Indications, Stability, and Surgical Outcomes of Using Osteochondral Nasal Septal Graft as a Septal Extension Graft in Rhinoplasty Patients: A Prospective Cohort Study.

Septal extension graft (SEG) is an adaptable tool that controls, supports, and stabilizes the nasal tip projection, rotation, length, and shape. Recent studies comparing SEGs to more conventional columellar strut grafts found that SEGs provided improved results. This prospective cohort study included 66 patients divided into 2 groups based on their indications. Group 1 was patients who underwent septorhinoplasty using osteochondral septal extension graft (OSEG), and group 2 underwent septorhinoplasty using cartilaginous SEG. The main reason for undergoing OSEG was insufficient septal cartilage (P<0.001). The outcomes were not significantly different between both groups, with the % of patients who experienced positive outcomes ranging from 78.8% to 97%. The OSEG is a safe, valid, and effective option in septorhinoplasty that can be used in patients with insufficient cartilaginous septum.

A Novel Technique for Spreader Flap by Folding the Dorsal Hump in Patients Undergoing Primary Rhinoplasty.

OBJECTIVES: We describe our novel modified spreader flap, which involves keeping the large cartilaginous septal T hump attached to the upper lateral cartilages to increase the thickness and length of the flap. Our objectives were to assess hump reduction and recurrence, nasal axis deviation, dorsal width, internal nasal valve grade, and Rhinoplasty Outcome Evaluation (ROE) score preoperatively and one year postoperatively. MATERIALS AND METHODS: In a prospective study that included 21 patients who met the criteria, patients were followed up for 1 year after surgery, with an assessment of the dorsal projection, tip projection, axis deviation, dorsal width, and internal nasal valve grade. In addition, the modified Cottle maneuver and Rhinoplasty Outcome Evaluation score were also performed and obtained, respectively. RESULTS: Our novel technique was performed in 20 patients (95.2%). In 1 additional patient, we added a regular auto-spreader flap on the contralateral side. One year postoperatively, the axis was found in the midline in all patients (100%). Assessment of internal valve collapse showed that collapse was reduced to grade 0 in 13 patients (61.9%) and grade 1 in 8 patients (38.1%). There were no hump recurrences or visible irregularities. The results showed a statistically significant difference between the pre- and postoperative values in dorsal projection, dorsal width, and rhinoplasty outcome evaluation score. CONCLUSIONS: This novel technique shows promising statistically significant results in reducing dorsal hump projection and width, correcting axis deviation, and improving internal nasal valve and rhinoplasty outcome evaluation score, while being less cartilage and time-consuming.