Journal archive · Rib, ear and septal grafts · Nasal tip · Septum, valve and airway · Outcomes, satisfaction and psychology · 2022
Columellar strut grafts versus septal extension grafts during rhinoplasty for airway function, patient satisfaction and tip support
Lathif A, Alvarado R, Kondo M, Mangussi-Gomes J, Marcells GN, Harvey RJ.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on columellar strut.
From the abstract
“Different techniques exist to provide tip support in rhinoplasty. There is little evidence to provide a consensus on the most effective choice. Objective: Evaluating columellar strut graft (CSG) and septal extension grafts (SEG) for their influence on airway function, patient satisfaction and tip support. Design,…”
Excerpt; the full abstract is on PubMed.
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Rib, ear and septal grafts
Modern rhinoplasty builds rather than removes, so the operation runs on cartilage: the septum first, then the ear, then the rib, and when none of those will do, a piece of donated rib from a tissue bank.
Nasal tip
Tip surgery is now a support problem rather than a sculpting problem: the septal extension graft holds projection and rotation where the columellar strut loses them (0.2% against 4.7% projection loss at one year), and the current series repair, reposition and reinforce the lower lateral cartilages instead of excising them.
Septum, valve and airway
Every rhinoplasty is a breathing operation whether it intends to be or not: the septum holds the nose up as well as dividing it, and the narrowest part of the whole airway is the internal valve the surgeon is standing over.
Outcomes, satisfaction and psychology
Rhinoplasty is measured with ten different questionnaires, none of which covers both the way the nose looks and the way it breathes, and the best-developed one has no airway questions at all.
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