Ayhan Işik Erdal1, İbrahim Giray Genç1, Burak Pasinlioğlu1, Kemal Findikçioğlu1. 1. From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Erzurum Regional Training and Research Hospital; and Department of Plastic, Reconstructive, and Aesthetic Surgery, Faculty of Medicine, Gazi University.
Abstract
BACKGROUND: The medial crura are almost always supported in tip surgery using columellar strut graft placement or tongue-in-groove suturing to the caudal septum. In this study, the authors present a modified tongue-in-groove (called "flexible tongue-in-groove") technique. METHODS: A total of 237 patients who underwent open rhinoplasty between January of 2016 and June of 2018 were included in this retrospective study. The patients were divided into three main groups: (1) flexible tongue-in-groove, (2) classic tongue-in-groove, and (3) columellar strut. Using standardized preoperative and postoperative (1-, 6-, and 12-month) lateral view photographs, the nasolabial angle and Goode ratio were measured for nasal tip rotation and projection, respectively. RESULTS: Flexible tongue-in-groove (n = 53) and classic tongue-in-groove (n = 107) techniques showed a significantly smaller decrease in the nasolabial angle from month 1 to month 12 than did the columellar strut technique (n = 77) (p < 0.05). These statistically significant differences were not found when the time intervals were narrowed (p > 0.05). Flexible and classic tongue-in-groove techniques showed significantly higher Goode ratios than did the columellar strut technique at 1, 6, and 12 months (p < 0.05 for all). In various analyses using the nasolabial angle and Goode ratio, no statistically significant difference was found between flexible and classic tongue-in-groove techniques (p > 0.05). CONCLUSIONS: Flexible and classic tongue-in-groove techniques provide more durable results in nasolabial angle and Goode ratio measurements than does the columellar strut technique in primary open-approach rhinoplasty. The flexible tongue-in-groove technique is as robust as the classic tongue-in-groove technique in appropriate cases. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
BACKGROUND: The medial crura are almost always supported in tip surgery using columellar strut graft placement or tongue-in-groove suturing to the caudal septum. In this study, the authors present a modified tongue-in-groove (called "flexible tongue-in-groove") technique. METHODS: A total of 237 patients who underwent open rhinoplasty between January of 2016 and June of 2018 were included in this retrospective study. The patients were divided into three main groups: (1) flexible tongue-in-groove, (2) classic tongue-in-groove, and (3) columellar strut. Using standardized preoperative and postoperative (1-, 6-, and 12-month) lateral view photographs, the nasolabial angle and Goode ratio were measured for nasal tip rotation and projection, respectively. RESULTS: Flexible tongue-in-groove (n = 53) and classic tongue-in-groove (n = 107) techniques showed a significantly smaller decrease in the nasolabial angle from month 1 to month 12 than did the columellar strut technique (n = 77) (p < 0.05). These statistically significant differences were not found when the time intervals were narrowed (p > 0.05). Flexible and classic tongue-in-groove techniques showed significantly higher Goode ratios than did the columellar strut technique at 1, 6, and 12 months (p < 0.05 for all). In various analyses using the nasolabial angle and Goode ratio, no statistically significant difference was found between flexible and classic tongue-in-groove techniques (p > 0.05). CONCLUSIONS: Flexible and classic tongue-in-groove techniques provide more durable results in nasolabial angle and Goode ratio measurements than does the columellar strut technique in primary open-approach rhinoplasty. The flexible tongue-in-groove technique is as robust as the classic tongue-in-groove technique in appropriate cases. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.