Facial Plast Surg 2024; 40(05): 670-678
DOI: 10.1055/a-2263-2101
Original Research

Effect of Dorsal Preservation Techniques on Septum Strength: An Experimental Animal Study

1   European Board Certified in ENT (FEBORL), Private Practice, Istanbul, Türkiye
,
2   Department of Otorhinolaryngology, Faculty of Medicine, Ege University, Izmir, Türkiye
,
3   International Fellow of the European Academy of Facial Plastic Surgery, Ege University, Izmir, Türkiye
,
Fazil Apaydin
4   Department of Otorhinolaryngology, Head of the Division of Facial Plastic and Reconstructive Surgery, Ege University, Izmir, Türkiye
› Author Affiliations

Abstract

This experimental animal model study investigates the impact of different methods employed in preservation rhinoplasty (PR) on the strength of the nasal roof, focusing on three techniques: high strip, low strip, and intermediate strip. Using 15 lamb heads as surgical models, the study addresses key questions related to the strengths of each PR techniques, the influence of septal cartilage harvesting on septum strength, and the effectiveness of spreader grafts for stability. The research involves detailed dissection steps and measurements at various nasal points, evaluating the resistance at each stage. Results indicate that the low strip technique demonstrates the most significant reduction in strength. Furthermore, the combination of PR techniques with structural grafts, specifically spreader grafts, is assessed, revealing the classical rectangular spreader graft to be more effective in stabilizing the dorsum. Despite the limitation of using the lamb heads as models, this study offers valuable insights into the effects of PR on nasal septum strength and provides a foundation for further research on the biomechanics of preservation techniques.



Publication History

Accepted Manuscript online:
07 February 2024

Article published online:
08 March 2024

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  • References

  • 1 Daniel RK. The preservation rhinoplasty: a new rhinoplasty revolution. Aesthet Surg J 2018; 38 (02) 228-229
  • 2 Saban Y, de Salvador S. Guidelines for dorsum preservation in primary rhinoplasty. Facial Plast Surg 2021; 37 (01) 53-64
  • 3 Goksel A, Saban Y, Tran KN. Biomechanical nasal anatomy applied to open preservation rhinoplasty. Facial Plast Surg 2021; 37 (01) 12-21
  • 4 Ng CL, D'Souza AR. 120 years of dorsal preservation in rhinoplasty. Facial Plast Surg 2021; 37 (01) 76-80
  • 5 Goodale JL. A new method for the operative correction of the exaggerated Roman nose. Boston Med Surg J 1899; 140: 112
  • 6 Lothrop OA. An operation for correcting the aquiline nasal deformity; the use of new instrument: report of a case. Boston Med Surg J 1914; 170: 835-837
  • 7 Cottle MH. Nasal roof repair and hump removal. AMA Arch Otolaryngol 1954; 60 (04) 408-414
  • 8 Huizing EH. Push-down of the external nasal pyramid by resection of wedges. Rhinology 1975; 13 (04) 185-190
  • 9 Saban Y, Daniel RK, Polselli R, Trapasso M, Palhazi P. Dorsal preservation: the push down technique reassessed. Aesthet Surg J 2018; 38 (02) 117-131
  • 10 Neves JC, Arancibia-Tagle D, Dewes W, Ferraz M. The segmental preservation rhinoplasty: the split tetris concept. Facial Plast Surg 2021; 37 (01) 36-44
  • 11 Mau T, Mau ST, Kim DW. Cadaveric and engineering analysis of the septal L-strut. Laryngoscope 2007; 117 (11) 1902-1906
  • 12 Menapace DC, Carlson KD, Dragomir-Daescu D, Matsumoto J, Hamilton GS. Finite element analysis of the septal cartilage L-strut. Facial Plast Surg Aesthet Med 2021; 23 (02) 90-97
  • 13 Lee SJ, Liong K, Tse KM, Lee HP. Biomechanics of the deformity of septal L-struts. Laryngoscope 2010; 120 (08) 1508-1515
  • 14 Erol O, Soto-Galindo GA, Apaydin F. Biomechanics of septal L-strut on lamb head models. Facial Plast Surg 2022; 38 (05) 518-524
  • 15 Neves JC. Preservation rhinoplasty: an update. Facial Plast Surg 2021; 37 (01) 1
  • 16 Joseph J. The classic reprint: nasal reductions. Plast Reconstr Surg 1971; 47 (01) 79-83
  • 17 Neves JC, Arancibia-Tagle D. Avoiding aesthetic drawbacks and stigmata in dorsal line preservation rhinoplasty. Facial Plast Surg 2021; 37 (01) 65-75
  • 18 Ishida LC, Ishida J, Ishida LH, Tartare A, Fernandes RK, Gemperli R. Nasal hump treatment with cartilaginous push-down and preservation of the bony cap. Aesthet Surg J 2020; 40 (11) 1168-1178
  • 19 Apaydin F, Saghir M, Garcia RFFP, Daoud M, Jaber A. Lamb head as a training model for septoplasty and rhinoplasty. Facial Plast Surg 2022; 38 (05) 525-529
  • 20 Apaydin F. Nasal septal reconstruction. Facial Plast Surg 2013; 29 (06) 447-448
  • 21 Dini PDGM, Gonella PDHA, Fregadolli L, Nunes B, Gozzano R. Training rhinoseptoplasty, sinusectomy, and turbinectomy in an animal model. Plast Reconstr Surg 2012; 130 (01) 224e-226e
  • 22 Mladina R, Vuković K, Štern Padovan R, Skitarelić N. An animal model for endoscopic endonasal surgery and dacryocystorhinostomy training: uses and limitations of the lamb's head. J Laryngol Otol 2011; 125 (07) 696-700
  • 23 Kurt Yazar S, Serin M, Rakici IT, Sirvan SS, Irmak F, Yazar M. Comparison of piezosurgery, percutaneous osteotomy, and endonasal continuous osteotomy techniques with a caprine skull model. J Plast Reconstr Aesthet Surg 2019; 72 (01) 107-113
  • 24 Erol O, Buyuklu F, Koycu A, Bas C, Erbek SS. Evaluation of nasal tip support in septorhinoplasty. Aesthetic Plast Surg 2019; 43 (04) 1021-1027
  • 25 Köycü A, Hızal E, Erol O, Büyüklü AF. Effect of suture type and suture distance on holding strength in nasal septal laceration model. Turk Arch Otorhinolaryngol 2021; 59 (01) 1-7