99%

New Technique in Nasal Tip Plasty: Sandwich Technique Using Cartilage and Septal Bone Complex

et al. 2019

View full text Add to dashboard Cite

Objectives: It is extremely difficult to obtain ideal tip projection and nose lengthening by septal extension graft using only septal cartilage in Asians, because their nasal septal and alar cartilages are small and weak. Therefore, we introduce a new septal extension graft using a cartilage–bone complex with the vomer and the perpendicular plate of the ethmoid bone as well as cartilage to obtain optimal outcomes. Methods: Participants included 30 patients who underwent surgery by external approach. The septal cartilage, vomer, and perpendicular plate of the ethmoid bone harvested by septoplasty were used. There were 2 layers of cartilage on each side and bone in between to create a strong cartilage–bone complex for projection and lengthening. The bony portion was placed in the tip side, and the double-layered cartilage portion was placed in the inferior portion of the caudal septum of the L-strut to create powerful fixation. Results: There were statistically significant improvements in nasal length (4.71 ± 0.65 vs 5.15 ± 0.53 cm, P value <.0001), tip projection (2.66 ± 0.40 vs 3.18 ± 0.42, P value <.0001), and nasolabial angle (94.0° ± 9.3° vs 107.2° ± 9.6°, P value <.0001) postoperatively. All patients were subjectively satisfied, and 2 different surgeons had excellent or good opinions in 28 (94%) patients. Conclusions: The sandwich technique using cartilage and bone complex results in satisfactory outcomes with stronger tip support, especially in Asians with a weak nasal tip who desire ideal tip projection and dramatic change.

show abstract

“…In recent years, the nasal septal cartilage has been widely used in caudal septal advancement and tip projection in East Asian [1,2]. However, a relatively smaller quantity of and less firm nasal cartilage was observed in East Asians compared with Caucasians and very few articles have been found dealing with the length, height, area, and thickness of the septal cartilage of the Chinese.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Study of Nasal Septal Cartilage in Eastern Chinese

Hu¹,

Xu²,

Zhang³

et al. 2019

View full text Add to dashboard Cite

Background: Asians tend to have foreshortened noses with more increased nostril show. In recent years, the nasal septal cartilage has been widely used in caudal septal advancement and nasal tip projection in East Asian. However, a relatively small quantity of less firm nasal cartilage was observed in East Asians compared with Caucasians and very few articles have been found dealing with septal cartilage anatomy of Chinese. Objective: The length, height, area, and thickness of nasal septal cartilage in 10 eastern Chinese were studied to provide anatomic data for the septorhinoplasty or harvesting of cartilage graft. Methods: The septal cartilages in 10 adult cadavers were anatomized and measured for their length, height, area, and thickness. Results: The average length and height of septal cartilage were respectively 2.83±0.47 cm and 2.41±0.39 cm. The average area was 4.94±1.26 cm^2. The average thickness is 0.97±0.15 mm, with the greatest thickness in region b 1.14±0.26 mm, the least thickness in region e (0.83±0.22) mm and region a (0.81±0.27) mm. Conclusion: The findings of this study reinforce the principle of key differences existing in the anatomic data of the septal cartilage between Asians and Caucasians.

show abstract

Septal Cartilage/Ethmoid Bone Composite Graft: A New and Improved Method for the Correction Underdeveloped Nasal Septum in Patients with Short Noses

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 24 publications

References 17 publications

Patient- and 3D morphometry-based nose outcomes after skeletofacial reconstruction

Patient- and 3D morphometry-based nose outcomes after skeletofacial reconstruction

New Technique in Nasal Tip Plasty: Sandwich Technique Using Cartilage and Septal Bone Complex

Anatomical Study of Nasal Septal Cartilage in Eastern Chinese

Contact Info

Product

Resources

About